[Efficacy analysis of 7 cases of mixed neuroendocrine-nonneuroendocrine neoplasm of the duodenal papilla]

The clinical data of 7 patients diagnosed with mixed neuroendocrine-nonneuroendocrine neoplasm were analyzed in the Department of Hepatobiliary Surgery of Hunan Provincial People's Hospital from January 2016 to December 2022. Among the 7 patients, 5 were male and 2 were female, with an average age of 59.3 years. Its clinical characteristics are similar to malignant ampulla tumors, and it is difficult to differentiate them. The preoperative puncture biopsy positivity rate is low, making it difficult to diagnose preoperatively, and the prognosis is worse.Comprehensive treatment including surgery, chemotherapy, and radiotherapy can be the preferred treatment option for this disease.

Epidemiology of healthcare-associated Pseudomonas aeruginosa in intensive care units: are sink drains to blame?

BACKGROUND

Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infection (PA-HAI) in the intensive care unit (ICU).

AIM

To describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and to identify episodes of sink-to-patient PA transmission.

METHODS

This was a prospective cohort study of patients in six ICUs from 2018 to 2019, with retrieval of PA clinical isolates, and PA-screening of antimicrobial-resistant organism surveillance rectal swabs, and of sink drain, air, and faucet samples. All PA isolates underwent whole-genome sequencing. PA-HAI was defined using US National Healthcare Safety Network criteria. ICU-acquired PA was defined as PA isolated from specimens obtained ≥48 h after ICU admission in those with prior negative rectal swabs. Sink-to-patient PA transmission was defined as ICU-acquired PA with close genomic relationship to isolate(s) previously recovered from sinks in a room/bedspace occupied 3-14 days prior to collection date of the relevant patient specimen.

FINDINGS

Over ten months, 72 PA-HAIs occurred among 60/4263 admissions. The rate of PA-HAI was 2.40 per 1000 patient-ICU-days; higher in patients who were PA-colonized on admission. PA-HAI was associated with longer stay (median: 26 vs 3 days uninfected; P < 0.001) and contributed to death in 22/60 cases (36.7%). Fifty-eight admissions with ICU-acquired PA were identified, contributing 35/72 (48.6%) PA-HAIs. Four patients with five PA-HAIs (6.9%) had closely related isolates previously recovered from their room/bedspace sinks.

CONCLUSION

Nearly half of PA causing HAI appeared to be acquired in ICUs, and 7% of PA-HAIs were associated with sink-to-patient transmission. Sinks may be an under-recognized reservoir for HAIs.

The utility of behavioral biometrics in user authentication and demographic characteristic detection: a scoping review

BACKGROUND

Objective measures of screen time are necessary to better understand the complex relationship between screen time and health outcomes. However, current objective measures of screen time (e.g., passive sensing applications) are limited in identifying the user of the mobile device, a critical limitation in children's screen time research where devices are often shared across a family. Behavioral biometrics, a technology that uses embedded sensors on modern mobile devices to continuously authenticate users, could be used to address this limitation.

OBJECTIVE

The purpose of this scoping review was to summarize the current state of behavioral biometric authentication and synthesize these findings within the scope of applying behavioral biometric technology to screen time measurement.

METHODS

We systematically searched five databases (Web of Science Core Collection, Inspec in Engineering Village, Applied Science & Technology Source, IEEE Xplore, PubMed), with the last search in September of 2022. Eligible studies were on the authentication of the user or the detection of demographic characteristics (age, gender) using built-in sensors on mobile devices (e.g., smartphone, tablet). Studies were required to use the following methods for authentication: motion behavior, touch, keystroke dynamics, and/or behavior profiling. We extracted study characteristics (sample size, age, gender), data collection methods, data stream, model evaluation metrics, and performance of models, and additionally performed a study quality assessment. Summary characteristics were tabulated and compiled in Excel. We synthesized the extracted information using a narrative approach.

RESULTS

Of the 14,179 articles screened, 122 were included in this scoping review. Of the 122 included studies, the most highly used biometric methods were touch gestures (n = 76) and movement (n = 63), with 30 studies using keystroke dynamics and 6 studies using behavior profiling. Of the studies that reported age (47), most were performed exclusively in adult populations (n = 34). The overall study quality was low, with an average score of 5.5/14.

CONCLUSION

The field of behavioral biometrics is limited by the low overall quality of studies. Behavioral biometric technology has the potential to be used in a public health context to address the limitations of current measures of screen time; however, more rigorous research must be performed in child populations first.

SYSTEMATIC REVIEW REGISTRATION

The protocol has been pre-registered in the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/92YCT ).

A simple and convenient model combining multiparametric MRI and clinical features to predict tumour-infiltrating lymphocytes in breast cancer

AIM

To develop a simple and convenient method based on multiparametric magnetic resonance imaging (MRI) and clinical features to non-invasively predict tumour-infiltrating lymphocytes (TILs) in breast cancer (BC) and to explore the relationship between TIL levels and disease-free survival (DFS).

MATERIALS AND METHODS

A total of 172 BC patients were enrolled between November 2017 and June 2021 in this retrospective study. The patients were divided into high (≥10%) and low (<10%) TIL groups. Clinicopathological data were collected. MRI features were reviewed by two radiologists. Predictors associated with TILs were determined by using multivariable logistic regression analyses. Kaplan-Meier survival curves based on TIL levels were used to estimate DFS.

RESULTS

A total of 102 patients with low TILs and 70 patients with high TILs were included in the study. Tumour size (odds ratio [OR], 1.040; 95% confidence interval [CI]: 1.006, 1.075; p=0.020), apparent diffusion coefficient (ADC; OR, 1.003; 95% CI: 1.001, 1.005; p=0.015), clinical axillary lymph node status (CALNS; OR, 3.222; 95% CI: 1.372,7.568; p=0.007), and enhancement pattern (OR, 0.284; 95% CI: 0.143, 0.563; p<0.001) were independently associated with TIL levels. These features were used in the ALSE model (where A is ADC, L is CALNS, S is size, and E is enhancement pattern). High TILs were associated with better DFS (p=0.016).

CONCLUSION

The ALSE model derived from multiparametric MRI and clinical features could non-invasively predict TIL levels in BC, and high TILs were associated with longer DFS, especially in human epidermal growth factor receptor 2 (HER2)-positive BC and triple-negative BC (TNBC).

Plant size, latitude, and phylogeny explain within-population variability in herbivory

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

Sediment arsenic remediation by submerged macrophytes via root-released O2 and microbe-mediated arsenic biotransformation

Arsenic (As)-contaminated water restoration is extremely challenging because As remobilization from sediments can result in episodic or long-term release of As to the overlying water. In this study, by combining high-resolution imaging techniques with microbial community profiling, we examined the feasibility of utilizing the rhizoremediation of submerged macrophytes (Potamogeton crispus) to decrease As bioavailability and regulate its biotransformation in sediments. Results showed that P. crispus considerably decreased the rhizospheric labile As flux to lower than 4 pg cm^-2 s^-1 from larger than 7 pg cm^-2 s^-1, suggesting its effectiveness in promoting As retention in sediments. Iron plaques induced by radial oxygen loss from roots decreased the mobility of As by sequestering it. Additionally, Mn-oxides may act as an oxidizer for the oxidation of As(III) to As(V) in the rhizosphere, which can further increase the As adsorption owing to the strong binding affinity between As(V) and Fe-oxides. Furthermore, microbially mediated As oxidation and methylation were intensified in the microoxic rhizosphere, which decreased the mobility and toxicity of As by changing its speciation. Our study demonstrated that root-driven abiotic and biotic transformation contribute to As retention in sediments, which lays a foundation for applying macrophytes to the remediation of As-contaminated sediments.

Mechanisms of antimony release from lacustrine sediments with increasing temperature

Antimony (Sb) is more mobile in lacustrine sediments with seasonal warming. However, the mechanisms of Sb mobility in sediments are still unclear, especially considering the interactions among Sb, iron (Fe), manganese (Mn), and dissolved organic matter (DOM). In this study, high-resolution dialysis (HR-Peeper) and multi-spectral techniques simultaneously investigated changes in Sb, Fe, Mn, and DOM in two different ecological types (algal and grass) sediments with increasing temperature. We found that the dissolved Sb rapidly increased with the increase in temperature. The oxidation of Sb(III) to Sb(V) by Fe/Mn oxides in oxygen (O₂) rich overlying water and surface sediment layers was one of the reasons for Sb concentration enhancement in pore water. Further, using excitation-emission matrix and parallel factor analysis (EEM-PARAFAC), synchronous fluorescence (SF) spectroscopy, fourier transform infrared (FTIR) spectroscopy, and two-dimensional correlation spectroscopy (2D-COS) revealed that complexation with DOM was the other reasons for Sb concentration increasing in sediments. This was demonstrated by the similar distribution pattern and significant correlation between Sb and tryptophan-like components. Titration experiments further revealed that Sb was more stably bound to tryptophan-like components in the aromatic C-H (660 cm^-1), alcoholic C-O (1115 cm^-1), alkene CC (1615 cm^-1), and carboxylic acid OH (3390 cm^-1) groups. The tryptophan-like components from the algae region had a higher binding force than that from the macrophytes region. Our study effectively promotes an understanding of Sb mobilization in lacustrine sediments.

