Longitudinal Trajectories of Clinical Decline in Amyloid Positive and Negative Populations

BACKGROUND

Brain beta-amyloid status portends different trajectories of clinical decline.

OBJECTIVE

Determine trajectories and predictive baseline variable(s).

DESIGN

Longitudinal, up to 24 months.

SETTING

ADNI sites.

PARTICIPANTS

Healthy control (n=325), early and late mild cognitive impairment (n=279; n=372), and Alzheimer's dementia (n=216) subjects from ADNI-1/GO/2.

MEASUREMENTS

Baseline amyloid status was based on first available CSF Aβ1-42 or, [11C]PiB or [18F]florbetapir (FBP) PET. Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog13) and Functional Activities Questionnaire (FAQ) were co-analyzed using Growth Mixture Modeling (GMM) to define latent class trajectories for each amyloid group. Classification and Regression Tree (CART) analysis determined which variables best predicted trajectory class membership using a number of variables available to clinicians.

RESULTS

GMMs found two trajectory classes (C1, C2) each for amyloid-positive (P; n=722) and negative (N; n=470) groups. Most (90%) in the negative group were C2N with mildly impaired baseline ADAS-Cog13, normal FAQ and nonprogression; 10% were C1N with moderately impaired baseline FAQ and ADAS-Cog13 and trajectory of moderately worsening scores on the FAQ. C1P (26%) had more impaired baseline FAQ and ADAS-Cog13 than C2P (74%) and a steeper declining trajectory. CART yielded 4 decision nodes (FAQ <10.5, FAQ <6.5, MMSE ≥26.5, age <75.5) in positive and 1 node (FAQ <6.5) in negative groups, with 91.4% and 92.8% accuracy for class assignments, respectively.

CONCLUSIONS

The trajectory pattern of greater decline in amyloid positive subjects was predicted by greater baseline impairment of cognition and function. While most amyloid-negative subjects had nonprogression irrespective of their diagnosis, a subgroup declined similarly to the gradually declining amyloid-positive group. CART predicted likely trajectory class, with known amyloid status, using variables accessible in a clinical setting, but needs replication.

A mullite oxide catalyst of SmMn2O5 for three-way catalysis: synthesis, characterization, and catalytic activity evaluation

CO conversion as a function of temperature for SMO and LCO is shown in the graphical abstract image. SMO reached 95% conversion at 150 °C and showed a better CO oxidation activity than LCO.

SPAG9 promotes endometrial carcinoma cell invasion through regulation of genes related to the epithelial-mesenchymal transition

OBJECTIVE

To investigate the impact of sperm-associated antigen 9 (SPAG9) on proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) in endometrial cancer.

MATERIALS AND METHODS

The present authors' previous study demonstrated that SPAG9 is highly expressed in endometrial cancer tissues. They analyzed correlation between the levels of SPAG9 and mRNA of EMT-related genes in endometrial carcinoma tissue by using quantitative real-time PCR. They induced EMT process in ECC endometrial cancer cell lines by TGF-beta1 treatment and spheroids formation assay, and analyzed SPAG9 expression as well as correlation with EMT-related genes. In addition, they performed SPAG9 gene silencing in KLE and ECC endometrial cancer cells and evaluated the expression of genes involved in EMT, using real time PCR and Western blot analysis. Cell proliferation, colony formation, and transwell assays were employed to evaluate the functional role of SPAG9 in endometrial cancer.

RESULTS

The results showed that SPAG9 expression was positively correlated with Slug and N-cadherin (NcaD) in human endometrial cancer tissues. The expression of SPAG9 in ECC cells with TGF-β1 treatment and spheroids formation was increased, which was correlated with EMT-related genes. SPAG9 knockdown significantly inhibited cell growth and proliferation and reduced the motility and invasion of endometrial cancer cells. These phenotypes may partly be explained by decreased expression of EMT-related genes, including Twist, Slug, and Vimentin, after SPAG9 depletion.

