EGFR Inhibitor CL-387785 Suppresses the Progression of Lung Adenocarcinoma

OBJECTIVE

This study aimed to explore the influence of the irreversible EGFR inhibitor CL-387785 on invasion, metastasis, and radiation sensitization of non-small cell lung cancer cells.

METHODS

The proliferation inhibitory rate at different time points was detected by MTT assay. The apoptosis of H1975 cells treated with CL-387785 was detected using flow cytometry. The invasion and migration of H1975 cells treated with CL-387785 were determined by Transwell assay and wound healing assay. The survival fraction (SF) of H1975 cells cultured with CL- 387785 under X-ray (0, 2, 4, 6, 8, and 10 Gy) was detected by cloning formation experiment, and the sensitization ratio (SER) was calculated by clicking the multi-target model to fit the cell survival curve.

RESULTS

CL-387785 restrained H1975 cell proliferation in a concentration- and time-dependent manner. CL-387785 promoted H1975 cell apoptosis and reduced cell migration distance and the number of transmembrane cells. The SF treated by different concentrations of CL-387785 (10, 25, 50, and 100 nM) was all below 0 nM. The radiation SER of CL-387785 (10, 25, 50 and 100 nM) were 1.17, 1.39, 2.88, and 3.64, respectively.

CONCLUSION

The invasion and metastasis of H1975 cells were restrained by irreversible EGFR inhibitor CL-387785. CL-387785 also exhibited the effect of radiotherapy sensitization.

Hypoxia-induced PVT1 promotes lung cancer chemoresistance to cisplatin by autophagy via PVT1/miR-140-3p/ATG5 axis

Lung cancer is one of the most common and lethal malignant tumors and the cases increased rapidly. Elevated chemoresistance during chemotherapy resistance remains a challenge. Hypoxia is one of the components that lead to chemoresistance. PVT1 participates in various tumor drug resistance and is associated with hypoxia conditions. The present study aimed to analyze the regulatory relationship of hypoxia and PVT1 and the mechanism of PVT1 in the hypoxia-induced chemoresistance process of lung cancer. The expression of PVT1 in lung cancer and adjacent tissues, and cell lines were analyzed using the TCGA database and qPCR. The regulatory relationship between hypoxia and PVT1 was validated and analyzed with qPCR, luciferase reporter system, and CHIP-qPCR. The role of PVT1 in chemoresistance ability induced by hypoxia was analyzed with CCK-8 assay and flow cytometry. The roles of PVT1, hypoxia, and chemoresistance were also analyzed with LC3-GFP transfection, WB, and IHC. Finally, the results were further validated in xenograft models. PVT1 is highly expressed in lung cancer and cell lines, and the expression of PVT1 is regulated by HIF-1α, and the luciferase reporter assay and CHIP-qPCR analysis indicated that HIF-1α could bind to the promoter region of PVT1 and regulate PVT1 expression. PVT1 participated in hypoxia-induced chemoresistance and induced higher viability and lower apoptosis rate by the autophagy signaling pathway via PVT1/miR-140-3p/ATG5 axis. All the findings were validated in the xenograft models. In conclusion, these results suggest that the expression of PVT1 is regulated by HIF-1α and participates in hypoxia-induced chemoresistance.

21 One-Shot Tract Dilatation for Supine Percutaneous Nephrolithotomy (PCNL) in Obese Patients

Introduction

With the rising incidence of both obesity and urolithiasis, the need to perform stone surgery in high BMI patients is increasing. We analysed the safety and efficacy of the one-shot tract dilatation (OSD) technique in obese patients undergoing supine percutaneous nephrolithotomy (PCNL).

Method

Retrospective review of all supine PCNLs performed by a single surgeon between January 2014 and December 2020. Patient factors (age and BMI), stone complexity and procedural characteristics (tract size and dilatation technique) were collected. Outcomes included access success, length of stay, operating duration, and inpatient complications.

Results

Overall 104 supine PCNLs were performed in 93 patients. Forty-four had a BMI >/ =  30 kg/m2 with a median age of 53 years, median BMI 35.12 kg/m2 and median Guy’s stone score of 2. When initial puncture was successful (43 cases (98%)), tract dilatation was satisfactory on all occasions. Dilatation was performed using a balloon dilator (24Ch) in 12 cases and OSD in 31 cases (range 16Ch to 24Ch, median 22Ch). Median length of stay was lower when OSD used (1 day) versus balloon (2 days), P = 0.03. Median operating time using OSD was 98 minutes versus 120 minutes using balloon (P = 0.10). There was no significant difference in operative time or length of stay when using OSD compared with BMI < 30 kg/m2. There were two Clavien-Dindo Grade I and one Grade II complications in patients where OSD was used. No transfusions were required.

Conclusions

One shot dilatation is an effective and safe means of access in obese patients when performing a supine PCNL.