Improving adenine and dual base editors through introduction of TadA-8e and Rad51DBD

Base editors, including dual base editors, are innovative techniques for efficient base conversions in genomic DNA. However, the low efficiency of A-to-G base conversion at positions proximal to the protospacer adjacent motif (PAM) and the A/C simultaneous conversion of the dual base editor hinder their broad applications. In this study, through fusion of ABE8e with Rad51 DNA-binding domain, we generate a hyperactive ABE (hyABE) which offers improved A-to-G editing efficiency at the region (A₁₀-A₁₅) proximal to the PAM, with 1.2- to 7-fold improvement compared to ABE8e. Similarly, we develop optimized dual base editors (eA&C-BEmax and hyA&C-BEmax) with markedly improved simultaneous A/C conversion efficiency (1.2-fold and 1.5-fold improvement, respectively) compared to A&C-BEmax in human cells. Moreover, these optimized base editors catalyze efficiently nucleotide conversions in zebrafish embryos to mirror human syndrome or in human cells to potentially treat genetic diseases, indicating their great potential in broad applications for disease modeling and gene therapy.

Investigating the mechanism of interactive regulation of B-cell lymphoma-2/Beclin 1 through electroacupuncture intervention during reperfusion in myocardial ischemia-reperfusion injury in a rat model

To observe the regulation of B-cell lymphoma-2 (Bcl-2)/Beclin 1 interaction through electroacupuncture (EA) intervention during reperfusion and to investigate the EA mechanism of apoptosis-autophagy interactive regulation against myocardial ischemia-reperfusion injury (MIRI). A total of 48 adult Sprague Dawley (SD) rats were randomly divided into the sham-operated group (group Sham), the model group (group Model), the EA group (group EA), and the JNK inhibitor (SP600125) group (group JNK), with 12 rats in each group. Biospecimens were collected randomly from six rats in each group four hours after reperfusion. Evans Blue and triphenyl tetrazolium chloride double-staining were applied to observe each group's myocardial damage area and risk area. We collected 4 ml of blood by abdominal aortic method to detect serum troponin cTnI level by enzyme-linked immunosorbent assay (ELISA). For the remaining six in each group, a part of myocardial tissue below the ligation line was stored in 4% paraformaldehyde for immunohistochemistry and TUNEL staining; the other amount of myocardial tissue was detected by Western blotting to determine the expression levels of Bcl-2, Beclin1, and the phosphorylation levels of Thr69, Ser70, and Ser87 in Bcl-2. In results: electroacupuncture (EA) intervention during reperfusion significantly reduced the myocardial infarction area, cTnI level, and myocardial apoptosis, upregulated Bcl-2 expression, downregulated Beclin 1 expression and inhibited phosphorylation levels of Thr69, Ser70, and Ser87 in Bcl-2. We concluded that EA effectively inhibited apoptosis by upregulating Bcl-2 expression and inhibiting the phosphorylation of Thr69, Ser70, and Ser87 in Bcl-2. This reduced the separation of Bcl-2 and Beclin 1, restrains excessive autophagy, alleviates MIRI, and has a protective effect on myocardial tissue.

Decrease in macrofauna density increases the sediment phosphorus release and maintains the high phosphorus level of water column in Lake Taihu: A case study on Grandidierella taihuensis

Internal phosphorus (P) loading can increase the P level in the water column and further sustains cyanobacterial blooms. This study focused on the role of benthic fauna bioturbation in affecting the sediment P release and the P level of water column in a eutrophic lake, Lake Taihu. The macrofauna density decreased from 4766.56 ± 10541.80 ind/m² in 2007 to 345 ± 447.63 ind/m² in 2020 due to the frequent bottom-water hypoxia in Lake Taihu. The reduced macrofauna density majorly resulted from Grandidierella taihuensis, Limnodrilus hoffmeisteri, and Tanypus chinensis larvae, and their total density decreased by approximately 97% in 2020 compared to 2007. G. taihuensis, one of the major benthic faunas, was further used as a representative to investigate the effects of bioturbation on sediment P release using high-resolution sampling and imaging techniques. The results show that G. taihuensis can increase the O₂ penetration depth by more than 20 mm through bio-irrigation, and causes the redox conditions in burrows and surrounding sediments to change dramatically within a few minutes due to the intermittent ventilation. Subsequent oxidation of the soluble Fe(II) led to the formation of Fe-oxide bound P in the surface sediments, thereby increasing the P retention in the sediments. When the G. taihuensis density was 1563 ind/m² at the sampling site, approximately 0.12 g m^-2 yr^-1 P can be retained in sediments. As previous studies have shown that L. hoffmeisteri and T. chinensis played a similar role in increasing the P retention in sediments through their bioturbation activities, the sharp decline in benthic fauna density and burrowing activities in Lake Taihu should be an important reason for maintaining the high P level in the water column by decreasing the P retention in sediments.

Selective and simultaneous high resolution 2-D imaging of AsIII, CrIII and SbIII and dissolved oxygen by developing a new DGT technique comprising a hybrid sensor

A new diffusive gradients in thin films technique (HR-MPTS DGT) with mercapto-functionalized attapulgite in a binding gel was developed for simultaneous two-dimensional (2-D) chemical imaging of As^III, Cr^III and Sb^III selectively at the submillimeter scale, combined with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) analysis. The HR-MPTS DGT exhibited selective accumulation of As^III, Sb^III and Cr^III (> 97%), yet negligible accumulation of As^V, Sb^V and Cr^VI (< 2%). Accumulation of As^III, Cr^III and Sb^III on the binding gel had a linear relationship (R² > 0.99) with the corresponding standardized laser ablation signals, proving the feasibility of LA-ICP-MS analysis. Analysis for As^III, Cr^III and Sb^III was provided with favorable analytical precision (relative standard deviation <10%). With the purpose of evaluating the dynamics of As^III, Cr^III, Sb^III and O₂ in the rooting zone, a hybrid sensor, which comprises the HR-MPTS gel overlying an O₂ planar optode, was deployed in rhizosphere sediments. Results showed that the consumption of both As^III and Sb^III due to the oxidation extended ~4.48 mm into the sediments, which was consistent with the extension length of the oxidized sediment layers around the roots created by O₂ leakage.

Mechanistic insights into trace metal mobilization at the micro-scale in the rhizosphere of Vallisneria spiralis

Mobilization of trace metals in the rhizosphere of macrophytes is controlled by root-driven chemical changes, especially the steep gradients of O₂ and pH from the rhizosphere to bulk sediments. Here, the O₂ and pH dynamics, and the distribution of trace metal, in the rhizosphere of Vallisneria spiralis were obtained using planar optodes and diffusive gradients in thin films, respectively. Radial O₂ loss (ROL) and acidification occurred on all visible roots of V. spiralis and exhibited highly spatiotemporal dynamics depending on the root growth and various environmental conditions. Trace metals showed different mobilization mechanisms in the rhizosphere. ROL and produced Fe(III) (oxyhydr)oxides decreased the mobility of Fe, As, Co, V and W in the rhizosphere. However, Mn, Ni and Cu exhibited greater mobility in the rhizosphere than bulk sediments as a result of the oxidation of metal sulfide and proton-induced dissolution of minerals. In particular, Co and Ni presented increased activity at the interface between rhizosphere and bulk sediment, which was attributed to the redox dissolution processes of Fe and Mn as a result of ROL and rhizosphere acidification. These results provide new insights into the roles of macrophyte root-induced O₂ and pH changes in controlling trace metal mobility in sediments.

Phosphorus acquisition strategy of Vallisneria natans in sediment based on in situ imaging techniques

Phosphorus (P) availability is closely related to the distributions of pH, O₂ and phosphatase activities in the rhizosphere of plants growing in soils and sediments. In this study, the P uptake processes and mechanisms of Vallisneria natans (V. natans) during two vegetation periods (i.e., week three and six) were revealed using three noninvasive 2D imaging techniques: planar optode (PO), diffusive gradients in thin films (DGT) and zymography. The results showed that increased phosphatase activity, O₂ concentration and root-induced acidification were observed together in the rhizosphere of root segments and tips. In week three, when V. natans was young, the flux of DGT-labile P accumulated more in the rhizosphere in comparison with the bulk sediment. This was because increased phosphatase activity (of up to 35%) and root-induced acidification (with pH decreasing by up to 0.25) enhanced P acquisition of V. natans by the third week. However, the flux of DGT-labile P turned to depletion during weeks three to six of V. natans growth, after Fe plaque formed at the matured stage. The constant hydrolysis of phosphatase and acidification could not compensate for the P demand of the roots by the sixth week. At this stage, Fe plaque become the P pool, due to P fixation with solid Fe(III) hydroxides. Subsequently, V. natans roots acquired P from Fe plaque via organic acid complexation of Fe(III).