CONCLUSIONS

SPAG9 may be required for cellular invasion and migration in endometrial cancer through regulation of EMT-related genes.

The complete mitochondrial genome of Tambocerus sp. (Hemiptera: Cicadellidae)

The complete mitochondrial genome of Tambocerus sp. (Hemiptera: Cicadellidae) from Zhejiang and Anhui provinces of China was sequenced. The total length of the mitogenome is 15 955 bp (GenBank accession no. KT827824) and consists of 22 transfer RNAs, 13 protein-coding genes, 2 ribosomal RNAs and 1 control region. The base composition of the heavy strand for A, T, C, and G is 41.39, 35.02, 14.00, and 9.59%, respectively. All of the protein-coding genes (PCGs) start with ATN. Five protein-coding genes use TAA as stop codons, four use TAG as stop codons, and others use incomplete stop codons ''T--'' or ''TA-''. The control region has a length of 1581 bp which is between rrnS and trnI genes with the AT content high to 85.96%. Phylogenetic analysis indicated that Tambocerus sp. was clustered in a closely related subgroup with Homalodisca vitripennis and Empoasca vitis. This is consistent with the result of the traditional taxonomy.

Hepatic steatosis depresses alpha-1-antitrypsin levels in human and rat acute pancreatitis

Hepatic steatosis (HS) can exacerbate acute pancreatitis (AP). This study aimed to investigate the relation between α1-antitrypsin (AAT) and acute pancreatitis when patients have HS. Using proteomic profiling, we identified 18 differently expressed proteins pots in the serum of rats with or without HS after surgical establishment of AP. AAT was found to be one of the significantly down-regulated proteins. AAT levels were significantly lower in hepatic steatosis acute pancreatitis (HSAP) than in non-HSAP (NHSAP) (P < 0.001). To explore the clinical significance of these observations, we measured the levels of AAT in the serum of 240 patients with HSAP, NHSAP, fatty liver disease (FLD), or no disease. Compared with healthy controls, serum AAT levels in patients with NHSAP were significantly higher (P < 0.01), while in patients with HSAP serum AAT levels were significantly lower (P < 0.01). Further studies showed that acute physiology and chronic health evaluation (APACHE-II) scores were negatively correlated with serum AAT levels (r = −0.85, P < 0.01). In conclusion, low serum levels of AAT in patients with HSAP are correlated with disease severity and AAT may represent a potential target for therapies aiming to improve pancreatitis.

Quantitative candidate gene association studies of metabolic traits in Han Chinese type 2 diabetes patients

Recent genome-wide association studies have identified many loci associated with type 2 diabetes mellitus (T2DM), hyperuricemia, and obesity in various ethnic populations. However, quantitative traits have been less well investigated in Han Chinese T2DM populations. We investigated the association between candidate gene single nucleotide polymorphisms (SNPs) and metabolic syndrome-related quantitative traits in Han Chinese T2DM subjects. Unrelated Han Chinese T2DM patients (1975) were recruited. Eighty-six SNPs were genotyped and tested for association with quantitative traits including lipid profiles, blood pressure, body mass index (BMI), serum uric acid (SUA), glycated hemoglobin (HbA1c), plasma glucose [fasting plasma glucose (FPG)], plasma glucose 120 min post-OGTT (P2PG; OGTT = oral glucose tolerance test), and insulin resistance-related traits. We found that CAMTA1, ABI2, VHL, KAT2B, PKHD1, ESR1, TOX, SLC30A8, SFI1, and MYH9 polymorphisms were associated with HbA1c, FPG, and/or P2PG; GCK, HHEX, TCF7L2, KCNQ1, and TBX5 polymorphisms were associated with insulin resistance-related traits; ABCG2, SLC2A9, and PKHD1 polymorphisms were associated with SUA; CAMTA1, VHL, KAT2B, PON1, NUB1, SLITRK5, SMAD3, FTO, FANCA, and PCSK2 polymorphisms were associated with blood lipid traits; CAMTA1, SPAG16, TOX, KCNQ1, ACACB, and MYH9 polymorphisms were associated with blood pressure; and UBE2E3, SPAG16, SLC2A9, CDKAL1, CDKN2A/B, TCF7L2, SMAD3, and PNPLA3 polymorphisms were associated with BMI (all P values <0.05). Some of the candidate genes were associated with metabolic and anthropometric traits in T2DM in Han Chinese. Although none of these associations reached genome-wide significance (P < 5 x 10(-8)), genes and loci identified in this study are worthy of further replication and investigation.