Xanthorrhizol inhibits non-small cell carcinoma (A549) cell growth and promotes apoptosis through modulation of PI3K/AKT and NF-κB signaling pathway

Xanthorrhizol (XNT) is a sesquiterpenoid agent isolated from Curcuma xanthorrhiza; It is known to exhibit various pharmacological activities including anti-cancer. We investigated the anti-cell proliferative and proapoptotic effects of XNT on Non-small cell carcinoma (A549) cells were analyzed by the generation of reactive oxygen species (ROS), alteration of mitochondrial membrane potential (ΔΨm), oxidative DNA damage, and apoptosis morphological changes were explored by Hoechst and AO/EtBr staining. Our study demonstrated that XNT treatment significantly reduced the viability of A549 cells in a concentration-dependent manner. We observed that XNT-induced oxidative stress-mediated apoptotic cell death by increasing intracellular ROS generation, depleting antioxidant levels, enhancing lipid peroxidation, increased apoptotic morphological changes, and % of DNA damage on human lung cancer cells. Furthermore, we observed that the XNT induce apoptosis through inhibits phosphorylation of PI3K, AKTand inhibit NF-κBp65 transcriptional signaling activity. In addition, XNT treatment alters the ΔΨm, thereby induces apoptosis was closely coordinated with the induction of pro-apoptotic markers Bax, Bad, caspase- 3, 9 and cytochrome c, and suppression of anti-apoptotic (Bcl-2, Bcl-XL) protein expression. According to our results, XNT-inducing apoptosis in A549 cells by causing oxidative damage and modulating apoptotic signaling events. Finally, XNT-induced apoptotic cell death was confirmed by the TUNEL assay. Therefore, XNT might be used as a chemotherapeutic agent for the treatment of lung cancer.

Genome-wide identification studies - A primer to explore new genes in plant species

Genome data have accumulated rapidly in recent years, doubling roughly after every 6 months due to the influx of next-generation sequencing technologies. A plethora of plant genomes are available in comprehensive public databases. This easy access to data provides an opportunity to explore genome datasets and recruit new genes in various plant species not possible a decade ago. In the past few years, many gene families have been published using these public datasets. These genome-wide studies identify and characterize gene members, gene structures, evolutionary relationships, expression patterns, protein interactions and gene ontologies, and predict putative gene functions using various computational tools. Such studies provide meaningful information and an initial framework for further functional elucidation. This review provides a concise layout of approaches used in these gene family studies and demonstrates an outline for employing various plant genome datasets in future studies.

The mechanism of radiotherapy for lung adenocarcinoma in promoting protein SIRT6-mediated deacetylation of RBBP8 to enhance the sensitivity of targeted therapy

Background

Lung cancer has the fastest increase in morbidity and mortality, and is one of the most threatening malignant tumors to human health and life. Both radiotherapy and targeted therapy are typical treatments after lung cancer surgery. Radiotherapy is a means of locally killing cancer lesions, and it plays an important role in the entire management of lung cancer. Gefitinib is one of the most commonly used targeted therapy drugs in the treatment of lung cancer. The purpose of this project is to explore the mechanism by which deacetylation of RBBP8 mediated by radiotherapy-promoting protein SIRT6 in lung adenocarcinoma enhances the sensitivity of targeted therapy.

Methods

In both the cell experiments and the animal experiments, the samples were divided into five groups: Model group, RT group, CT group, RT+CT group, and RT+CT+inhibitor group. The CCK8 method was used to detect the viability of each group of cells. The flow cytometry experiment was used to analyze the apoptotic characteristics of each group of cells. The scratch test was used to detect the migration ability of each group of cells. Transwell invasion test was used to determine the invasion ability of each group of cells. The lung tumor tissues of each group of mice were collected to analyze the tumor size, volume, and metastasis characteristics. The TUNEL experiment was used to detect the apoptosis characteristics of the cells in the lung cancer tissues of each group mice. Immunohistochemistry experiments were used to analyze the distribution and relative expression characteristics of protein SIRT6 in mouse lung cancer tissues. The colorimetric experiments were used to detect the activity of Caspase 3 and Caspase 8 in each group. Western blot method was used to detect the expression of SIRT6, RBBP8, and MYC in each group.

Results

In each experiment, the results of the experiment have mutually proven consistency, and there is no contradiction. In addition to the Model group, the other 4 groups used different treatment methods. The better the curative effect, the lower the cell viability of cancer cells and the higher the apoptotic ratio. This is reflected in the CCK8 test, flow cytometry analysis, cell scratch test, Transwell cell migration test, and TUNEL detection. At the same time, colorimetric detection and Western blot analysis also analyzed the levels of SIRT6, RBBP8 and other cancer-related proteins in each group at the molecular level, implying the importance of SIRT6 protein in the treatment process.

Conclusion

Our project has proved that radiotherapy can promote the protein SIRT6 to deacetylate RBBP8 proteins, and ultimately enhance targeted therapy drug sensitivity.

A constriction channel analysis of astrocytoma stiffness and disease progression

Studies have demonstrated that cancer cells tend to have reduced stiffness (Young's modulus) compared to their healthy counterparts. The mechanical properties of primary brain cancer cells, however, have remained largely unstudied. To investigate whether the stiffness of primary brain cancer cells decreases as malignancy increases, we used a microfluidic constriction channel device to deform healthy astrocytes and astrocytoma cells of grade II, III, and IV and measured the entry time, transit time, and elongation. Calculating cell stiffness directly from the experimental measurements is not possible. To overcome this challenge, finite element simulations of the cell entry into the constriction channel were used to train a neural network to calculate the stiffness of the analyzed cells based on their experimentally measured diameter, entry time, and elongation in the channel. Our study provides the first calculation of stiffness for grades II and III astrocytoma and is the first to apply a neural network analysis to determine cell mechanical properties from a constriction channel device. Our results suggest that the stiffness of astrocytoma cells is not well-correlated with the cell grade. Furthermore, while other non-central-nervous-system cell types typically show reduced stiffness of malignant cells, we found that most astrocytoma cell lines had increased stiffness compared to healthy astrocytes, with lower-grade astrocytoma having higher stiffness values than grade IV glioblastoma. Differences in nucleus-to-cytoplasm ratio only partly explain differences in stiffness values. Although our study does have limitations, our results do not show a strong correlation of stiffness with cell grade, suggesting that other factors may play important roles in determining the invasive capability of astrocytoma. Future studies are warranted to further elucidate the mechanical properties of astrocytoma across various pathological grades.

