Identification of TRIM14 as a Type I IFN-Stimulated Gene Controlling Hepatitis B Virus Replication by Targeting HBx

Hepatitis B virus (HBV) remains a major cause of hepatic disease that threatens human health worldwide. Type I IFN (IFN-I) therapy is an important therapeutic option for HBV patients. The antiviral effect of IFN is mainly mediated via upregulation of the expressions of the downstream IFN-stimulated genes. However, the mechanisms by which IFN induces ISG production and inhibits HBV replication are yet to be clarified. TRIM14 was recently reported as a key molecule in the IFN-signaling pathway that regulates IFN production in response to viral infection. In this study, we sought to understand the mechanisms by which IFN restricts HBV replication. We confirmed that TRIM14 is an ISG in the hepatic cells, and that the pattern-recognition receptor ligands polyI:C and polydAdT induce TRIM14 dependent on IFN-I production. In addition, IFN-I-activated STAT1 (but not STAT3) directly bound to the TRIM14 promoter and mediated the induction of TRIM14. Interestingly, TRIM14 played an important role in IFN-I-mediated inhibition of HBV, and the TRIM14 SPRY domain interacted with the C-terminal of HBx, which might block the role of HBx in facilitating HBV replication by inhibiting the formation of the Smc-HBx–DDB1 complex. Thus, our study clearly demonstrates that TRIM14 is a STAT1-dependent ISG, and that the IFN-I–TRIM14–HBx axis shows an alternative way to understand the mechanism by which IFN-I inhibits virus replication.

[Clinical outcome of receptor expression discordance between primary and metastatic breast cancer]

Objective: To investigate the clinical outcome of expression discordance of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in primary breast cancer and the corresponding metastatic lesions. Methods: A retrospective analysis was performed on 178 breast cancer patients with metastasis confirmed by the National Cancer Center & Cancer Hospital, Chinese Academy of Medical Sciences in the past 6 years. The data of expressions of ER, PR and HER-2 in primary and metastatic breast cancer, the metastatic sites, disease progression were collected and the relationships of the expression discordance of receptors with prognosis were analyzed. Results: The discordance rates of ER, PR and HER-2 between the primary tumor and the metastatic sites were 27.0%, 39.8% and 18.7%, respectively. The discordance rates of ER, PR and HER-2 of patients with locoregional recurrence were 21.9%, 36.6% and 12.7%, respectively, while those of patients with distant metastases were 31.3%, 42.7% and 23.8%. The median progression free survivals (PFS) of ER+/+、ER+/-、ER-/+、ER-/- of primary tumor and metastatic sites were 17.7 months, 10.3 months, 14.0 months and 9.0months, respectively (P=0.025). The median PFS of PR+/+, PR+/-, PR-/+, PR-/- were 23.0 months, 10.7 months, 14.0 months and 9.2months, respectively (P=0.002). The median PFS of HER-2+/+, HER-2+/-, HER-2-/+, HER-2-/- were 14.9 months, 15.2 months, 12.3 months and 14.0 months, respectively, without significant differences (P=0.588). Conclusions: This study confirms that expression discordances of ER, PR and HER-2 between primary breast cancer and the corresponding metastatic lesions are dramatic, especially in the patients with distant metastasis. The unstable levels of ER and PR seem to be significantly associated with prognosis of breast patients.

Downregulated NDR1 protein kinase inhibits innate immune response by initiating an miR146a-STAT1 feedback loop

Interferon (IFN)-stimulated genes (ISGs) play crucial roles in the antiviral immune response; however, IFNs also induce negative regulators that attenuate the antiviral response. Here, we show that both viral and bacterial invasion downregulate Nuclear Dbf2-related kinase 1 (NDR1) expression via the type I IFN signaling pathway. NDR1 promotes the virus-induced production of type I IFN, proinflammatory cytokines and ISGs in a kinase-independent manner. NDR1 deficiency also renders mice more susceptible to viral and bacterial infections. Mechanistically, NDR1 enhances STAT1 translation by directly binding to the intergenic region of miR146a, thereby inhibiting miR146a expression and liberating STAT1 from miR146a-mediated translational inhibition. Furthermore, STAT1 binds to the miR146a promoter, thus decreasing its expression. Together, our results suggest that NDR1 promotion of STAT1 translation is an important event for IFN-dependent antiviral immune response, and suggest that NDR1 has an important role in controlling viral infections.