Giant elastic tunability in strained BiFeO3 near an electrically induced phase transition

Elastic anomalies are signatures of phase transitions in condensed matters and have traditionally been studied using various techniques spanning from neutron scattering to static mechanical testing. Here, using band-excitation elastic/piezoresponse spectroscopy, we probed sub-MHz elastic dynamics of a tip bias-induced rhombohedral−tetragonal phase transition of strained (001)-BiFeO₃ (rhombohedral) ferroelectric thin films from ∼10³ nm³ sample volumes. Near this transition, we observed that the Young's modulus intrinsically softens by over 30% coinciding with two- to three-fold enhancement of local piezoresponse. Coupled with phase-field modelling, we also addressed the influence of polarization switching and mesoscopic structural heterogeneities (for example, domain walls) on the kinetics of this phase transition, thereby providing fresh insights into the morphotropic phase boundary in ferroelectrics. Furthermore, the giant electrically tunable elastic stiffness and corresponding electromechanical properties observed here suggest potential applications of BiFeO₃ in next-generation frequency-agile electroacoustic devices, based on the utilization of the soft modes underlying successive ferroelectric phase transitions.

Ferroelectric materials possess spontaneous electrical polarization coupled to their underlying lattice structure, which may be utilized technologically. Here, the authors use band-excitation piezoresponse/elastic spectroscopy to study the sub-megahertz dynamics of a structural phase transition in BiFeO₃.

Baseline characteristics and management of patients with atrial fibrillation/flutter in the emergency department: results of a prospective, multicentre registry in China

BACKGROUND/AIM

There have been several studies of atrial fibrillation (AF) over the past decades; however, data from Chinese patients are scarce. The aim of the study was therefore to describe the patient characteristics, risk profile and management strategies for Chinese AF patients presenting to emergency department (ED).

METHODS

We conducted a prospective, multicentre registry of patients with AF or atrial flutter (AFL) in China. Participants were enrolled at 20 EDs, then data regarding baseline characteristics and treatment in EDs were collected.

RESULTS

Of the 2016 Chinese patients, 1104 (54.8%) were female. Six hundred eighteen (30.7%) had paroxysmal AF, 452 (22.4%) had persistent AF and 945 (46.9%) had permanent AF. The most common comorbidity was hypertension (55.5%), followed by coronary artery disease (41.8%) and heart failure (HF, 37.4%). The prevalence of concomitant cardiovascular risk factors, such as HF and valvular heart disease, increased as AF progressed. Among the patients with non-valvular AF, 110 (12.7%) of those with CHADS2 (congestive HF, hypertension, age of 75 years and greater, diabetes mellitus and history of stroke) ≥2 were prescribed oral anticoagulants (OAC), while 119 (15.6%) of those with CHADS2 <2 received such agents. Among the 324 patients with valvular AF, 134 (41.4%) actually were treated with OAC. The international normalised ratio value was within the target range (2.0-3.0) in 96 patients only (26.4%). Moreover, a total of 16.2% of the patients received ≥1 anti-arrhythmic agents, whereas rate control agents were used more frequently (68.4%).

CONCLUSIONS

According to the present study, the risk profile and management of Chinese patients with AF/AFL differed from that observed in previous studies. The use of OAC inadequately deviate from current guidelines.