Setting the new FRAX reference threshold without bone mineral density in Chinese postmenopausal women

PURPOSE

Despite the large number of osteoporosis patients in China, the diagnosis and treatment rates remain low. The Fracture Risk Assessment Tool (FRAX) can be used to effectively evaluate fracture risk. In this study, we explored the Chinese-specific thresholds of FRAX without the T-score.

METHODS

In all, 264 postmenopausal women aged > 50 years were randomly recruited from community-medical centers. All subjects completed self-reported questionnaires, BMD measurements, and spinal radiographs. The 10-year hip and major osteoporotic fracture risks were calculated by FRAX. A new threshold for both 10-year hip and major osteoporotic fracture risk was explored with receiver operating characteristic (ROC) curve analysis.

RESULTS

Overall, 92 subjects were diagnosed with osteoporosis. Among them, 14 participants with T-score > - 2.5 were diagnosed with osteoporosis based on clinical fractures. ROC analysis showed the cut-off value of the 10-year hip osteoporotic fracture for detecting osteoporosis was 0.95%, while that of 10-year major osteoporotic fracture was 4.95%. The sensitivity and specificity of the 10-year hip osteoporotic fracture probability for detecting osteoporosis were 0.86 and 0.59, respectively, while the guideline-recommended threshold had a sensitivity of 0.49 and specificity of 0.83. The sensitivity and specificity of the 10-year major osteoporotic fractures with the new threshold were 0.76 and 0.69, respectively, while the recommended threshold had a sensitivity of 0 and specificity of 1.

CONCLUSION

Current guideline-recommended FRAX thresholds without BMD showed low sensitivity. Therefore, 10-year osteoporotic hip fracture probability ≥ 0.95% and 10-year osteoporotic major fracture probability ≥ 4.95% are recommended as the new thresholds.

Comparison of therapeutic efficacy and mechanism of paclitaxel alone or in combination with methotrexate in a collagen-induced arthritis rat model

OBJECTIVE

To compare the therapeutic efficacy of paclitaxel (PTX) alone to its combination with methotrexate (MTX) on rheumatoid arthritis.

METHODS

A collagen-induced arthritis (CIA) rat model was established by induction of type II collagen. Rats were divided into blank control group, CIA model group, MTX group 1 mg/kg, PTX 1.5 mg/kg, PTX 2.5 mg/kg, PTX 3.5 mg/kg, and MTX 1 mg/kg + PTX 3.5 mg/kg, with 10 rats per group. The inflammation of the ankle joint was analyzed by H&E staining and interleukin (IL)-1β and IL‑6 expression was detected by immunohistochemistry. TUNEL assay was performed to detect synovial tissue cell apoptosis after administration of PTX and MTX either alone or in combination. TLR4 and p‑NF-κBp65 protein expression in synovial tissue and the changes of serum IL‑1β, IL‑6, IL‑12, MMP‑3, and TNFα protein factors were detected by western blot and ELISA, respectively.

RESULTS

PTX and MTX improved histopathological changes in CIA rats. Besides, the apoptosis rate of synovial tissue cells in the PTX 3.5 mg/kg group was more than that of the PTX + MTX group. Immunohistochemistry and western blot results indicated that PTX and MTX reduce the expression rate of IL‑6 and IL‑1β and downregulate TLR4 and p‑NF-κBp65 protein expression. Furthermore, TLR4 and p‑NF-κBp65 reduced the concentration of MMP‑3, IL‑12, IL‑6, IL1‑β, and TNFα.

CONCLUSION

Both PTX and MTX exert significant suppression on rheumatoid arthritis, and the combined effect of the two drugs is weaker than that of PTX alone. Moreover, intraperitoneal injection of PTX 3.5 mg/kg every other day was the optimal dose observed in this study.

Prognostic value of age-adjusted d-dimer cutoff thresholds in patients with myocardial infarction treated by percutaneous coronary intervention

Introduction

The association between D-dimer and outcomes of patients with myocardial infarction (MI) remains controversial. Using age-adjusted D-dimer cutoff thresholds significantly improves the accuracy of diagnosis for thrombotic diseases. This study aimed to investigate the prognostic value of age-adjusted D-dimer in MI patients treated by percutaneous coronary intervention (PCI).

Methods

In this observational study, 3614 consecutive patients with MI treated by PCI were retrospectively recruited. The baseline age-adjusted D-dimer threshold was 500 ng/mL, and was calculated as age × 10 in patients older than 50 years. Cox regression was used for outcome analysis. The primary outcome was all-cause death. Discrimination and reclassification were calculated to assess the additional prognostic value of D-dimer when combined with established clinical risk factors and the Global Registry of Acute Coronary Events (GRACE) risk score.