The authors show that NDR1 promotion of STAT1 translation is an important event for IFN-dependent antiviral immune response. These data suggest that NDR1 has an important role in controlling viral infections.

2015-16 floods and droughts in China, and its response to the strong El Niño

The features of hydro-climate anomalies in China in 2015-2016 were analyzed in great detail, together with possible responses to the super 2015-16 El Niño event. The 2015-16 El Niño is characterized as a "strong" event in terms of the duration, intensity, and coverage of warming sea surface temperature (SST) in the central and east-central equatorial Pacific in comparison to the 1982-83 and 1997-98 events. The floods and droughts frequency were incidence of floods and droughts per year, respectively. The results show several significant anomalies in China: 1) About 9%-173% of precipitation variance in 2015-16 can be attributed to this El Niño; 2) There was significant inconformity between hydro-climate anomalies and the occurrence of floods and droughts; 3) Flood frequency has increased, especially over Southeast China and the Yangtze River in the summer of 2016; 4) Drought frequency has also increased, especially over Northeast China in summer of 2015, Northwest China in spring of 2016, and most parts in winter of 2015. The response of China hydro-climate anomalies to the 2015-16 El Niño was significant via El Niño and warm Indian Ocean induced circulation anomalies, which were characterized by stronger and more westward-extending western Pacific subtropical high and anomalous water vapor transport. Knowledge of the response of hydro-climate extremes to El Niño can provide valuable information to improve flood and drought forecasting in China.

Inducible overexpression of RUNX1b/c in human embryonic stem cells blocks early hematopoiesis from mesoderm

RUNX1 is absolutely required for definitive hematopoiesis, but the function of RUNX1b/c, two isoforms of human RUNX1, is unclear. We established inducible RUNX1b/c-overexpressing human embryonic stem cell (hESC) lines, in which RUNX1b/c overexpression prevented the emergence of CD34+ cells from early stage, thereby drastically reducing the production of hematopoietic stem/progenitor cells. Simultaneously, the expression of hematopoiesis-related factors was downregulated. However, such blockage effect disappeared from day 6 in hESC/AGM-S3 cell co-cultures, proving that the blockage occurred before the generation of hemogenic endothelial cells. This blockage was partially rescued by RepSox, an inhibitor of the transforming growth factor (TGF)-β signaling pathway, indicating a close relationship between RUNX1b/c and TGF-β pathway. Our results suggest a unique inhibitory function of RUNX1b/c in the development of early hematopoiesis and may aid further understanding of its biological function in normal and diseased models.

Inhibition of MALAT1 sensitizes liver cancer cells to 5-flurouracil by regulating apoptosis through IKKα/NF-κB pathway

Metastasis associated lung adenocarcinoma transcript 1 (MALAT1) is involved in tumor cell growth process. However, its role and molecular mechanism in liver cancer is still not fully understood. In this study, we found that MALAT1 was significantly expressed in liver cancer cell lines. And knockdown of MALAT1 suppressed proliferation, migration and invasion of HepG2 cells, accompanied with decrease of Rho-associated coiled-coil-forming protein kinase 1 (ROCK1), α-smooth muscle actin (α-SMA), N-cadherin, Vimentin and TWIST. Significantly, MALAT1 deletion sensitized HepG2 cells to 5-FU-induced cell cycle arrest in G1 phase, as evidenced by the significant reduction in Cyclin D1 and CDK4 and increase in p53, p21 and p27 protein levels. In addition, MALAT1 knockdown triggered 5-FU induced apoptosis in HepG2 cells by inducing intrinsic apoptosis-related signals, including Cyto-c, Apaf-1, cleaved Caspase-9/-7/-3 and poly (ADP-ribose) polymerase (PARP). Furthermore, phosphorylated nuclear factor-κB (p-NF-κB) was also down-regulated by MALAT1 silence. Importantly, suppression of IKKα/NF-κB significantly elevated apoptosis and reduced liver cancer cell viability in MALAT1-knockdown cells with 5-FU incubation. The nude mice transplantation model also confirmed the promoted sensitivity of MALAT1-silenced HepG2 cells to 5-FU by blocking tumor cell proliferation and inducing apoptosis. Therefore, our data supplied a potential mechanism by which knockdown of MALAT1 might play an important role in augmenting sensitivity of HepG2 cells to 5-FU in therapeutic approaches, demonstrating suppressing of MALAT1 may serve as a combination with chemotherapeutic agents in liver cancer treatment.