Solid pseudopapillary neoplasms of the pancreas: clinical analysis of 45 cases

AIMS

This study investigated the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) at a single institution in China.

METHODS

We investigated 45 patients who underwent surgery for pathologically confirmed SPNs between 1996 and 2014.

RESULTS

The 45 cases included 44 female and 1 male patients, and the average age was 32.2 years. The tumor was located in the body and/or tail in 33 patients, the head in 9 patients and the neck in 3 patients. The median tumor size was 6.3 cm (range 1.5 to 16). All 45 patients had curative resections including 29 distal pancreatectomies, 9 pancreaticoduodenectomy, 5 central pancreatectomy and 2 enucleation. 2 patients required superior mesenteric vein resection due to local tumor invasion. Eight patients had malignant tumors. Ki-67 was detected positive in 5 patients with malignant potential. After a median follow-up of 51.7 months, one patient with malignant SPN had evidence of tumor recurrence.

CONCLUSION

SPN is an infrequent tumor, typically affect young women with low malignant potential. Surgical resection is warranted even in the presence of local invasion or metastases as patients demonstrate excellent long-term survival. Positive immunoreactivity for Ki-67 may predict the malignant potential and poor outcome of SPNs.

Heterogeneous vesicles in mucous epithelial cells of posterior esophagus of Chinese giant salamander (Andrias davidianus)

The Chinese giant salamander belongs to an old lineage of salamanders and endangered species. Many studies of breeding and disease regarding this amphibian had been implemented. However, the studies on the ultrastructure of this amphibian are rare. In this work, we provide a histological and ultra-structural investigation on posterior esophagus of Chinese giant salamander. The sections of amphibian esophagus were stained by hematoxylin & eosin (H&E). Moreover, the esophageal epithelium was observed by transmission electron microscopy (TEM). The results showed that esophageal epithelium was a single layer epithelium, which consisted of mucous cells and columnar cells. The esophageal glands were present in submucosa. The columnar cells were ciliated. According to the diverging ultrastructure of mucous vesicles, three types of mucous cells could be identified in the esophageal mucosa: i) electron-lucent vesicles mucous cell (ELV-MC); ii) electron-dense vesicles mucous cell (EDV-MC); and iii) mixed vesicles mucous cell (MV-MC).

Tectonic 1 accelerates gastric cancer cell proliferation and cell cycle progression in vitro

Hedgehog (Hh) pathway is important in development and cancer. Hh signaling is constitutively active in gastric cancer. Recently, tectonic 1 (TCTN1) was identified as one regulator of the Hh pathway. In the present study, the biological role of TCTN1 was examined in gastric cancer via an RNA interference lentivirus system. The constructed lentivirus efficiently suppressed TCTN1 expression in three gastric cancer cell lines. The proliferation of gastric cancer cells was significantly inhibited in TCTN1 knockdown cells, as determined by 3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyltetrazolium bromide and colony formation assays. Furthermore, in order to determine the underlying mechanism, the cell cycle progression of MGC80‑3 cells was analyzed by flow cytometry. Knockdown of TCTN1 led to cell cycle arrest at the G2/M phase, which contributed to inhibition of growth. In conclusion, the results demonstrated that TCTN1 was essential in the growth of gastric cancer cells in vitro, suggesting TCTN1 as a potential target candidate for the treatment of gastric cancer.

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

AIM

The aim of this study was to determine the clinicopathological features, surgical management, and prognosis of solid pseudopapillary neoplasms (SPNs) of the pancreas.

METHODS

This study conducted a retrospective analysis of 97 patients who underwent surgery for a pathologically confirmed SPN in five hospitals between January 1996 and December 2014.