Results

During a median follow-up of 652 days, a total of 194 deaths occurred. High D-dimer level, as defined by age-adjusted thresholds, was an independent predictor for all-cause death (hazard ratio:1.67, 95% confidence interval: 1.23–2.27, P=0.001). Addition of D-dimer level (high or low) significantly improved risk classification for death when combined with established clinical risk factors (net reclassification index [NRI]: 0.601, P<0.001; integrated discrimination improvement [IDI]: 0.011, P=0.046) and GRACE score (NRI: 0.618, P<0.001; IDI: 0.015, P=0.011).

Conclusions

In patients with MI treated by PCI, D-dimer elevation defined by age-adjusted thresholds was an independent predictor for adverse outcomes, and provided additional prognostic value when combined with clinical risk factors and GRACE score.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Previous studies reported the cardiac protection effect of pre-infarction angina (PIA) in patients with acute myocardial infarction (AMI). However, the association between PIA and culprit plaques characteristics in AMI patients through optical coherence tomography (OCT)assessment remains unclear.

Purpose

We sought to identify culprit-plaque morphology associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using OCT.

Methods

A total of 279 STEMI patients who underwent intravascular OCT of culprit-lesion were included. Baseline clinical data and culprit-plaque characteristics were compared between the PIA group the non-PIA group.

Results

Patients with PIA represented 54.8% of the study population (153 patients). No differences were observed in clinical and angiographic data between two groups, except STEMI onset with exertion was significantly less common in PIA group (24.2% versus 40.5%, P=0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5% versus 61.9%, P<0.001) and lipid-rich plaques (48.4% versus 69.0%, P=0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3% versus 30.2%, P=0.070; 129.1±92.0μm versus 111.4±78.1μm, P=0.088; respectively). Multivariate logistic regression analysis indicated that PIA was an independent negative predictor for plaque rupture (odds ratio: 0.44, 95% confidence interval: 0.268–0.725, P=0.001).

Conclusion

STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit-lesion than non-PIA group, implying different mechanisms of STEMI attack.

Flow chart + Bar graphs of OCT findings

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: An optical coherence tomography study

Experimental studies on the protective effects of the overexpression of lentivirus-mediated sirtuin 6 on radiation-induced lung injury

BACKGROUND

Sirtuin 6 (SIRT6) can increase the radiosensitivity of non-small cell lung cancer and exert protective effects on radiation-induced lung injury.

OBJECTIVES

To investigate protective effects of SIRT6 overexpression on radiation-induced lung injury in rats.

MATERIAL AND METHODS

Male Wistar rats (n = 72) were randomly divided into 3 groups. Models were made by radiating both lungs with a 6MV X linear accelerator. Each group was injected through the tail vein with normal saline (the control group and radiation group) and lentivirus carrying overexpressed SIRT6 (the Lent-SIRT6 group) on the same day as the modeling. Routine blood indexes (white blood cells (WBC), red blood cells (RBC), neutrophils and lymphocytes) were recorded; the rats were sacrificed and their lung tissues taken; pathological changes in the lungs were evaluated using hematoxylin and eosin (H&E) staining; and tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and interleukin 1β (IL-1β) were detected with enzyme-linked immunosorbent assay (ELISA) 8 weeks after radiotherapy.

RESULTS

The lung structure including alveolar walls and interstitium in the control group was normal, but the alveolar walls in the radiation group were obviously thickened and a large amount of hyperplastic fibrous tissue was found in the alveolar interstitium. The thickness and interstitial fibrosis of the alveolar walls were more alleviated in the Lent-SIRT6 group than in the radiation group. Compared with those in the control group, the respiratory rates, levels of TNF-α and IL-6 in serum, neutrophils and levels of TNF-α, IL-6 and IL-1β in the liver all were increased, while WBCs and lymphocytes were decreased in the radiation group. The respiratory rates, levels of TNF-α and IL-6 in serum, neutrophils and levels of TNF-α, IL-6 and IL-1β in the liver were all decreased, and WBCs and lymphocytes were increased after injection with lentivirus carrying overexpressed SIRT6.

CONCLUSIONS

Sirtuin 6 inhibits inflammation and alleviates radioactive pneumonia and lung injury. Therefore, SIRT6 can exert certain protective effects on lung injury.

LncRNA HMMR-AS1 promotes proliferation and metastasis of lung adenocarcinoma by regulating MiR-138/sirt6 axis

Purpose: Long noncoding RNAs (lncRNA) play critical roles in cancer development. In this study, we aimed to explore the function and possible molecular mechanism of HMMR-AS1 involved in lung adenocarcinoma (LUAD).

Experimental Design: Firstly, we analyzed HMMR-AS1 expression in LUAD tissues with the sequencing data from The Cancer Genome Atlas (TCGA). Next, we evaluated the effects of HMMR-AS1 on LUAD cell proliferation and apoptosis, and its regulation of miR-138 by acting as a ceRNA. The animal model was used to support the in vitro experimental findings.