O2 distribution and dynamics in the rhizosphere of Phragmites australis, and implications for nutrient removal in sediments

Root-triggered microscale variations in O₂ distribution in the rhizosphere of young Phragmites australis are important for nutrient removal in sediments. In this study, the micro-scale O₂ dynamics and the small-scale changes of soluble reactive phosphorus (SRP) and ammonium (NH₄⁺) in the rhizosphere of P. australis were investigated using planar optodes and high-resolution dialysis (HR-Peeper), respectively. Results suggested that root O₂ leakage has a highly variable distribution depending on the stage of root growth, the site of O₂ leakage gradually shift from the entire emerging main roots to the main root tip and subsequently shifted the emerging lateral roots. The O₂ concentration increased in the rhizosphere with increasing light intensity and O₂ levels in the overlying water. Continuous O₂ release from the lateral roots causes the formation of iron plaque on the surface of lateral roots, which reduce the mobility of P by adsorption of iron plaque in the rhizosphere. The oscillation of oxic-anoxic root zones improves nitrogen removal through the processes of anammox, heterotrophic denitrification and nitrification. This work from the micro-scale demonstrates that the O₂ concentration is the spatio-temporal variations in the rhizosphere, and it presents an important role for nutrient removal in sediments.

Terrain-modulated deposition of atmospheric lead in the soils of alpine forest, central China

Alpine ecosystem has a potential to intercept the transport of atmospheric metals, while the regulation mechanisms with variations in altitude and slope direction remain unclear. In this study, the soil and moss samples on the northern and southern slopes of Shennongjia Mountain were collected with altitude to quantitatively identify the sources of lead (Pb) and to decipher the regulation mechanisms of altitude and slope on the Pb distribution. The results showed that the concentrations of Pb decreased evidently with soil depth, and in the O (organic soils) and A (surface mineral soils) horizons they increased with altitude. The Pb isotopes and moss biomonitoring revealed that Pb was mainly from atmospheric deposition, and the sources included fossil fuel combustion, ore mining and smelting. Based on a binary mixing model of Pb isotopes, the percentage of atmospheric Pb in the O and A horizons and mosses averaged 58.8%, 43.7% and 71.0%, respectively. Atmospheric wet deposition strikingly controlled the distribution of soil Pb along the altitude. Canopy filtering and leaching also impacted the accumulation of Pb in the forest floor. The significant difference in the atmospheric Pb accumulation in the soils between the two slopes was not observed as expected, since atmospheric dry deposition from northwestern China contributed to the Pb accumulation on the northern slope according to the Pb isotopic ratios and air mass trajectories. The results of this study indicate that altitude determines the distribution pattern of atmospheric Pb, while slope direction screens the source region of Pb in alpine ecosystems.

Characterization of serum adiponectin and leptin in healthy perinatal dairy cows or cows with ketosis, and their effectson ketosis involved indices

We investigated changes in concentrations of ADP (adiponectin), LEP (leptin), BHBA (beta-hydroxybutyric acid), NEFA (non-esterified fatty acid), Glucose (Glu) and INS (insulin) in serum of healthy perinatal dairy cows and cows with ketosis. Twenty-one healthy cows and seventeen cows with ketosis from a herd of a total 60 Holstein cows (near dry period i.e. 56 days antepartum) were selected. Blood was collected through the tail vein every 7 days, from 56 day antepartum to 56 day postpartum. Serum ADP, LEP, BHBA, NEFA, Glu, and INS concentrations were determined, and ketosis was diagnosed through serum BHBA (≥1.2 mmol/L). We showed the concentration of serum adipokines and energy balancing indices were stable during antepar- tum period. However, ADP concentration increased while LEP decreased, and there were a significant increase in cows with ketosis compared to that of in healthy cows. Serum BHBA and NEFA concentrations increased significantly at first, and then gradually decreased in both healthy cows and cows with ketosis. However, cows with ketosis showed higher concentrations of BHBA and NEFA which restored later. The serum concentration of Glu in both healthy dairy cows and cows with ketosis showed a decreasing trend. INS concentration in healthy cows was decreased while it was increased in cows with ketosis. The results reflect the extent of hypo- glycemia and lipid mobilization postpartum, suggest IR exists in cows with ketosis while serum ADP and LEP might play roles in the development of ketosis.

Mutations of the c-Kit and PDGFRA gene in gastrointestinal stromal tumors among hakka population of Southern China

Aims

The aim of the present study was to investigate mutation status of the cKit and PDGFRA genes in patients with a gastrointestinal stromal tumor (GIST).

Methods

In total, 96 patients with a GIST were included in the study, in which polymerase chain reaction amplification and gene sequencing were used to detect the sequences of exons 9, 11, 12, 13, 14, 17, and 18 in KIT and exons 12, 14, and 18 in PDGFRA.

Results

KIT mutations were detected in 65 cases (67.71%), of which 81.54% (53/65) were located on exon 11, 12.31% (8/65) were located on exon 9, 4.61% (3/65) were located on exon 17, which included a concomitant mutation of exon 9 and 11, and 4.08% (2/65) were located on exon 13, which included a concomitant mutation on exon 11. The most common mutation in exon 11 was deletion, which accounted for 77.36% (41/53) of the cases, followed by a point mutation observed in 22.64% (12/53) of the cases. Among the 31 GIST cases without a KIT mutation, a mutation in PDGFRA was detected in 5 cases (5.21%, 5/96; 16.13%, 5/31). With respect to gender, age, tumor max diameter, tumor position, and mitotic index, there were no significant differences between KIT/PDGFRA mutations and non-mutations.

Conclusions

GIST mainly occurs in the stomach, and the cytological morphology is mainly spindle cells, and the mutations mainly occur in KIT genes. We need a large sample size to analyze the regularity of GIST gene mutations in Hakka population and understand the independent prognostic correlation of all KIT/PDGFRA genotypes.

AB0791 THE DIAGNOSIS VALUE OF SYNOVIAL FLUID LYMPHOCYTE IN GOUT PATIENTS

Background:

Synovial fluid cell counts have long been recognised to have utility in the diagnosis and management of arthritis. Few studies have explained the diagnosis value of synovial fluid cell counts in gout patients.

Objectives:

The study aims to investigate the diagnosis value of synovial fluid cell counts in gout patients.

Methods:

A total of 185 gout, 64 rheumatoid arthritis(RA), 26 axial spondyloarthritis(axSpA) and 24 osteoarthritis(OA) patients were included into the study. According to serum uric acid(sUA) level on attack, gout patients were divided into normal sUA gout patients and high sUA gout patients. The laboratory data was recorded and ROC curve was performed.

Results:

The synovial fluid WBC, PBMC, monocyte, PMN and neutrophil in gout patients were higher than OA patients (P<0.05). The synovial fluid PBMC and lymphocyte in gout patients were lower than RA and axSpA patients (P<0.05). Compared with RA, axSpA and OA patients, ROC curve showed that the AUC value of lymphocyte and sUA for gout were 0.728 and 0.881, which were higher than other variables. The optimal cut off value of lymphocyte for gout was 1.362, with sensitivity of 83.3% and specificity of 60.6%. The AUC value of lymphocyte and sUA for normal sUA gout patients were 0.694 and 0.643, which were higher than other variables. The optimal cut off value of lymphocyte for normal sUA gout patients was 1.362, with sensitivity of 81.6% and specificity of 60.6%.

Conclusion:

Synovial fluid cell counts of gout patients were different from RA, axSpA, and OA patients. Synovial fluid lymphocyte had a higher diagnosis value for gout.

References:

[1]Scanu A, Oliviero F, Ramonda R, et al. Cytokine levels in human synovial fluid during the different stages of acute gout: role of transforming growth factor β1 in the resolution phase. Ann Rheum Dis. 2012, 71(4): 621-4.

Table 1.