RESULTS

The 97 cases included 93 female and 4 male patients, and the average age was 31.2 years. The tumor was located in the body or tail (70.1%), the head (20.6%), and the neck (9.3%). All patients underwent surgical exploration, including distal pancreatectomy (63.9%), pancreaticoduodenectomy (20.6%) (partial portal vein or superior mesenteric vein resection and artificial vascular graft reconstruction performed in 4.1% of the patients), central pancreatectomy (10.3%), enucleation (5.2%), and liver resection (1.0%). 16.5% of the patients had malignant tumors. The positive rate of Ki-67 was 66.7% in patients diagnosed with a malignant neoplasm and was comparable to 8.4% of the patients diagnosed to have a benign neoplasm (p < 0.001). After a median follow-up of 70.1 months, three patients had recurrence and one patient died of liver metastasis.

CONCLUSIONS

SPN is a rare neoplasm with low malignant potential. Surgical resection is warranted even in the presence of local invasion or metastases as patients demonstrate excellent long-term survival. Positive immunoreactivity for Ki-67 may predict the malignant potential and poor outcome of SPNs.

No influence of CYP2D6*10 genotype and phenotype on the pharmacokinetics of nebivolol in healthy Chinese subjects

WHAT IS KNOWN AND OBJECTIVE

Nebivolol, a clinically important antihypertensive drug, mainly metabolized by cytochrome P450 (CYP) 2D6, shows wide interindividual variability in pharmacokinetics. The CYP2D6*10 allele (100C>T; rs1065852), present at a high frequency in the Chinese population, is associated with alteration in the pharmacokinetics of many drugs, but its effect on the pharmacokinetics of nebivolol is unknown. The aim of our study was to investigate whether the CYP2D6*10 genotype and phenotype are associated with changes in the pharmacokinetics of nebivolol in Chinese subjects.

METHODS

Twenty-four healthy subjects were divided into three groups according to CYP2D6*1/*1 (n = 7), CYP2D6*1/*10 (n = 5) and CYP2D6*10/*10 (n = 12) genotypes. The *1/*1 homozygotes and *1/*10 heterozygotes were C allele carriers. All subjects received oral single dose of nebivolol and dextromethorphan. Blood and urine samples were gathered at various times.

RESULTS

There were no statistically significant differences in the pharmacokinetics of nebivolol between the three CYP2D6*10 genotypes, and no gene-dose effect was seen. The pharmacokinetic parameters of CYP2D6*10/*10 subjects were also similar to those of CYP2D6*1 carriers. A weak relationship between CYP2D6 phenotype and nebivolol clearance was found.

WHAT IS NEW AND CONCLUSION

The CYP2D6*10 genotype and phenotype were not associated with significant alterations in the pharmacokinetics of nebivolol. CYP2D6*10 alone does not account for the large interindividual differences observed in the disposition of nebivolol among Chinese healthy subjects.

[Resectibility assessment of enhanced CT and contrast-enhanced endoscopic ultrasonography for the periampullary neoplasm]

OBJECTIVE

To evaluate the efficacy of enhanced CT and contrast-enhanced endoscopic ultrasonography (CE-EUS) for assessment of the resectibility of periampullary neoplasm.

METHODS

a retrospective analysis of 93 patients with periampullary neoplasm underwent CT and CE-EUS was conducted to compare the imaging data with the surgical and pathological findings, in order to evaluate their efficacies for the resectibility assessment.

RESULTS

There was no significant difference in sensitivity and specificity between CT and CE-EUS for the evaluation of adjacent organ invasion, lymph node metastasis and liver metastasis (P > 0.05). For the diagnosis of periampullary neoplasm and assessment of vascular invasion, CE-EUS was better than CT (94.6% vs 84.1%, P = 0.023; 96.2% vs 85.9%, P = 0.041). Logistic regression indicated that the accuracy of CE-EUS in determing adjacent organ invasion was correlated with the tumor size, and vascular invasion was correlated with the tumor location and size.