[The status quo and analysis of quality control of cancer chemotherapy in 76 hospitals in Beijing]

Objective: Investigated the status quo of quality control of cancer chemotherapy in hospitals in Beijing to discover the main problems and provide the improvement measures. Methods: One medical record of cancer chemotherapy was taken every month for examination of quality control, and a total of 10 medical records in each hospital were examined. A total of 756 medical records from 76 hospitals were examined. Results: The results of analysis showed that the overall standardization and quality control of cancer chemotherapy was positively correlated with the grade of hospital. Only 36.8% of the hospitals were equipped with Pharmacy Intravenous Admixture Services (PIVAS). In terms of quality control of chemotherapy and medicine, the department of oncology had better performance than other departments (P<0.01). The scores of quality control of chemotherapy and medicine in the hospitals with clinical specialist pharmacists were 50.6 and 14.5, significantly higher than 47.2 and 12.7 of those without clinical specialist pharmacists (P<0.05). Conclusion: We should focus on the quality control of cancer chemotherapy in secondary hospitals, reinforce the training of oncology specialists, establish the admission system of oncologists, enhance the training of oncology clinical pharmacists and promote the standardization of cancer chemotherapy.

Preparation and properties of cryogel based on poly(hydroxypropyl methacrylate)

A novel supermacroporous poly(hydroxypropyl methacrylate) (p(HPMA)) cryogel was synthesized by cryogelation method at -16 °C. In this synthesis process, HPMA was used as a monomer, and N,N'-methylenebisacrylamide (MBAAm) was used as cross-linker; the reaction was carried out in the presence of redox initiator pair N,N,N',N'-tetramethylene diamine (TEMED) and ammonium persulfate (APS). The effect of monomer concentration, cross-linker content, cooling rate, and dioxane co-solvent were determined with respect to the pore structure, mechanical behavior, swelling degree, and porosity of cryogel. The ESEM images indicate that the pore wall structure of cryogels was rough; moreover, small holes were present in the pore walls of cryogels. The result of compression test indicates that cryogels can be compressed by at least 80% without any breakdown. The result of swelling kinetics indicates that cryogels attain swelling equilibrium in 10 s. Furthermore, p(HPMA)-Cu²⁺ cryogel was prepared by loading Cu²⁺ ions on functionalized poly(hydroxypropyl methacrylate)-iminodiacetic acid (p(HPMA)-IDA) cryogel. We investigated the adsorption of bovine serum albumin (BSA) on cryogels. The results indicate that compared to Freundlich isotherm, Langmuir isotherm could more suitably describe the adsorption process of BSA on cryogels. Meanwhile, the adsorption capacity of p(HPMA)-Cu²⁺ cryogel was significantly greater than that of p(HPMA) cryogel. The maximum adsorption capacity of BSA on p(HPMA)-Cu²⁺ cryogel, which was treated with 1 M Cu²⁺ ions, was as high as 196.87 mg/g cryogel (equivalent to 20.48 mg/mL cryogel) at 25 °C and pH = 7.8; therefore, the maximum adsorption capacity of BSA on p(HPMA)-Cu²⁺ cryogel was 4.35 times higher than that of p(HPMA) cryogel. Thus, the adsorption capacity of cryogels was strongly influenced by Cu²⁺ concentration, moreover, temperature changes clearly affected the adsorption capacity of p(HPMA)-Cu²⁺cryogel. The adsorption capacity at 25 °C was twice as that at 15 °C. By calculating Gibbs free energy change (∆G) of adsorption, we found that the adsorption process was spontaneous; moreover, adsorption process occurred better at higher temperature.

[Association between carotid artery plaques and all-cause mortality and cardiovascular events]