Basic characteristics of the participants

Gout(n=185)RA(n=64)axSpA (n=26)OA(n=24)P valueAge (years)48.58±15.5856.19±12.39*32.96±15.19*#69.63±12.43*#&<0.001Gender (male/female)176/911/5321/58/16<0.001WBC(×109/L)18.58±22.9422.24±20.8715.52±15.033.03±5.59*#&0.002PBMC(×109/L)1.85±1.993.68±2.43*3.85±3.34*0.74±1.01*#&<0.001Monocyte(×109/L)1.02±1.591.24±1.111.34±1.520.29±0.37*#&0.030PMN(×109/L)16.77±21.5118.57±19.3215.75±24.172.30±5.00*#&0.008Lymphocyte (×109/L)0.80±0.832.43±1.76*2.50±2.04*0.45±0.80#&<0.001Eosinophil (×109/L)1.32±3.750.56±0.930.11±0.170.49±1.850.098Neutrophil (×109/L)16.42±21.1618.82±20.8911.13±14.232.23±4.87*#0.003UA(μM)497.92±132.24299.31±97.91*351.81±118.93*333.38±75.19*<0.001ESR(mm/h)61.02±37.6882.42±32.87*68.12±36.2542.34±35.91*#&<0.001CRP(mg/L)56.52±45.6444.01±35.27*65.49±39.85#22.11±40.65*#&<0.001

*P<0.05 vs gout group, #P<0.05 vs RA group, &P<0.05 vs axSpA group

Disclosure of Interests:

None declared

POS1144 SERUM URIC ACID TO CREATININE RATIO IS ASSOCIATED WITH URINARY URIC ACID EXCRETION IN PATIENTS WITH GOUT

Background:

Underexcretion of uric acid is the dominant mechanism leading to hyperuricemia [1] and the 24-hour urinary uric acid excretion is an important measurement. However, it is inconvenient due to accurate timing and complete collection of the specimen.

Objectives:

The aim of this study was to investigate the relationship between serum uric acid to creatinine ratio (sUACR) and 24-hour urinary uric acid excretion in gout patients.

Methods:

A total of 110 gout patients fulfilling 2015 ACR/EULAR classification criteria from Guangdong Second Provincial General Hospital from January 2019 to January 2021 were retrospectively enrolled in this study. Patients were divided into underexcretion group (<3600 μmol/24h) and non-underexcretion group (≥3600 μmol/24h). The correlation between sUACR and 24-hour urinary uric acid excretion was analyzed by the Pearson’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to assess the utility of sUACR for discriminating between underexcretion group and non-underexcretion group. Furthermore, the risk factors of uric acid underexcretion were evaluated using binary logistic regression analysis.

Results:

sUACR in the underexcretion group was significantly lower than the non-underexcretion group (p=0.0001). Besides, sUACR was positively correlated with 24-hour urinary uric acid excretion (r=0.4833, p<0.0001). Furthermore, ROC suggested that the area under the curve (AUC) of sUACR was 0.728, which was higher that of serum uric acid and creatinine. The optimal cutoff point of sUACR was 5.2312, with a sensitivity and specificity of 71.9% and 67.9%. Logistic analysis results revealed that decreased sUACR (<5.2312) was an independent risk factor of underexcretion of uric acid (OR =5.510, 95% CI: 1.952-15.550, P=0.001).

Conclusion:

sUACR is lower in gout patients with underexcretion of uric acid and may serve as a useful and convenient marker of assessing underexcretion of uric acid in gout patients.

References:

[1]Perez-Ruiz F, Calabozo M, Erauskin GG, Ruibal A, Herrero-Beites AM. Renal underexcretion of uric acid is present in patients with apparent high urinary uric acid output. Arthritis Rheum 2002; 47: 610–13.

Figure 1.

A. Comparison of serum uric acid to creatinine ratio between underexcretion group and non-underexcretion group. B. Correlation between serum uric acid to creatinine ratio and 24h uric acid excretion.

Disclosure of Interests:

None declared.

AB0645 CLINCAL CHARACTERISTICS OF GOUT PATIENTS WITH RENAL CYSTS

Background:

Gout is a crystal-related arthropathy caused by monosodium urate deposition, which is a common and treatable form of inflammatory arthritis and becoming more prevalent[1]. A few studies have found that gout patients have an increased prevalence of simple renal cysts[2, 3]. The relationship between gout and renal cysts is still insufficient.

Objectives:

Compare the difference between gout with renal cyst and without renal cyst.

Methods:

We retrospectively collected data on 200 gout patients. The data includes age, gender, uric acid, creatinine, glomerular filtration rate, 24-hour urine collection, and whether they have kidney stones, renal cysts, coronary heart disease, hypertension, and diabetes. Chi-square and exact Fisher’s tests were utilized, while continuous variables were assessed by Student’s t-test. A P value of less than 0.05 was considered statistically significant.

Results:

Of the 200 gout patients, 56 have kidney cysts(28%). In gout patients who had a renal cyst, were significantly older than patients without renal cysts (59.14 vs. 46.87, P = 0.000), more number of people suffering from coronary heart disease (7 vs. 5, P = 0.016). The glomerular filtration rate was lower (58.5 vs. 71.6, P = 0.000), with lower urinary creatinine, uric acid, and urinary potassium.

Conclusion:

Gout patients with and without simple renal cysts have significant differences in age, hypertension, cardiovascular disease, GFR, serum creatinine, urine creatinine, and urine potassium.

References:

[1]N. Dalbeth, T.R. Merriman, L.K. Stamp, Gout, Lancet 388(10055) (2016) 2039-2052.

[2]E.M. Hasegawa, R. Fuller, M.C. Chammas, F.M. de Mello, C. Goldenstein-Schainberg, Increased prevalence of simple renal cysts in patients with gout, Rheumatol Int 33(2) (2013) 413-6.

[3]Y. Han, M. Zhang, J. Lu, L. Zhang, J. Han, F. Zhao, H. Chen, Y. Bao, W. Jia, Hyperuricemia and overexcretion of uric acid increase the risk of simple renal cysts in type 2 diabetes, Sci Rep 7(1) (2017) 3802.

Table 1.

Clinical characteristics of gout patients

Renal cyst(n=56)Without Renal cyst(n=144)PDisease duration, (month)98.7(±64.1)91.2(±67.0)0.468Age, (year)59.14(±14.3)46.78(±15.9)0.000Gender, n(F/M)7/4911/1330.281Smoking history, n(%)18(32.1%)47(32.6%)0.946Drinking history, n(%)10(17.9%)32(22.2%)0.496Hypertension, n(%)31(55.3%)49(34.0%)0.006Diabetes, n(%)9(16.1%)15(10.4%)0.269CVDs, n(%)7(12.5%)5(3.4%)0.016Nephrolithiasis, n(%)14(25%)43(29.9%)0.494UA, (μmol/L)494.8(±158.0)544.3(±121.0)0.037Serum creatinine, (μmol/L)139.4(±57.2)116.5(±35.45)0.007GFR, (ml/L)58.5(±22.5)71.6(±22.3)0.000FEUA, (%)7.0(±3.2)6.0(±3.2)0.052Urine creatinine, (μmol/L)4687.09(±1832.9)5565.2(±2599.8)0.008Urine Uric acid, (μmol/L)1204.9(±772.0)1542.1(±1048.5)0.030Urine sodium, (mmol)132.1(±68.7)131.2(±76.6)0.939Urine potassium, (mmol)25.6(±12.5)31.8(±14.2)0.005

Disclosure of Interests:

None declared.

Altitudinal-modulated sediment inputs rather than the land-uses determine the distribution of lead in the riparian soils of the Three Gorges Reservoir

Lead (Pb) as a toxic metal has potential ecological hazards for aquatic quality. However, the variation in the distribution patterns of Pb and its fractions in flooding soils with frequent and anti-seasonal water-level fluctuation and various human disturbances remains unclear. In this study, the distribution of Pb and its fractions in the riparian soils of the Three Gorges Reservoir (TGR) were delineated based on the differences in altitude and land-uses including farmland, orchard, forest and residential area. Then, we assessed the contamination and eco-risk of Pb in the soils and deciphered the key factors determining the distribution of Pb and its fractions. The results showed that the concentrations of Pb and its fractions in the soils decreased significantly with altitude, while the significant difference was not observed among the land-uses. The contamination of Pb in the soils reached a moderate level, and its eco-risk was very low by the potential eco-risk index and mobile Pb fraction. The source of soil Pb at the upper zone (> 160 m) was mainly from natural inputs, while the source at the lower zone (≤ 160 m) was attributed to anthropogenic contributions including ores mining, fossil fuel combustion, vehicle emissions and atmospheric deposition indicated by Pb isotopic ratios. With the limited effect of land-uses, the sediment inputs regulated by frequent water-level fluctuation determined the altitudinal distribution of Pb and its fractions in the flooding soils. The soil particle size dominated the migration and transformation of Pb over other soil properties such as pH and organic matters. The results of this study indicate that the anthropogenic Pb mainly exists in the soils of lower riparian zone in the TGR, and the frequent and anti-seasonal dry and rewetting alternation aggravates the potential for the Pb migration downstream due to the determinant of soil particles.