Results: HMMR-AS1 expression was significantly upregulated in LUAD tissues and was associated with larger tumor diameter, advanced TNM stage, lymph node metastasis, and shorter survival. Knockdown of HMMR-AS1 induced apoptosis and growth arrest in vitro and inhibited tumorigenesis in mouse xenografts. Mechanistically, HMMR-AS1 functioned as a ceRNA of miR-138, thereby leading to repression of its endogenous target sirt6. Moreover, knockdown of HMMR-AS1 dramatically inhibited tumor growth and metastasis of LUAD in vivo.

Conclusions: Taken together, HMMR-AS1 is significantly over-expressed in LUAD, and HMMR-AS1–miR-138–sirt6 axis play a critical role in LUAD tumorigenesis. Our findings highlight an oncogenic role of HMMR-AS1 in LUAD.

[Features of gut microbiota in patients with idiopathic Parkinson's disease]

Objectives: To investigate whether the fecal microbiome of Parkinson's disease patients differs from that of healthy population and explore the pathogenesis and new treatment of idiopathic Parkinson's disease. Methods: A total of 30 patients diagnosed as idiopathic Parkinson disease (PD group) in Beijing Friendship Hospital between April 2017 and June 2018 were enrolled and 30 healthy controls (NC group) were recruited at the same time.Medical records and score of unified Parkinson's disease rating scale (UPDRS) were collected and fresh fecal samples were obtained and stored in refrigerator (-80℃). The microbial compositions of fecal samples were investigated by 16S rRNA gene sequencing targeting the V3-V4 region. The taxa abundance and microbial composition were tested. Results: There was no difference of age and sex in PD and NC groups. Chao1 and Shannon indexes tended to be higher in PD group, yet failed to reach statistic significance (P=0.115 and 0.052). Relative abundance of gut microbiota differed in each taxonomic category. The relative abundance of Firmicutes in PD group was 53.6%(41.7%-64.8%), while that of Bacteroidetes in NC group was 51.7%(31.7%-65.3%). The ratios of Firmicutes to Bacteroidetes were significantly different between the two groups (1.6(0.9-3.4) vs 0.7(0.5-1.4), P=0.001). In Clostridia, Bacilli and Erysipelotrichia of Firmicutes, the relative abundances of Clostridiales, Christensenellaceae, Peptoclostridium, Lactobacillus and Erysipelatoclostridium were higher in PD group (P=0.024, 0.046, 0.036, 0.022 and 0.037). The relative abundance of Prevotella of Bacteroidales, was lower in PD group, yet failed to reach statistic significance (P=0.121). The relative abundances of Alistipes of Rikenellaceae and Butyricimonas of Marinilabiliales in PD group were significantly higher than those in NC group (P=0.047 and 0.033). The relative abundance of Bifidobacterium of Actinobacteria was significanly higher in PD group when compared with NC group (P=0.009). Despite the relatively low abundance, Akkermansia of Verrucomicrobia was significantly higher in PD group than in NC group (P=0.025). Conclusion: The structures of the fecal microbiota differ significantly between PD patients and healthy controls.

Assessment of Apparent Internal Carotid Tandem Occlusion on High-Resolution Vessel Wall Imaging: Comparison with Digital Subtraction Angiography

BACKGROUND AND PURPOSE

Not all tandem occlusions diagnosed on traditional vascular imaging modalities, such as MRA, represent actual complete ICA occlusion. This study aimed to explore the utility of high-resolution vessel wall imaging in identifying true ICA tandem occlusions and screening patients for their suitability for endovascular recanalization.

MATERIALS AND METHODS

Patients with no signal in the ICA on MRA were retrospectively reviewed. Two neuroradiologists independently reviewed their high-resolution vessel wall images to assess whether there were true tandem occlusions and categorized all cases into intracranial ICA occlusion, extracranial ICA occlusion, tandem occlusion, or near-occlusion. DSA classified patient images into the same 4 categories, which were used as the comparison with high-resolution vessel wall imaging. The suitability for recanalization of occluded vessels was evaluated on high-resolution vessel wall imaging compared with DSA.

RESULTS

Forty-five patients with no ICA signal on MRA who had available high-resolution vessel wall imaging and DSA images were included. Among the 34 patients (34/45, 75.6%) with tandem occlusions on DSA, 18 cases also showed tandem occlusions on high-resolution vessel wall imaging. The remaining 16 patients, intracranial ICA, extracranial ICA occlusions and near-occlusions were found in 2, 6, and 8 patients, respectively, on the basis of high-resolution vessel wall imaging. A total of 20 cases (20/45, 44.4%) were considered suitable for recanalization on the basis of both DSA and high-resolution vessel wall imaging. Among the 25 patients deemed unsuitable for recanalization by DSA, 11 were deemed suitable for recanalization by high-resolution vessel wall imaging.

CONCLUSIONS

High-resolution vessel wall imaging could allow identification of true ICA tandem occlusion in patients with an absence of signal on MRA. Findings on high-resolution vessel wall imaging can be used to screen more suitable candidates for recanalization therapy.

Dual roles of misshapen/NIK-related kinase (MINK1) in osteoarthritis subtypes through the activation of TGFβ signaling

OBJECTIVE

To identify the role of misshapen/NIK-related kinase (MINK1) in age-related Osteoarthritis (OA) and injury-induced OA, and the effects of enhanced TGFβ signaling in these progresses.