Objective: To observe the association of carotid artery plaque with all-cause mortality and cardiovascular events. Methods: A total of 7 017 participants who completed the carotid sonography examination between 2010 and 2011 were selected from the stroke and the elderly prospective cohort Kailuan study. The participants of stroke cohort received health examination between 2006 and 2007, and participants of elderly cohort received health examination between 2010 and 2011. All participants were divided into plaque group (3 285 cases) and without plaque group (3 732 cases) according to with or without carotid artery plaque.The all-cause mortality and cardiovascular events were compared between the 2 groups. Multivariate Cox regression analysis was used to identify the association of carotid artery plaque with all-cause mortality and cardiovascular events. Results: (1) There were 4 297 male (61.2%) and 2 720 female (38.8%) in this cohort and participants were (58.1±11.8) years old. Age, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, rates of male, smoking, drinking, history of hypertension and diabetes mellitus were higher in the plaque group than in the without plaque group, and high density lipoprotein cholesterol was lower in the plaque group than in the without plaque group (all P<0.01) at baseline. (2) During a follow-up period of (4.92±0.59) years, the incidence rates of all-cause mortality in the plaque group and without plaque group were 5.5% (180/3 285) and 1.5% (57/3 732) ,respectively (P<0.01) .The incidence rates of cardiovascular events in the plaque group and without plaque group were 3.8% (124/3 285) and 1.4% (52/3 732) , respectively (P<0.01) . (3) Multivariate Cox regression analysis showed that carotid plaque was an independent risk factor of all-cause mortality (HR=1.667, 95%CI 1.160-2.395, P<0.01) and cardiovascular events (HR=1.942, 95%CI 1.312-2.876, P<0.01) after adjusting for age, sex, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, body mass index, total cholesterol,low density lipoprotein cholesterol, high density lipoprotein cholesterol, smoking, drinking, history of hypertension and diabetes mellitus, and use of lipid-regulating drugs. Conclusion: Carotid plaque is an independent risk factor of all-cause mortality and cardiovascular events. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-TNC-11001489.

Short- and long-term prognostic value of hyponatremia in patients with acute coronary syndrome: A systematic review and meta-analysis

Hyponatremia is relevant to heart failure, liver cirrhosis and stroke, but the prognostic value of serum sodium levels in patients with acute coronary syndrome are still unclear. So we did a systematic review and meta-analysis to assess the prognostic value of hyponatremia on adverse events in patients after ACS. We systematically searched PubMed, Embase and Cochrane Library to find literatures which studied the prognostic value of hyponatremia in patients with ACS. Our main endpoints were the all-cause mortality and heart failure in the short- and long-term. Of 369 identified studies, 20 studies were included in our analysis. Compared with the normal natrium, hyponatremia was significantly associated with the increased risks of all-cause mortality within 30 days (RR: 2.18; 95%CI: 1.96–2.42) and during the follow-ups (HR: 1.74; 95%CI: 1.56–1.942). For the second endpoint of short- and long-term heart failure, the pooled effect sizes in hyponatremia patients were 1.72(95%CI: 1.38–2.14) and 1.69(95%CI: 1.12–2.55) respectively. In conclusion, hyponatremia has a significant prognostic value for short- and long-term adverse event in patients after ACS, the dynamic monitoring of serum sodium levels may could help physicians to identify high risk ACS patients and to stratify risk for optimal management.

The chromatin remodeling subunit Baf200 promotes normal hematopoiesis and inhibits leukemogenesis

Background

Adenosine triphosphate (ATP)-dependent chromatin remodeling SWI/SNF-like BAF and PBAF complexes have been implicated in the regulation of stem cell function and cancers. Several subunits of BAF or PBAF, including BRG1, BAF53a, BAF45a, BAF180, and BAF250a, are known to be involved in hematopoiesis. Baf200, a subunit of PBAF complex, plays a pivotal role in heart morphogenesis and coronary artery angiogenesis. However, little is known on the importance of Baf200 in normal and malignant hematopoiesis.

Methods

Utilizing Tie2-Cre-, Vav-iCre-, and Mx1-Cre-mediated Baf200 gene deletion combined with fetal liver/bone marrow transplantation, we investigated the function of Baf200 in fetal and adult hematopoiesis. In addition, a mouse model of MLL-AF9-driven leukemogenesis was used to study the role of Baf200 in malignant hematopoiesis. We also explored the potential mechanism by using RNA-seq, RT-qPCR, cell cycle, and apoptosis assays.

Results

Tie2-Cre-mediated loss of Baf200 causes perinatal death due to defective erythropoiesis and impaired hematopoietic stem cell expansion in the fetal liver. Vav-iCre-mediated loss of Baf200 causes only mild anemia and enhanced extramedullary hematopoiesis. Fetal liver hematopoietic stem cells from Tie2-Cre⁺, Baf200^f/f or Vav-iCre⁺, Baf200^f/f embryos and bone marrow hematopoietic stem cells from Vav-iCre⁺, Baf200^f/f mice exhibited impaired long-term reconstitution potential in vivo. A cell-autonomous requirement of Baf200 for hematopoietic stem cell function was confirmed utilizing the interferon-inducible Mx1-Cre mouse strain. Transcriptomes analysis revealed that expression of several erythropoiesis- and hematopoiesis-associated genes were regulated by Baf200. In addition, loss of Baf200 in a mouse model of MLL-AF9-driven leukemogenesis accelerates the tumor burden and shortens the host survival.