A new DGT technique comprising a hybrid sensor for the simultaneous high resolution 2-D imaging of sulfides, metallic cations, oxyanions and dissolved oxygen

A new diffusive gradients in thin films technique (HR-ZCA DGT) was developed for simultaneous two-dimensional (2-D) chemical imaging of sulfides, metallic cations and oxyanions (S, Cd, Co, Fe, Cu, Mn, Ni, Pb, Zn, As, Cr, Mo, Sb, Se, V, P and W) at the submillimeter scale, combined with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) analysis. A novel binding gel was prepared using a double precipitation method with AgI and zirconium oxide (Zr-oxide) deposited sequentially on a preformed Chelex-100 resin gel. A good linear relationship was observed (R²>0.99) between mass accumulation of the 17 assessed elements on the binding gel and the corresponding standardized laser ablation signals (signals of elements divided by signals of internal standard ¹³C), proving the feasibility of LA-ICP-MS analysis. Good analytical precision (RSD<12 %) was achieved for all 17 elements. A hybrid sensor comprising the novel DGT binding gel overlying an O₂ planar optrode was then tested in sediments to evaluate the dynamics of O₂ and multiple elements. Results showed that the mobility of As, P and W were controlled by precipitation/dissolution processes with Fe/Mn oxides. V, Co, Ni, Zn, Mo, Cd and Sb were released at the sediment surface with the oxidation of iron sulfides.

A new generation of direct X-ray detectors for medical and synchrotron imaging applications

Large-area X-ray imaging is one of the most widely used imaging modalities that spans several scientific and technological fields. Currently, the direct X-ray conversion materials that are being commercially used for large-area (> 8 cm × 4 cm without tiling) flat panel applications, such as amorphous selenium (a-Se), have usable sensitivities of up to only 30 keV. Although there have been many promising candidates (such as polycrystalline HgI2 and CdTe), none of the semiconductors were able to assuage the requirement for high energy (> 40 keV) large-area X-ray imaging applications due to inadequate cost, manufacturability, and long-term performance metrics. In this study, we successfully demonstrate the potential of the hybrid Methylammonium lead iodide (MAPbI3) perovskite-based semiconductor detectors in satisfying all the requirements for its successful commercialization in synchrotron and medical imaging. This new generation of hybrid detectors demonstrates low dark current under electric fields needed for high sensitivity X-ray imaging applications. The detectors have a linear response to X-ray energy and applied bias, no polarization effects at a moderate bias, and signal stability over long usage durations. Also, these detectors have demonstrated a stable detection response under BNL's National Synchrotron Light Source II (NSLS-II) 70 keV monochromatic synchrotron beamline.

2D shear wave elastography combined with age and serum biomarkers prior to kasai surgery predicts native liver survival of biliary atresia infants

BACKGROUND

The prognosis of patients with biliary atresia (BA) after Kasai portoenterostomy (KPE) varies, and precisely predicting the outcomes of KPE before surgery is still challenging.

METHODS

A total of 158 patients who underwent KPE in our hospital were included in this study. The patients in the training cohort were recruited from January 2012 to October 2017 (n = 118), and then, those in the validation cohort were recruited from November 2017 to April 2019 (n = 40). Combined nomogram models were developed based on two-dimensional shear wave elastography (2D SWE) values and other biomarkers. The utility of the proposed models was evaluated by C-index.

RESULTS

2D SWE played a potentially important role in predicting native liver survival (NLS) of BA patients with a C-index of 0.69 (0.63 to 0.75) in the training cohort and 0.76 (0.67 to 0.85) in the validation cohort. The nomogram A based on 2D SWE values, age, gamma-glutamyl transferase (GGT) and aspartate aminotransferase-to-platelet ratio (APRI) had a better C-index in the training cohort [0.74 (0.68-0.80) vs. 0.66 (0.60-0.73), P = 0.017] and in the validation cohort [0.78 (0.70-0.86) vs. 0.60 (0.49-0.71), P = 0.002] than the nomogram B (without 2D SWE). Using risk score developed from nomogram A, we successfully predicted 88.0% (22/25) of patients in the training cohort and 75.0% (9/12) in the validation cohort to have survival time of less than 12 months after KPE.

CONCLUSION

The combined nomogram model based on 2D SWE values, age, GGT and APRI prior to KPE can effectively predict NLS in BA infants.

A new DGT technique comprised in a hybrid sensor for the simultaneous measurement of ammonium, nitrate, phosphorus and dissolved oxygen

A new diffusive gradients in thin films technique (ZrO-AT DGT) with zirconium oxide, A-62 MP and T-42H resins containing in a single binding gel was developed for simultaneous measurement of nitrate (NO₃-N), ammonium (NH₄-N) and phosphate (PO₄-P). The DGT uptake was found to be independent of pH variation from 3.2-8.7. Ionic strengths below 5, 10 and 750 mmol·L^-1 NaCl did not affect DGT uptake of NH₄-N, NO₃-N and PO₄-P, respectively. This new DGT was deployed in natural freshwater environments, with in situ measurements of the three nutrients found to be accurate. It ensured that rinsing the exposed surface of the DGT device at 3-day intervals can prevent biofouling. Additionally, a hybrid sensor comprising the novel DGT binding layer overlying an O₂ planar optrode was tested in sediments to evaluate the dynamics of O₂ and the three nutrients. Results showed that PO₄-P and NO₃-N fluxes decreased while fluxes of NH₄-N increased under aerobic conditions. Nearly simultaneous variation in O₂ and NO₃-N was observed at the sediment-water interface (SWI) and transformation of NO₃-N and PO₄-P was found to be sensitively influenced by O₂ dynamics.

Spatiotemporal distribution of vanadium in the flooding soils mediated by entrained-sediment flow and altitude in the Three Gorges Reservoir

The re-emergence of vanadium (V) as a toxic metal has been highlighted recently due to its long-standing environmental and health hazard. This work targeted the world largest reservoir-Three Gorges Reservoir (TGR) to explore the spatial variation of V in the flooding soils from 2014 to 2018; meanwhile, the typical riparian zones with different altitudes and land-uses at the middle reach of the TGR were selected to decipher the key drivers on the V distribution. The results showed that the concentrations of soil V in the mainstream markedly exceeded local background, but they did not vary significantly with time except a marked increase at the upper-middle reaches. Spatially, the concentrations of soil V increased towards the dam, and the increase trend became increasingly significant with time. At the typical riparian zone, the concentrations of soil V decreased strikingly with altitude despite the difference in the land-uses, and a marked change-point occurred at 160-165 m. The soil V dominated by residual fraction, followed by oxidizable and reducible fractions, and then the minimal acid-soluble fraction. The contamination and eco-risk of V in the soils were low with similar spatiotemporal variation to its concentrations. Entrained-sediment flow and particle size rather than pH and organic matters led to the spatiotemporal variation in the distribution of soil V in the mainstream, and the driving effects tended to be more predominant with time. Altitude-regulated alteration of soil properties including particle sizes and iron/manganese (hydr)oxides with different flooding duration dominated the vertical distribution of V over the local land-uses at the riparian zone. Our results reveal the hotspots of V contamination in the riparian soils of the TGR and highlight unceasing focus on the variation in the distribution and dynamic migration of soil V due to its levels out of limits and changing soil conditions.

THU0405 SERUM METABOLIC PROFILING ANALYSIS OF GOUT PATIENTS BASED ON UHPLC-Q-TOF/MS

Background:

Gout is a common kind of inflammatory arthritis with metabolic disorders. The detailed pathogenesis of gout remains largely unknown. Metabolomics has become an important tool in detecting the new pathogenesis and biomarkers. However, few studies have focused on the serum metabolic profiling of gout.

Objectives:

The study aims to investigate the metabolic profiling of gout patients with ultra-performance liquid chromatograph quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and explore the potential pathological mechanisms and biomarkers.

Methods:

Serum samples from 31 gout patients and 31 healthy controls were analyzed by UPLC-Q-TOF-MS. Principal components analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA) and Hierarchical clustering analysis were performed to detect different compounds between the two groups. Receiver operating characteristic (ROC) curve analysis and pathway analysis of the different metabolites were conducted.

Results:

A total of 9192 compounds were detected, of which 138 significantly different compounds were selected, according to the criteria of (Variable importance in projection (VIP)>3,P<0.05). Eventually, 96 reliable metabolites matched the HMDB database were confirmed. ROC curve results showed that the area under the curve (AUC) value of 4-hydroxytriazolam for gout was 0.933 (CI95%: 0.875-0.992), yielding a highest AUC value, with the sensitivity of 83.9% and specificity of 93.5%. The pathway analysis results indicated that the significantly different metabolites were mainly involved in “primary bile acid biosynthesis”, “purine metabolism” and “glycerophospholipid metabolism”.

Conclusion:

The serum metabolic profiling in gout patients were significantly different from healthy subjects. 4-hydroxytriazolam was the potential biomarkers. Primary bile acid biosynthesis may be a novel metabolic pathway of gout.

References:

[1]Banoei MM, et al. Metabolomics and Biomarker Discovery in Traumatic Brain Injury. J Neurotrauma, 2018. 35(16): p. 1831-1848.