DESIGN

The effect of MINK1 was analyzed with MINK1 knock out (Mink1-/-) mice and C57BL/6J mice. OA progress was studied in age-related OA and instability-associated OA (destabilization of the medial meniscus, DMM) models. The murine knee joint was evaluated through histological staining, Osteoarthritis Research Society International (OARSI) scores, immunohistochemistry, and μCT analysis. Primary chondrocytes were isolated from wild type and Mink1-/- mice and subjected to osteogenic induction and Western blot analysis.

RESULTS

MINK1 is highly expressed during cartilage development and in normal cartilage. Mink1-/- mice displayed markedly lower OARSI scores, aggrecan degradation neoepitope positive cells and increased Safranin O and pSMAD2 staining in aging-related OA model. However, in injury-induced OA, loss of MINK1 accelerates extracellular matrix (ECM) destruction, osteophyte formation, and subchondral bone sclerosis. Accelerated subchondral bone remodeling in Mink1-/- mice was accompanied with increased numbers of nestin-positive mesenchymal stem cells (MSCs) and osterix-positive osteoprogenitors. pSMAD2 staining was increased in the subchondral bone marrow of Mink1-/- mice and overexpression of MINK1 inhibited SMAD2 phosphorylation in vitro.

CONCLUSIONS

This study shows for the first time that activation of TGFβ/SMAD2 by MINK1 deficiency plays opposite roles in aging-related and injury-induced OA. MINK1 deficiency protects cartilage from degeneration in aging joints through increased SMAD2 activation in chondrocytes, while accelerating OA progress in injury-induced model through enhanced osteogenesis of MSCs in the subchondral bone. These findings provide insights for developing precision OA therapeutics targeting TGFβ/SMAD2 signaling.

106Plasma trimethylamine N-oxide is associated with culprit plaque characterization as assessed by optical coherence tomography in patients with acute myocardial infarction

Background

Previous study have demonstrated that plasma trimethylamine N-oxide (TMAO) is associated with vulnerable plaque characteristics as assessed by optical coherence tomography (OCT) in patients with coronary artery disease. However, the relation between TMAO and the culprit plaque characteristics as assessed by OCT in patients with acute myocardial infarction (AMI) exhibiting plaque rupture at the site of the culprit stenosis is unknown.

Objective

To explore the relation between plasma TMAO and coronary culprit plaque characterization assessed by OCT in AMI patients exhibiting plaque rupture.

Method

We prospectively enrolled 90 AMI patients with plaque rupture identified by OCT and collected demographic data, risk factors, coronary angiography and OCT data, medical history and laboratory findings of all patients. Plasma TMAO levels were detected by stable isotope dilution liquid chromatography tandem mass spectrometry. Macrophage presence in coronary culprit plaque was quantified by normalized standard deviation (NSD).

Result

All patients were divided into two groups (high TMAO group and low TMAO group) according to the median plasma TMAO level (3.22uM). The culprit plaques in the high TMAO group exhibited a thinner fibrous cap thickness (60um [60–100um] versus 90um [70–110um], P=0.013]), higher frequency of thin-cap fibroatheroma (TCFA) (15.6% versus 55.6%, P<0.001), microvessel (24.4% versus 4.4%, P=0.014) and macrophage infiltration (66.7% versus 26.7%, P<0.001) compared with the low TMAO group. Moreover, the level of TMAO was significantly positively associated with NSD (Pearson's correlation coefficient: r=0.766, P<0.001).

Conclusion

Plasma TMAO levels are associated with coronary plaque vulnerability and inflammation in patients with AMI exhibiting plaque rupture.

Acknowledgement/Funding

Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2016-I2M-1-009)

P819Post-procedural cholesterol and inflammatory risk in acute myocardial infarction patients undergoing percutaneous coronary intervention

Objective

This study sought to depict the combined association of post-procedural cholesterol and inflammatory risk with clinical outcomes among acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) and pick out patients with highest comprehensive risk.

Methods

A total of 4802 AMI-PCI patients were divided into quartiles according to post-procedural low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) level respectively and in combinations for risk analysis. Univariate and adjusted multivariate analysis with Cox model were performed. Hazard ratio (HR) for short-term (90 days) and long-term (1 year) were compared for major adverse cardiovascular events (MACE), including cardiac death, recurrent myocardial infarction and ischemic stroke.

Results

A significant change in the hazards of 90-day MACE was seen among patients in the highest quartile of post-procedural LDL-C [HR: 0.526 (0.291, 0.951), p=0.034] and highest quartile of CRP [HR: 2.119 (1.150, 3.920), p=0.016]. For 1-year outcomes, only a trend for increasing risk was seen in patients with higher post-procedural CRP (p-trend = 0.016). Combination analysis for cholesterol/inflammatory risk showed that patients lying simultaneously in the lowest quartile of LDL-C and highest quartile of CRP gained the highest risk in the 90-day [HR: 3.16 (1.124, 8.886), p=0.029] and 1-year [HR: 2.515 (1.153, 5.486), p=0.020] follow up.