Conclusion

Our current studies uncover critical roles of Baf200 in both normal and malignant hematopoiesis and provide a potential therapeutic target for suppressing the progression of leukemia without interfering with normal hematopoiesis.

Electronic supplementary material

The online version of this article (10.1186/s13045-018-0567-7) contains supplementary material, which is available to authorized users.

Abstract PD3-08: A randomized phase II trial of pyrotinib plus capecitabine versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer previously treated with taxanes, anthracyclines and/or trastuzumab

Background:Pyrotinib is an oral, irreversible pan-ErbB receptor tyrosine kinase inhibitor (TKI) with activity against epidermal growth factor receptor (EGFR) / HER1, HER2, and HER4. Lapatinib in combination with capecitabine is one of the standards of care for patients with HER2-positive metastatic breast cancer (MBC) who have received prior taxanes, anthracyclines and/or trastuzumab.

Methods: We conducted an open label, multicenter, randomized phase II trial to comparatively evaluate efficacy and safety of pyrotinib + capecitabine (PC) or lapatinib + capecitabine (LC) in women with HER2-positive MBC. Key eligibility criteria included prior treatment with taxanes, anthracyclines and/or trastuzumab, ≤2 prior chemotherapies for metastatic disease, no CNS metastases, and no prior treatment with HER2 targeted TKI. Eligible patients were randomized 1:1 to PC Arm (P 400 mg QD D1–21 + C 1000 mg/m2BID D1–14, 21-D cycle) or LC Arm (L 1250 mg QD D1–21 + C 1000 mg/m2BID D1–14, 21-D cycle). The primary endpoint was objective response rate (ORR) as assessed by investigator, and secondary endpoints included progression-free survival (PFS), time to progression (TTP), duration of response (DoR), overall survival (OS), and safety.

Results: Between May 2015 and Mar 2016, 128 patients (65 in PC arm and 63 in LC arm) were enrolled in this study. Median age was 48 years (range 25-70), ECOG performance status was 0 (53.9%) or 1 (46.1%), 62.5% had hormone receptor-positive disease, 76.6% had visceral disease and 53.9% had received prior trastuzumab in (neo)adjuvant and/or mestastatic setting. Baseline characteristics were well balanced in two arms. Median follow-up time was 15.0 months. ORR was 78.5% in PC arm and 57.1% in LC arm (p=0.01), Median PFS was 18.1 months in PC arm and 7.0 months in LC arm (hazard ratio 0.363; 95% CI 0.228, 0.579; p&lt;0.0001), PFS benefit in PC arm compared to LC arm was observed irrespective of prior trastuzumab or not. Treatment related Grade 3-4 toxicities occurred in &gt;2% patients in PC arm vs LC arm included hand-foot syndrome (21.5% vs 19.0%), diarrhea (13.8% vs 4.8%), decreased neutrophil (7.7% vs 1.6%), decreased WBC (6.2% vs 1.6%), vomiting (4.6% vs 0%), increased AST (3.1% vs 1.6%), decreased hemoglobin (3.1% vs 1.6%), increased total bilirubin (0% vs 4.8%) and increased conjugated bilirubin (0% vs 3.2%).

Conclusions: In women with HER2-positive MBC previously treated with taxanes, anthracyclines and/or trastuzumab, pyrotinib + capecitabine yield statistically significant better PFS and ORR than lapatinib + capecitabine in this randomized phase II trial. Phase III study is ongoing to validate this finding.

Citation Format: Xu B, Ma F, Ouyang Q, Li W, Jiang Z, Tong Z, Liu Y, Li H, Yu S, Feng J, Wang S, Hu X, Zhu X, Zou J. A randomized phase II trial of pyrotinib plus capecitabine versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer previously treated with taxanes, anthracyclines and/or trastuzumab [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD3-08.

Abstract P1-13-13: The treatment patterns and clinical outcomes of trastuzumab in early human epidermal growth factor receptor 2 (HER2) positive breast cancer in the real-world setting in China

Background:Several prospective interventional studies have proved the efficacy and safety of trastuzumab in adjuvant treatment in HER2positive breast cancer,while limited data existed to address the treatment patterns and real-world performance of trastuzumab in early HER2 positive breast cancer in China.