Disclosure of Interests: :

None declared

AB0931 THE QUALITY OF LIFE IN GOUT PATIENTS WITH ULCERATION OVER TOPHI

Background:

The prevalence of gouty patients with ulcerations over tophi are increasing over time and it has been reported that gouty patients have significantly poor quality of life (QoL) compared to those healthy controls. [1, 2] there is no study on comparison of the QoL in patients with or without ulceration over tophi.

Objectives:

To compare the QoL in gout patients with or without ulcerations over tophi.

Methods:

A total of 79 inpatients with gout who were admitted to Guangdong Second Provincial General Hospital from January 2019 to January 2020 were included. Among them, ulcerations were identified in 28 patients. Short Form-36 Scales (SF-36) were chosen to assess patients. Differences between the groups were tested with Student’s t test or Mann-Whitney U test for continuous variables, and Chi-square tests for categorical variables.

Results:

Of 79 subjects, 74 were male, mean age was 54.23±14.3 years, disease duration was 10.94±7.06 years. Gouty patients had moderate- to high-quality levels in general health, vitality, social functioning, role emotional, and mental health (median: 65, 75, 75, 88, and88, respectively), while had low levels of quality in role physical, and bodily pain (median: 0, and 22, respectively). Patients presenting with ulcerations over tophi had worse scores on five SF-36 domains, the mental component summary (MCS) and the physical component summary (PCS) than gout patients without ulcerations [mean (SD); P < 0.05 for all]: Bodily pain, 30.86(31.59) vs 35.17(33.40); General health, 49.46(27.01) vs 64.17(23.69); Vitality, 57.14(32.53) vs 72.84(26.38); Mental health, 75.4(22.43) vs 83.05(20.96); Reported health transition, 3.58(0.89) vs 3.78(1.42); MCS, 52.62(21.82) vs 66.65(21.44); PCS, 35.85(21.17) vs 46.67(23.86).

Conclusion:

Patients with ulcerations over tophi present much worse QoL compared those without ulcerations. Our study suggests that the presence of ulceration over tophi further deteriorates the QoL in gout patients.

References:

[1]Z. Huang, X. Liu, Y. Liu, et al., Clinical characteristics and risk factors of ulceration over tophi in patients with gout, Int J Rheum Dis, 22 (2019) 1052-1057.

[2]T. Fu, H. Cao, R. Yin, et al., Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study, BMC Musculoskelet Disord, 18 (2017) 429.

Table 1.

Clinical characteristics

VariableTotal (n=79)Non-ulcerations (n=51)Ulcerations (n=28)PvalueMale, n (%)74(93.7)47(92.1)27(96.4)0.462Agea, mean, y54.23±14.3053.96±12.2454.71±17.690.842Body mass indexa, kg/m224.87±3.9725.13±4.0224.40±3.910.444Gout durationa,y10.96±7.0610.04±6.7512.63±7.410.119Maximum Serum uric acid, mg/dL625.5±133.86630.9±124.23614.3±166.430.639Smoking, n (%)38(48.1)23(45.1)15(53.5)0.477Alcohol, n (%)26(32.9)13(25.5)13(46.4)0.072Hypertension, n (%)34(43.0)18(35.3)16(57.1)0.062Diabetes mellitus, n (%)13(16.5)10(19.6)3(10.7)0.281Regular treatment, n(%)3(3.8)3(5.9)0(0)0.971Glucocorticoid abuse, n (%)18(22.8)11(21.5)7(25.0)0.173

aMean (SD).

Table 2.

QoL scores

Median (IQR)Non-ulcerations (n=51), mean (SD)Ulcerations (n=28), mean (SD)PvaluePhysical functionb50(20-80)58.62(32.17)40.89(35.97)0.095Role physicalb0 (0-100)33.03(46.91)17.85(37.17)0.119Bodily painb22(0-62)35.17(33.40)30.86(31.59)0.007General healthb65 (40-80)64.17(23.69)49.46(27.01)0.014Vitalityb75 (50-95)72.84(26.38)57.14(32.53)0.023Social functionb75(38-100)72.55(3.02)60.27(33.85)0.107Role emotionalb88 (68-96)33.98(47.37)15.43(34.45)0.135Mental healthb88 (68-96)83.05(20.96)75.4(22.43)0.007Reported health transition3.78(1.42)3.58(0.89)0.007PCS46.67(23.86)35.85(21.17)0.048MCS66.65(21.44)52.62(21.82)0.007

b(range = 0-100)

Disclosure of Interests:

None declared

THU0450 OPTIMISTIC STATUS ASSOCIATES WITH COMPLIANCE TO URATE-LOWERING THERAPY IN GOUT PATIENTS

Background:

Compliance to urate-lowering therapy (ULT) is poor in gout patients, which contributes to increased frequency of acute gout attacks, deposition of tophi and urate nephropathy [1]. Optimistic status is probably a potential and considerable factor affecting compliance to ULT in gout patients.

Objectives:

To compare optimistic status between gout patients and healthy controls, and also between gout patients with good and poor compliance. Relationship between optimistic status and compliance to ULT, sUA target achievement of gout patients were assessed as well.

Methods:

This was a monocentric and observational study which was performed from August 2018 to December 2019. Adult patients who met the 2015 gout classification criteria were included in this study. The healthy controls were individuals who were free of gout, hyperuricemia and other rheumatic diseases from the physical examination center of our hospital. Demographic data, including age, gender and education were collected from all individuals. Serum uric acid (sUA) were collected from gout patients at enrollment and again after 3 months. Disease duration of gout, visual analogue scale (VAS) of pain were also assessed for gout patients at enrollment. Compliance to ULT was measured using the medication possession ratio (MPR) in the following 3 months. Poor compliance was defined as MPR<0.8 and good compliance was defined as MPR≥0.8. All subjects completed the life orientation test-revised (LOT-R) for optimistic status assessment.

Results:

Five hundred and thirty gout patients and 307 healthy controls matched by age (41.4±12.3 vs. 42.1±9.3 years), gender (male 97.1% vs. 95.1%) and education (college graduated 54.2% vs. 58.0%) were included in this study. Of the 530 gout patients, the mean disease duration was 5.7±4.9 years, and 292 (55.1%) patients’ MPR were lower than 0.8. There was no statistic difference in LOT-R between gout patients and healthy controls (19.0±2.4 vs. 19.2±2.5, P>0.05) (Table 1). Gout patients with poor compliance (MPR<0.8) had higher level of sUA (525.5±138.0 vs. 471.2±152.5 μmol/L, P<0.05), followup sUA (450.1±154.5 vs. 361.6±120.0 μmol/L, P<0.05) and higher LOT-R (19.6±2.6 vs. 17.8±1.7, P<0.05) than those with good compliance (MPR≥0.8). Of the 292 gout patients with poor compliance, there were only 83 (28.4%) patients achieved sUA target after 3 months, and their LOT-R were significantly lower than those did not achieve sUA target (18.8±2.1 vs. 19.6±2.4, P<0.05). Finally, LOT-R correlated positively with sUA (r=0.131, P<0.05) and followup sUA (r=0.09, P<0.05), but negatively with MPR (r=-0.473, P<0.05) of gout patients (Table 2).

Table 1

Demographic and optimistic status of gout patients and healthy controls

VariablesGout patients(n=530)Controls(n=307)PAge (years)41.4±12.342.1±9.30.116Male gender, n (%)511 (96.4)292 (95.1)0.368College graduated, n (%)287 (54.2)178 (58.0)0.312LOT-R19.0±2.419.2±2.50.189

LOT-R:life orientation test-revised

Table 2

Correlation analysis between LOT-R and clinical variables in gout patients

VariablesLOT-RrPAge00.994Disease duration-0.0580.182VAS0.0340.432sUA0.1310.003*Followup sUA0.1260.016*MPR-0.393<0.001*

LOT-R: life orientation test-revised,VAS:visual analogue scale,sUA:serum uric acid,MPR:medication possession ratio

*P<0.05

Conclusion:

Gout patients share similar optimistic status to healthy controls. However, optimistic status relates to compliance to ULT and sUA target achievement of gout patients.

References:

[1]Harrold L R, Andrade S E, Briesacher B A, et al. Adherence with urate-lowering therapies for the treatment of gout. Arthritis research & therapy 2009, 11(2):R46.