Hazard ratios (HR) for short-term (90 days) and long-term (1 year) primary outcomes according to cholesterol and inflammatory risk 90 days 1 year Type of risk Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend LDL, mmol/L   Quartile 2 0.742 (0.441, 1,248) 0.260 0.663 (0.390, 1.125) 0.128 0.033 0.722 (0.364, 1.125) 0.150 0.683 (0.435, 1.072) 0.097 0.251   Quartile 3 0.653 (0.381, 1.121) 0.122 0.597 (0.344, 1.038) 0.068 0.850 (0.557, 1.229) 0.453 0.850 (0.550, 1.312) 0.462   Quartile 4 0.517 (0.288, 0.928) 0.027 0.526 (0.291, 0.951) 0.034 0.673 (0.427, 1.061) 0.088 0.708 (0.444, 1.131) 0.149 CRP, mg/L   Quartile 2 1.365 (0.717, 2.599) 0.334 1.295 (0.654, 2.522) 0.448 0.007 1.063 (0.656, 1.722) 0.805 0.998 (0.608, 1.636) 0.992 0.016   Quartile 3 1.306 (0.681, 2.502) 0.442 1.279 (0.654, 2.499) 0.472 0.999 (0.612, 1.630) 0.996 0.968 (0.586, 1.597) 0.897   Quartile 4 2.354 (1.312, 4.221) 0.004 2.119 (1.150, 3.920) 0.016 1.657 (1.069, 2.570) 0.024 1.528 (0.967, 2.413) 0.069 Multivariate analysis was adjusted for age, sex and traditional cardiovascular risk factors.

Combined cholesterol/inflammatory risk

Conclusion

AMI-PCI patients with lower post-procedural LDL-C and higher CRP might encounter greater cardiovascular risk. Patients with the lowest LDL-C and highest CRP gained extremely high risk and required special attention.

A population-based study of the association between food insecurity and potentially avoidable hospitalization among persons with diabetes using linked survey and administrative data

Background

Studies have found food insecurity to be more prevalent among persons with diabetes mellitus. Other research using areal-based measures of socioeconomic status have pointed to a social gradient in diabetes hospitalizations, but without accounting for individuals’ health status. Linking person-level data from health surveys to population-based hospital records enables profiling of the role of food insecurity with hospital morbidity, focusing on the high-risk diabetic population.

Objective

This national study aims to assess the association between income-related household food insecurity and potentially avoidable hospital admissions among community-dwelling persons living with diagnosed diabetes.

Methods

We use three cycles of the Canadian Community Health Survey (2007, 2008, and 2011) linked to multiple years of hospital records from the Discharge Abstract Database (2005/06 to 2012/13), covering 12 of Canada’s 13 provinces and territories. We apply multiple logistic regression for testing the association of household food insecurity with the risk of hospitalization for diabetes and common comorbid ambulatory care sensitive conditions among persons aged 12 and over living with diabetes.

Analysis

Data linkage allowed us to analyze inpatient hospital records among 10,260 survey respondents with diabetes; 590 respondents had been hospitalized at least once for diabetes or a common comorbid chronic physical or mental illness. The regression results indicated that the odds of experiencing a preventable hospital admission were significantly higher among persons with diabetes who were food insecure compared to their counterparts who were food secure (OR=1.66 [95%CI=1.24-2.23]), after controlling for age, sex and other characteristics.

Conclusion

We found food insecurity to significantly increase the odds of hospital admission for ambulatory care sensitive conditions among Canadians living with diabetes. These results reinforce the need to consider food insecurity in public health and clinical strategies to reduce the hospital burden of diabetes and other nutrition-related chronic diseases, from primary prevention to post-discharge care.

Radiosensitization effects of curcumin plus cisplatin on non-small cell lung cancer A549 cells

The aim of the present study was to determine the radiosensitization effect of the combination of curcumin and cisplatin on non-small cell lung cancer (NSCLC) A549 cells. Cell viability was analyzed using the MTT assay following treatment with different concentrations of curcumin and cisplatin for 24~72 h. Survival fraction (SF) value of the treatment groups (single irradiation, curcumin + irradiation, cisplatin + irradiation, and curcumin + cisplatin + irradiation) treated with different doses of X-ray radiation were evaluated using colony formation assay, according to a multi-target single-hit model. Migration and invasion as well as the levels of epidermal growth factor receptor (EGFR) protein following 24 h were detected by scratch wound assay, Matrigel assay and western blot analysis, respectively. The results of the present study demonstrated that the viability of the cells decreased after being treated by curcumin, and the inhibitory effect was dose and time-dependent as the concentration of curcumin increased from 10 to 200 µmol/l (P<0.05). SF value was lower in the curcumin + cisplatin + irradiation group compared with the other three treatment groups at 2~10 Gy. Furthermore, SF value was lower in the curcumin + irradiation group at 4~10 Gy. The SF value was also lower in the cisplatin + irradiation group at 2~10 Gy compared with the single irradiation group (P<0.05). The sensitization enhancement ratios in the curcumin + irradiation, cisplatin + irradiation, and curcumin + cisplatin + irradiation groups were 1.24, 1.31 and 1.96, respectively. The migration distance, the number of cells invaded through the transmembrane, and the level of EGFR protein in four treatment groups were the highest in the single irradiation group, compared with the other three treatment groups (P<0.05). Furthermore, the radiosensitization effects of curcumin and cisplatin on NSCLC A549 cells, which include inhibition of proliferation, migration and invasion, may be associated with the inhibition of the EGFR-associated signaling pathway.