Methods:We retrospectively analyzed all the pts who were diagnosed with HER2-positive breast cancer,underwent surgery and received adjuvant treatment in National Cancer Center from 2000 to 2012.The treatment patterns and disease free survival (DFS),overall survival (OS) were analyzed respectively.

Results:A total of 1398 HER2 positive breast cancer pts were identified.The median follow-up time was 79.1 months.68.5% pts received chemotherapy alone,3.4% pts only received mono trastuzumab,28.2% pts received trastuzumab plus chemotherapy.Among 433 trastuzumab treated pts,64.7% received concurrent trastuzumab with chemotherpy,and 35.3% pts received sequential trastuzumab with chemotherapy

Baseline characteristics by Chemotherapy alone and Chemotherapy + Trastuzumab.No(%) of patients   characteristicTrastuzumab- (N=957)Trastuzumab+ (N=441)Total (N=1398)Age (years)   &lt;=3596 ( 10.0)44 ( 10.0)140 ( 10.0)36 - 50434 ( 45.4)244 ( 55.3)678 ( 48.5)&gt;50427 ( 44.6)153 ( 34.7)580 ( 41.5)Histologic grade   I15 ( 1.6)7 ( 1.6)22 ( 1.6)I-II,II480 ( 50.2)224 ( 50.8)704 ( 50.4)II-III,III285 ( 29.8)166 ( 37.6)451 ( 32.3)IDC148 ( 15.5)29 ( 6.6)177 ( 12.7)Other29 ( 3.0)15 ( 3.4)44 ( 3.1)Clinical stage   026 ( 2.7)16 ( 3.6)42 ( 3.0)I259 ( 27.1)108 ( 24.5)367 ( 26.3)II434 ( 45.4)196 ( 44.4)630 ( 45.1)III238 ( 24.9)121 ( 27.4)359 ( 25.7)Hormone receptor status   Positive635 ( 66.4)256 ( 58.0)891 ( 63.7)Negative322 ( 33.6)185 ( 42.0)507 ( 36.3)

.Trastuzumab plus chemo had significantly longer DFS compared with chemo alone.(85.03%vs72.15%,hazard ratios,HR=0.531,95% confidence interval,95%CI:0.406-0.696, p&lt;0.001).In addition,the concurrent trasuzumab showed the trend with longer DFS compared to the sequential regimen(86.07%vs82.35%,HR=0.843,95%CI:0.515-1.378, p=0.495).Age,tumor size, lymph node status,clinical stage were associated with DFS

Results of Cox regression hazard model with treatment groups and patient characteristics on DFSGroupHR95% CIP valueTreatment group   Concurrent Trastuzumab0.8430.515-1.3780.495Sequential Trastuzumab   Chemotherapy+Trastuzumab0.5310.406-0.696&lt;0.001Chemotherapy alone   Age group (years)  0.001&lt;=351.6501.198-2.2730.00236 - 500.8880.702-1.1220.319&gt;50   Histologic grade  &lt;0.001I0.5200.210-1.2880.158I-II,II0.5040.379-0.671&lt;0.001II-III,III0.5320.390-0.725&lt;0.001Other0.5140.264-0.9970.049IDC   Clinical stage  &lt;0.00100.2610.107-0.6370.003I0.2860.207-0.395&lt;0.001II0.4800.379-0.607&lt;0.001III   Hormone receptor status  0.022Positive0.7730.621-0.9620.021Negative   

.OS was also prolonged in trastuzumab plus chemotherapy compared with chemotherapy alone.(93.20%vs85.45%,HR=0.561,95%CI:0.377-0.835, p=0.004).

Conclusions:Our study revealed that,there were still more than half of HER2-positive breast cancer pts couldn't reach anti-HER2 therapy in China,the early stage HER2-positive breast cancer pts could significantly benefit from trastuzumab adjuvant therapy in real-world setting.

Citation Format: Guo J, Xu B, Li Q, Zhang P, Yuan P, Wang J, Ma F, Fan Y, Cai R, Luo Y, Li Q. The treatment patterns and clinical outcomes of trastuzumab in early human epidermal growth factor receptor 2 (HER2) positive breast cancer in the real-world setting in China [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-13.