Disclosure of Interests: :

None declared

Relationship of adiponectin, leptin, visfatin and IGF-1 in cow's venous blood and venous cord blood with calf birth weight

The Intrauterine fetal development process is complicated and affected by many regulating factors such as maternal nutritional status, transcription factors and adipokines. Adipokines are kinds of active substances secreted by adipose tissue, including more than 50 kinds of molecules. To explore the correlation between calf birth weights and adipokines including adiponectin, leptin, visfatin, and IGF-1 in cows venous and venous cord blood. Fifty-four healthy multiparous Chinese Holstein cows were used; in which, cows with a calf weight less than 40 kg were included in group A (n=9); those with a calf weight between 40 kg~45 kg were included in group B (n=25) and ≥45 kg were included in group C (n=20), venous blood and cord venous blood was collected. An ELISA kit was used to evaluate the concentration of adiponectin, leptin, visfatin, and IGF-1, correlations between index-index and index-calf birth weight were analysed. In both cows venous and cord venous blood, adiponectin, leptin, visfatin, and IGF-1 levels were significantly correlated with each other (p⟨0.01), and levels of these adipokines in venous blood were significantly higher than cord venous blood (p⟨0.01). Adiponectin, leptin, visfatin, and IGF-1 in venous cord blood were positively correlated with calf birth weights, and significantly correlated with calf birth weights respectively (p⟨0.01). Our study showed that adiponectin, leptin, and IGF-1 were found in venous blood and cord venous blood, and adiponectin, leptin, and IGF-1 in venous and cord venous blood potentially inter-regulated each other; adiponectin, leptin, and IGF-1 in venous blood were not significantly correlated with calf birth weights, while adiponectin, leptin, visfatin, and IGF-1 in venous cord blood were significantly correlated with calf birth weights, respectively.

Phase-space matching between bent Laue and flat Bragg crystals

Through phase-space analysis of Dumond diagrams for a flat Bragg crystal, a single bent Laue crystal and a monochromator consisting of double-bent Laue crystals, this work shows that it is possible to match the flat Bragg crystal to both the single-crystal and double-crystal Laue monochromators. The matched system has the advantage that the phase space of the bent crystal's output beam is much larger than that of the flat crystal, making the combined system stable. Here it is suggested that such a matched system can be used at synchrotron facilities to realize X-ray dark-field imaging, analyzer-based imaging and diffraction-enhanced imaging at beamlines using double-Laue monochromators.

Mutation Analysis of Pre-mRNA Splicing Genes PRPF31, PRPF8, and SNRNP200 in Chinese Families with Autosomal Dominant Retinitis Pigmentosa

BACKGROUND

To screen variants in pre-mRNA Splicing genes in 95 Chinese autosomal dominant retinitis pigmentosa (adRP) families.

METHODS

Clinical examination and pedigree analysis were performed. Targeted exome sequencing (TES) and / or Sanger sequencing were performed to detect the variants in genes of Splicing factors and conduct intra-familiar segregation analysis with DNA available. In silico analysis was performed to predict pathogenicity of variants in protein level and in vitro splicing assays were performed to compare splicing variants with their corresponding wildtype about their splicing effect.

RESULTS

In this study, total nine different variants were identified in PRPF31, SNRNP200, and PRPF8 respectively, including six PRPF31 variants [five novel variants 322+1G>A, c.527+2T>G, c.590T>C(p.Leu197Pro), c.1035_1036insGC (p.Pro346Argfs X18), and c.1224dupG (p.Gln409AlafsX66) plus one reported variant c.1060C>T (p.Arg354X)], a recurrent PRPF8 variant c.6930G>T (p.Arg2310Ser), two SNRNP200 variants [one heterozygous and homozygous SNRNP200 recurrent variant c.3260G>A (p.Ser1087Leu), and a reported heterozygous c.2042G>A(p.Arg681His)]. In family 20009, incomplete penetrance was observed. A novel PRPF31 missense variant c.590T>C (p.Leu197Pro) was predicted to be pathogenic in protein level via in silico analysis and in vitro splicing assay demonstrated that two novel splicing PRPF31 variants c.322+1G>A and c.527+2T>G affect splicing compared with the wildtype.

CONCLUSIONS

In our studies, RP-causing variants of pre-mRNA Splicing genes (PRPF31, PRPF8 and SNRNP200) were identified in nine of the ninety-five adRP families respectively, which extend the spectra of RP variant and phenotype. And we provide the first example that SNRNP200-related RP can be caused by both heterozygous and homozygous variants of this gene.

Comparison of microRNAs in adipose and muscle tissue from seven indigenous Chinese breeds and Yorkshire pigs

Elucidation of the pig microRNAome is essential for interpreting functional elements of the genome and understanding the genetic architecture of complex traits. Here, we extracted small RNAs from skeletal muscle and adipose tissue, and we compared their expression levels between one Western breed (Yorkshire) and seven indigenous Chinese breeds. We detected the expression of 172 known porcine microRNAs (miRNAs) and 181 novel miRNAs. Differential expression analysis found 92 and 12 differentially expressed miRNAs in adipose and muscle tissue respectively. We found that different Chinese breeds shared common directional miRNA expression changes compared to Yorkshire pigs. Some miRNAs differentially expressed across multiple Chinese breeds, including ssc-miR-129-5p, ssc-miR-30 and ssc-miR-150, are involved in adipose tissue function. Functional enrichment analysis revealed that the target genes of the differentially expressed miRNAs are associated mainly with signaling pathways rather than metabolic and biosynthetic processes. The miRNA-target gene and miRNA-phenotypic traits networks identified many hub miRNAs that regulate a large number of target genes or phenotypic traits. Specifically, we found that intramuscular fat content is regulated by the greatest number of miRNAs in muscle tissue. This study provides valuable new candidate miRNAs that will aid in the improvement of meat quality and production.

Serum IgG Antibodies against Periodontal Microbes and Cancer Mortality

INTRODUCTION

Periodontitis is a chronic inflammatory condition initiated by microorganisms and is positively linked to systemic conditions such as cancer, cardiovascular disease, and diabetes mellitus.

OBJECTIVES

To prospectively investigate associations between empirically derived clusters of IgG antibodies against 19 selected periodontal microorganisms and cancer mortality in a representative sample of the US population.

METHODS

We evaluated 6,491 participants aged ≥40 y from the Third National Health and Nutrition Examination Survey (1988 to 1994), who had complete data on IgG antibody titers against 19 selected periodontal microorganisms and were free of cardiovascular disease and cancer. In a prior study, antibodies were categorized into 4 mutually exclusive groups via cluster analysis: red-green, orange-red, yellow-orange, and orange-blue. Cluster scores were estimated by summing z scores of the antibody titers making up each cluster. Participants were followed up to death until December 31, 2011. Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% CIs for all-cancer mortality by tertiles of cluster scores.

RESULTS

During follow-up for a median of 15.9 y, there were 2,702 deaths (31.3%), including 631 cancer-related deaths (8.1%). After adjusting for multiple confounders, the orange-blue cluster was inversely associated with cancer mortality (tertile 2 vs. tertile 1: HR = 0.67, 95% CI = 0.54 to 0.84; tertile 3 vs tertile 1: HR = 0.62, 95% CI = 0.46 to 0.84). The association between the yellow-orange cluster and all-cancer mortality was also inverse but not significant, and the orange-red cluster and the red-green cluster were not associated with all-cancer mortality.

CONCLUSIONS

Antibodies against Eubacterium nodatum and Actinomyces naeslundii may be novel predictors of cancer mortality. If further studies establish a causal relationship between these antibodies and cancer mortality, they could be targets to prevent possible systemic effects of periodontal disease with potential interventions to raise their levels.

KNOWLEDGE TRANSFER STATEMENT

Periodontal antibodies against Eubacterium nodatum and Actinomyces naeslundii were inversely associated with cancer mortality among adults followed up for an average of 16 y. Periodontal antibodies may predict cancer mortality.

RNA-seq of circular RNAs identified circPTPN22 as a potential new activity indicator in systemic lupus erythematosus

Background

Circular RNAs (circRNAs) are possible biomarkers for many diseases, but the knowledge of circRNAs in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE) remains limited. This study aimed to assess the expression of circRNAs in PBMCs from patients with SLE and healthy individuals by RNA sequencing (RNA-seq).

Methods

In total, 128 circRNAs were significantly differentially expressed including 39 upregulated and 89 downregulated circRNAs in four new-onset SLE patients compared with three healthy controls. After verification of the four candidate circRNAs in 49 patients with SLE and 37 controls using quantitative real-time polymerase chain reaction (qRT-PCR) assays, a previously undescribed circRNA with potential translation activity, circPTPN22, was selected to confirm its clinical significance.

Results

Bioinformatics analysis demonstrated that the parent gene of circPTPN22 was protein tyrosine phosphatase non-receptor type 22 (PTPN22), a potent regulator of T cell activation. The downregulation of circPTPN22 in patients with SLE was strongly negatively correlated with their Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. circRNA-miRNA-mRNA co-expression network analysis indicated a correlation between circPTPN22 and the miRNAs and mRNAs related to immunological regulation including the development of SLE. Patients with higher SLEDAI scores had lower circPTPN22 expression levels, and long-term hormone treatment significantly increased circPTPN22 levels. Receiver operating characteristic curve analysis indicated that circPTPN22 has good diagnostic value for SLE.

Conclusion

Our data demonstrated the aberrant expression of circRNAs in patients with SLE compared with healthy controls; circPTPN22 might function as a diagnostic and disease severity indicator in SLE.