Characterization of Ablation Thresholds for 3D-Cultured Patient-Derived Glioma Stem Cells in Response to High-Frequency Irreversible Electroporation

High-frequency irreversible electroporation (H-FIRE) is a technique that uses pulsed electric fields that have been shown to ablate malignant cells. In order to evaluate the clinical potential of H-FIRE to treat glioblastoma (GBM), a primary brain tumor, we have studied the effects of high-frequency waveforms on therapy-resistant glioma stem-like cell (GSC) populations. We demonstrate that patient-derived GSCs are more susceptible to H-FIRE damage than primary normal astrocytes. This selectivity presents an opportunity for a degree of malignant cell targeting as bulk tumor cells and tumor stem cells are seen to exhibit similar lethal electric field thresholds, significantly lower than that of healthy astrocytes. However, neural stem cell (NSC) populations also exhibit a similar sensitivity to these pulses. This observation may suggest that different considerations be taken when applying these therapies in younger versus older patients, where the importance of preserving NSC populations may impose different restrictions on use. We also demonstrate variability in threshold among the three patient-derived GSC lines studied, suggesting the need for personalized cell-specific characterization in the development of potential clinical procedures. Future work may provide further useful insights regarding this patient-dependent variability observed that could inform targeted and personalized treatment.

Effects of microRNA-513b on cell proliferation, apoptosis, invasion, and migration by targeting HMGB3 through regulation of mTOR signaling pathway in non-small-cell lung cancer

This study aimed to explore the underlying mechanism of miR-513b and HMGB3 in regulating non-small-cell lung cancer (NSCLC). NSCLC tumor, adjacent tissues, and cell lines were extracted, and the expression of miR-513b and HMGB3 were determined by quantitative real-time polymerase chain reaction (RT-qPCR) and western blot analysis. Then, miR-513b was overexpressed in NSCLC cell, and the proliferation, migration, invasion, and apoptosis of cells were determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), wound healing, transwell, and flow cytometry, respectively. Regulatory relationship between miR-513b and HMGB3 was determined using luciferase activity reporter assay. Lastly, HMGB3 and/or miR-513b were overexpressed in NSCLC cells, and the proliferation, migration, invasion, and apoptosis of cells were determined. Compared with the controls, the expression of miR-513b was significantly downregulated in the NSCLC tissues and cells lines by RT-qPCR ( p < 0.05). However, the expression of HMGB3 was significantly downregulated at both messenger RNA and protein levels ( p < 0.05). Overexpression of miR-513b could significantly inhibit the proliferation, invasion, migration, and promote apoptosis of NSCLC cells ( p < 0.05). HMGB3 was a target of miR-513b, and overexpression of HMGB3 could obviously reverse the effect of miR-513 on the proliferation, invasion, migration, and apoptosis of NSCLC cells ( p < 0.05). The present results could suggest miR-513b was downregulated in NSCLC and could regulate the proliferation, invasion, migration, and apoptosis of NSCLC cells via HMGB3.

SIRT6 overexpression inhibits HIF1α expression and its impact on tumor angiogenesis in lung cancer

OBJECTIVE

To investigate the effect of silencing information regulator 6 (SIRT6) on HIF1α expression of cell line A549 in non-small cell lung cancer and on tumor angiogenesis in lung cancer.

METHODS

Cell line A549 in the logarithmic growth phase was transfected with Ad-SIRT6 and Ad-null respectively. According to the study design, the cells were divided into control group, Ad-null group and Ad-SIRT6 group. The HIF1α and HIF2α mRNA expression in each group were detected by real-time quantitative PCR (qPCR). The level of prolyl hydroxylase (PHD) 1-3 after 48 h of Ad-SIRT6-transfected cell line A549 and the levels of VEGF-C, VEGF-D, VEGFR-2 and VEGFR-3 in the supernatants were determined by ELISA. The nude mice were injected subcutaneously with Ad-null or Ad-SIRT6 transfected cell line A549. The tumor volume was observed at 6, 12, 18, 24 and 30 d after inoculation, and the tumor mass was weighed at 30 d. Also, microvessel density (MVD) and the number of positive HIF1α and VEGF cells were detected by immunohistochemistry. The VEGF and HIF1α levels in tumor tissue were detected by ELISA and qPCR respectively.

RESULTS

qPCR showed that the levels of HIF-1α mRNA, VEGF-C, VEGF-D, VEGFR-2 and VEGFR-3 in the supernatant were decreased, the level of PHD2 was increased (P<0.05), and the levels of HIF-2α mRNA, PHD1 and PHD3 did not change much (P>0.05) in the Ad-SIRT6 group as compared with those in the control group and Ad-null group. The tumor growth rate was decreased, and the tumor volume at 12-30 d after inoculation was less in the Ad-SIRT6 group than in the control group and Ad-null group (P<0.05); the tumor mass was also lower than that of control and Ad-null groups (P<0.05). Immunohistochemistry showed that MVD and the number of HIF-1α and VEGF positive cells were less in the Ad-SIRT6 group than in control and Ad-null groups (P<0.05); and HIF-1α and VEGF levels in tumor tissue were decreased in the Ad-SIRT6 group compared to the control and Ad-null groups (P<0.05). There were no significant differences in the above measurements between the control group and Ad-null group (P>0.05).

CONCLUSION

SIRT6 overexpression can inhibit HIF1α and VEGF expression, promoting PHD2 expression, which can inhibit angiogenesis and xenograft growth and may play a role in reducing HIF1α and VEGF expression.