Abstract P3-12-09: CYP2D6*10 genotype was associated with worse outcome of premenopausal breast cancer patients receiving adjuvant tamoxifen but not toremifene: A single institution expericence

Background: Tamoxifen(TAM), a selective estrogen receptor modulator(SERM), is the most widely used adjuvant endocrine therapy for premenopausal breast cancer patients. Cytochrome P-450(CYP450) enzyme, CYP2D6, is involved in the conversion of tamoxifen to endoxifen which is one of the main active metabolites of tamoxifen in vivo. Variants of CYP2D6 gene may result in a decreased enzyme activity and lead to poor prognosis of the patients. Different from caucasians, the most common polymorphism among Chinese women is allelic variant *10, which generates a 188 C to T transition, resulting in a lower activity of the enzyme. Based on some retrospective studies, tamoxifen-treated patients with the CYP2D6*10 T/T genotype have a worse clinical outcome. Toremifene(TOR), another kind of SERM is not metabolited by CYP2D6 enzyme thus may not be influenced by its polymorphism. We conducted this study to validate the association between CYP2D6*10 genotype and the outcomes of patients receiving TAM and TOR respectively.

Methods: A total of 276 patients with primary early-stage ER-positive breast cancer received adjuvant tamoxifen (n=169) or toremifene (n=107) therapy at Natinal Cancer Center from 2004-2012 were analyzed. All patients had received 5-year endocrine therapy after completion of surgery. TaqMan SNP genotyping assays was performed on CYP2D6*10 from blood samples. The association of CYP2D6 *10 genotype with disease free survival (DFS) and clinicopathological characteristics was analyzed in patients receiving tamoxifen and toremifen.

Results: 32.6% (90 of 276) of the patients were homozygous for wild-type C/C genotype, 47.1% (130 of 276) were heterozygous for C/T genotype, and 20.3% (56 of 276) were homozygous for variant T/T genotype. The frequency of CYP2D6 *10 allele in our study was 43.8%. The 5-year DFS rate for tamoxifen and toremifene treatment group were 81.6% and 83.2% respectively. There was no significant difference of DFS between the two groups(P=0.274). Among 169 patients in tamoxifen group, 5-year DFS rate was considerably lower in patients with homozygous variant T/T genotype than those with wild-type C/C or C/T genotype (73.4% versus 83.2%, P=0.004). And the T/T genotype was found to be a significant prognostic marker for DFS in multivariate analysis (hazard ratio = 4.7; P&lt;0.001) after adjusting for patient's characteristics mentioned above. For the toremifene group, there was no difference of DFS between T/T genotype and the others(P=0.332). For all the 56 homozygous variant T/T genotype patients, patients receiving toremifene treatment had a much higher 5-year DFS rate than those receiving tamoxifen but unfortunately it was not statistically significant (90.0% versus 73.4%, P=0.192).

Conclusions: About one fifth of Chinese breast cancer patients had homozygous T/T genotype which might get less benefit from TAM adjuvant treatment. Toremifene may be a better option for this kind of patients. Further large-scale prospective clinical studies are warranted to validate this concept.

Citation Format: Lan B, Ma F, Fan Y, Zhai X, Xu B. CYP2D6*10 genotype was associated with worse outcome of premenopausal breast cancer patients receiving adjuvant tamoxifen but not toremifene: A single institution expericence [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-12-09.

MEIS1 Regulates Hemogenic Endothelial Generation, Megakaryopoiesis, and Thrombopoiesis in Human Pluripotent Stem Cells by Targeting TAL1 and FLI1

Human pluripotent stem cells (hPSCs) provide an unlimited source for generating various kinds of functional blood cells. However, efficient strategies for generating large-scale functional blood cells from hPSCs are still lacking, and the mechanism underlying human hematopoiesis remains largely unknown. In this study, we identified myeloid ectopic viral integration site 1 homolog (MEIS1) as a crucial regulator of hPSC early hematopoietic differentiation. MEIS1 is vital for specification of APLNR⁺ mesoderm progenitors to functional hemogenic endothelial progenitors (HEPs), thereby controlling formation of hematopoietic progenitor cells (HPCs). TAL1 mediates the function of MEIS1 in HEP specification. In addition, MEIS1 is vital for megakaryopoiesis and thrombopoiesis from hPSCs. Mechanistically, FLI1 acts as a downstream gene necessary for the function of MEIS1 during megakaryopoiesis. Thus, MEIS1 controls human hematopoiesis in a stage-specific manner and can be potentially manipulated for large-scale generation of HPCs or platelets from hPSCs for therapeutic applications in regenerative medicine.