Abstract P6-03-01: Development of patient-derived xenograft tumor model with organ-specific metastatic potential for evaluation of new therapeutics for hormone receptor-positive advanced breast cancer

Background: Breast cancer (BC) is a heterogeneous disease with most common metastatic sites of liver, lung, brain, and bone. Endocrine resistance in hormone receptor-positive (HR+) advanced BC (ABC) cancer is a clinical challenge. ESR1 mutations are a key mechanism in acquired resistance, primarily occurs after exposure to endocrine therapy such as aromatase inhibitors but also selective estrogen modulators and degraders (i.e. Tamoxifen and Fulvestrant). Circulating tumor cells (CTCs) enumeration is a prognostic biomarker in ABC but the relation between the onset of ESR1 mutations and CTCs status is still unclear. Aim of this project is to define the clinical behavior of ESR1 mutated ABC in terms of metastasizing potential, through CTC enumeration and pattern; and to establish ESR1 mutated HR+ ABC PDX models able to recapitulate these characteristics.

Methods: CTCs and circulating tumor DNA (ctDNA) were characterized in 55 HR+ ABC patients. ESR1 mutations status from 55 patient plasma cell-free DNA were generated using Guardant Next Generation Sequencing. Samples were also examined for numbers of CTCs by CellSearch. Association of ESR1 mutations with sites of distant organ metastasis and with CTC enumeration was analyzed by Chi square test and Kruskal–Wallis test, respectively. In preclinical model development, six samples of pleural effusion-derived tumor cells from Stage IV HR+ ABC patients were collected to establish HR+ ABC with ESR1 mutation PDX tumor model and its derived 3D organoid/spheroid cultures

Results: ESR1 mutations were identified in 10 out of 55 patients (4 Y537S variant and 3 D538G variant, 4 other variants, 1 patient with both variants). In 55 patients, 72 visceral vs 27 bone metastatic incidences were observed; the data indicated 9 observed vs 4.5 expected in ESR1 mutated and 16 observed vs 20.5 expected in wild type (WT) (P=0.003) for liver metastasis; 10 observed vs 7.1 expected in ESR1 mutated and 29 observed vs 31.9 expected in WT (P=0.026) for bone metastasis. Further liver metastasis analysis of individual hot spot mutation site indicated 4 observed vs 1.8 expected in Y537S and 21 observed vs 23.2 expected in WT (P=0.037); and 3 observed vs 1.4 expected in D538G and 22 observed vs 23.6 expected in wild type (P=0.088). The analysis of correlation/distribution between CTCs numbers and ESR1 mutated suggested CTCs median of 13 (IQR 7-49) in ESR1 mutated and 0 (IQR 0-4) in WT HR+ patients (P=0.0044). Four ABC PDX tumor models were developed in immunodeficient NSG female mice demonstrated by pathology to have highly heterogeneous characteristics and metastatic features of the origin patient tumor, in particular, breast fat pad xenografted PDX tumor can result in metastasis to liver and lung tissue. In addition, two patient 3D tumor organoid/spheroid cultures were successfully established.

Conclusions: ESR1 mutated ABC is associated with more aggressive (Stage IV) clinical behavior demonstrated by association with visceral metastases and CTCs detection. ESR1-mutated PDX models recapitulate aggressive features of the disease and can be used for preclinical testing of novel agents in endocrine resistant disease.

Citation Format: Qiang W, Zhong Z, Gerratana L, Zhang Y, Zhang Q, Gursel D, Wei J-J, Bleher R, James C, O'Halloran T, Cristofanilli M. Development of patient-derived xenograft tumor model with organ-specific metastatic potential for evaluation of new therapeutics for hormone receptor-positive advanced 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 P6-03-01.

Divergent patterns of soil phosphorus discharge from water-level fluctuation zone after full impoundment of Three Gorges Reservoir, China

Phosphorus (P) discharged from soils in the water-level fluctuation (WLF) zone becomes increasingly important to the water quality control of the Three Gorges Reservoir (TGR) as the decrease in P input from upstream reaches and point-source pollution. To investigate the amount of soil P discharge from the WLF zone since the full impoundment of the TGR in 2010, soil and sediment samples were collected along the altitudinal gradients (140, 150, 160, 170, and 180 m above sea level) in three transects in the middle reaches of the TGR. Soil P composition was determined by a sequential extraction procedure. Different amounts of P discharge from the WLF zone were found among three soil types because of their difference in the initial P content before impoundment, with an order of yellow earth (171.1 g m^-2), fluvo-aquic soil (141.7 g m^-2), and purple soil (73.8 g m^-2). An altitudinal pattern of soil P discharge was observed with the maximum at the 170-m sites. The downward transport of exchangeable P and clay-bound P with runoff was the major path of the soil P discharge at the 170-m sites with a slope gradient > 15°. Considerable P discharge with erosion at the upper section of the WLF zone was facilitated by the longer exposure period compared with that at bottom section (150-m sites) because of the annual anti-seasonal impoundment-exposure cycles of the TGR. The transformation of Al/Fe-P and subsequent release to water was a main mechanism of the soil P discharge during the impoundment period. The altitudinal pattern of P discharge was a result of joint effects of slope gradient, soil P forms, and the anti-seasonal hydrological regime of the TGR. The results highlight the critical role of the upper section (165-175 m) in controlling the P output from the WLF zone into the water of the TGR.

The impact of timing of maternal influenza immunization on infant antibody levels at birth

Pregnant women and infants are at an increased risk of severe disease after influenza infection. Maternal immunization is a potent tool to protect both these at-risk groups. While the primary aim of maternal influenza vaccination is to protect the mother, a secondary benefit is the transfer of protective antibodies to the infant. A recent study using the tetanus, diphtheria and acellular pertussis (Tdap) vaccine indicated that children born to mothers immunized in the second trimester of pregnancy had the highest antibody titres compared to children immunized in the third trimester. The aim of the current study was to investigate how the timing of maternal influenza immunization impacts infant antibody levels at birth. Antibody titres were assessed in maternal and cord blood samples by both immunoglobulin (Ig)G-binding enzyme-linked immunosorbent assay (ELISA) and haemagglutination inhibition assay (HAI). Antibody titres to the H1N1 component were significantly higher in infants born to mothers vaccinated in either the second or third trimesters than infants born to unvaccinated mothers. HAI levels in the infant were significantly lower when maternal immunization was performed less than 4 weeks before birth. These studies confirm that immunization during pregnancy increases the antibody titre in infants. Importantly, antibody levels in cord blood were significantly higher when the mother was vaccinated in either trimesters 2 or 3, although titres were significantly lower if the mother was immunized less than 4 weeks before birth. Based on these data, seasonal influenza vaccination should continue to be given in pregnancy as soon as it becomes available.

[Role of Testin in nasopharyngeal squamous cancer with high ability of metastasis]

Objective:To explore the influence and regulatory mechanism of TES gene on proliferation and migration of nasopharyngeal squamous cancer(NSPC) 5-8F cell.Method:DNA fragment encoding TES was obtained by RT-PCR method from the human highly metastatic nasopharyngeal squamous carcinoma cell line 5-8F. we identified the recombinant plasmid pEGFP-N1-TES by RT-PCR and DAN sequencing. we stablely transfected the pEGFP-N1-TES into the human highly metastatic nasopharyngeal squamous carcinoma cell line 5-8F, and detected the expression of TES by the RT-PCR and Western-blot method. And detected the impact of 5-8F cells transfection by flow cytometry and scratch tests.Result:Flow cytometry analysis showed that the apoptotic in 5-8F/pEGFP- N1-TES was significantly higher than non-transected TES and 5-8F/pEGFP-N1,and the differences were statistically significant(P<0.05).Cell scratch experiments showed that the 5-8F/pEGFP-N1-TES group cell migration rate was obviously lower than nontransected TES and 5-8F/pEGFP-N1 group in the first 12 h, 24 h and 48 h.The difference was significant(P<0.01).Conclusion:The stable transfectant cell model was established successfully. TES in vitro could significantly increase apoptosis and reduce the athletic ability. And thus TES gene might be a novel candidate of tumor-suppressor.

Localized Control of Curie Temperature in Perovskite Oxide Film by Capping-Layer-Induced Octahedral Distortion

With reduced dimensionality, it is often easier to modify the properties of ultrathin films than their bulk counterparts. Strain engineering, usually achieved by choosing appropriate substrates, has been proven effective in controlling the properties of perovskite oxide films. An emerging alternative route for developing new multifunctional perovskite is by modification of the oxygen octahedral structure. Here we report the control of structural oxygen octahedral rotation in ultrathin perovskite SrRuO_{3} films by the deposition of a SrTiO_{3} capping layer, which can be lithographically patterned to achieve local control. Using a scanning Sagnac magnetic microscope, we show an increase in the Curie temperature of SrRuO_{3} due to the suppression octahedral rotations revealed by the synchrotron x-ray diffraction. This capping-layer-based technique may open new possibilities for developing functional oxide materials.