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MEIS1 knockout impairs hematopoiesis of hPSCs by suppressing HEP specification

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MEIS1^−/− megakaryocytes fail to undergo polyploidization and thrombopoiesis

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TAL1 mediates the function of MEIS1 in HEP specification

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FLI1 acts as a downstream target of MEIS1 during megakaryopoiesis and thrombopoiesis

One-Pot Synthesis of Cu2ZnSnSe4 Nanoplates and their Visible-Light-Driven Photocatalytic Activity

A SeO₂ ethanol solution as the facile precursor has been used for the preparation of quaternary Cu₂ZnSnSe₄ (CZTSe) nanoplates. Monodispersed single-phase CZTSe nanoplates have been prepared successfully by a facile one-pot thermal chemical method. The as-prepared CZTSe nanoplates show uniform morphology with a bandgap of ~ 1.4 eV. As a proof of concept, the CZTSe nanoplates have been used as a visible-light-driven photocatalyst for Rhodamine B dye degradation and show high photocatalytic activity and stability. The excellent dye removal is mainly ascribed to the efficient light utilization of CZTSe nanoplates.

Hypoxia-induced activation of Twist/miR-214/E-cadherin axis promotes renal tubular epithelial cell mesenchymal transition and renal fibrosis

The epithelial-to-mesenchymal transition (EMT) induced by chronic hypoxia is one of the critical causes of renal fibrosis. Previous work reported that the transcription factors Twist plays an important role in hypoxia-induced EMT and renal fibrosis. Recent evidence indicates that miR-214 was regulated by Twist in many fibrotic diseases, but their role in hypoxia-induced EMT and renal fibrosis remains unknown. Here, we found that hypoxia significantly upregulated the expression of miR-214-3p in HK-2 cells, unilateral ureteral obstruction (UUO) nephropathy and patients with chronic kidney disease. Knockdown of miR-214-3p reversed the EMT of renal tubular epithelial cells (TECs) and alleviated fibrosis in the UUO mouse in vivo, while the overexpression of miR-214-3p promoted EMT phenotype and expression of fibrotic factors in TECs under hypoxic condition. In addition, Twist was also observed increased gradually with the prolongation of hypoxia, and it positively correlated with the expression of miR-214-3p in HK-2 cells transfected with Twist-overexpression or Twist-siRNA plasmid. Moreover, miR-214-3p negatively regulated the expression of epithelial cadherin (E-cadherin) by binding the E-cadherin 3' UTR under hypoxic condition. Overall, hypoxia-induced activation of Twist/miR-214/E-cadherin axis is involved in the EMT of TECs, and anti-miR-214 may be an attractive strategy to ameliorate the progression of renal fibrosis.

Risk model for deaths and renal replacement therapy dependence in patients with acute kidney injury after cardiac surgery

OBJECTIVES

Acute kidney injury (AKI) is a serious complication after cardiac surgery and is associated with increased in-hospital deaths. Renal replacement therapy (RRT) is becoming a routine strategy for severe AKI. Our goal was to evaluate the risk factors for death and RRT dependence in patients with AKI after cardiac surgery.

METHODS

We included 190 eligible adult patients who had AKI following cardiac surgery and who required RRT at our centre from November 2010 to March 2015. We collected preoperative, intraoperative, postoperative and RRT data for all patients.

RESULTS

In this cohort, 87 patients had successful RRT in the hospital, whereas 103 patients had RRT that failed (70 deaths and 33 cases of RRT dependence). The multivariable logistic analysis identified old age [odds ratio (OR): 1.042, 95% confidence interval (CI): 1.012-1.074; P = 0.011], serum uric acid (OR: 1.015, 95% CI: 1.003-1.031; P = 0.024), intraoperative concentrated red blood cell transfusions (OR: 1.144, 95% CI: 1.006-1.312; P = 0.041), postoperative low cardiac output syndrome (OR: 3.107, 95% CI: 1.179-8.190; P = 0.022) and multiple organ failure (OR: 5.786, 95% CI: 2.115-15.832; P = 0.001) as factors associated with a higher risk for RRT failure. The prediction model (-4.3 + 0.002 × preuric acid + 0.10 × concentrated red blood cells + 0.04 × age + 1.12 × [low cardiac output syndrome = 1] + 1.67 × [multiple organ failure = 1]) based on the multivariate analysis had statistically significant different incriminatory power with an area under the curve of 0.786.

CONCLUSIONS

The prediction model may serve as a simple, accurate tool for predicting in-hospital RRT failure for patients with AKI following cardiac surgery.