CONCLUSIONS

CE-EUS has advantages in the assessment of the resectibility of periampullary neoplasm, especially for the assessment of vascular invasion, and can be used as a supplementary Image technology to the enhanced CT.

Evaluations of tropospheric aerosol properties simulated by the community earth system model with a sectional aerosol microphysics scheme

A sectional aerosol model (CARMA) has been developed and coupled with the Community Earth System Model (CESM1). Aerosol microphysics, radiative properties, and interactions with clouds are simulated in the size-resolving model. The model described here uses 20 particle size bins for each aerosol component including freshly nucleated sulfate particles, as well as mixed particles containing sulfate, primary organics, black carbon, dust, and sea salt. The model also includes five types of bulk secondary organic aerosols with four volatility bins. The overall cost of CESM1-CARMA is approximately ∼2.6 times as much computer time as the standard three-mode aerosol model in CESM1 (CESM1-MAM3) and twice as much computer time as the seven-mode aerosol model in CESM1 (CESM1-MAM7) using similar gas phase chemistry codes. Aerosol spatial-temporal distributions are simulated and compared with a large set of observations from satellites, ground-based measurements, and airborne field campaigns. Simulated annual average aerosol optical depths are lower than MODIS/MISR satellite observations and AERONET observations by ∼32%. This difference is within the uncertainty of the satellite observations. CESM1/CARMA reproduces sulfate aerosol mass within 8%, organic aerosol mass within 20%, and black carbon aerosol mass within 50% compared with a multiyear average of the IMPROVE/EPA data over United States, but differences vary considerably at individual locations. Other data sets show similar levels of comparison with model simulations. The model suggests that in addition to sulfate, organic aerosols also significantly contribute to aerosol mass in the tropical UTLS, which is consistent with limited data.

miR-23b-3p regulates the chemoresistance of gastric cancer cells by targeting ATG12 and HMGB2

Chemotherapy is an important treatment modality for gastric cancer (GC); however, it usually fails because of drug resistance, especially multidrug resistance (MDR). Previously, we found a novel subset of MDR-associated microRNAs (miRNAs) through high-throughput functional screening. In this report, we investigated the exact roles and mechanisms of miR-23b-3p in the MDR of GC. Using gain or loss-of-function in in vitro and in vivo experiments, we found that overexpression of miR-23b-3p reversed cancer cell resistance to multiple chemotherapeutics in vitro and sensitize tumors to chemotherapy in vivo. Reporter gene assay and western blot analysis showed that ATG12 and HMGB2 were the direct targets of miR-23b-3p. Meanwhile, ATG12 and HMGB2 were positively associated with the occurrence of autophagy. Reducing the expression of these target genes by siRNA or inhibition of autophagy both sensitized GC cells to chemotherapy. These findings suggest that a miR-23b-3p/ATG12/HMGB2/autophagy-regulatory loop has a critical role in MDR in GC. In addition, miR-23b-3p could be used as a prognostic factor for overall survival in GC. In conclusion, our data demonstrated that miR-23b-3p inhibited autophagy mediated by ATG12 and HMGB2 and sensitized GC cells to chemotherapy, and suggested the potential application of miR-23b-3p in drug resistance prediction and treatment.

Composition and physical properties of the Asian Tropopause Aerosol Layer and the North American Tropospheric Aerosol Layer

Recent studies revealed layers of enhanced aerosol scattering in the upper troposphere and lower stratosphere over Asia (Asian Tropopause Aerosol Layer (ATAL)) and North America (North American Tropospheric Aerosol Layer (NATAL)). We use a sectional aerosol model (Community Aerosol and Radiation Model for Atmospheres (CARMA)) coupled with the Community Earth System Model version 1 (CESM1) to explore the composition and optical properties of these aerosol layers. The observed aerosol extinction enhancement is reproduced by CESM1/CARMA. Both model and observations indicate a strong gradient of the sulfur-to-carbon ratio from Europe to the Asia on constant pressure surfaces. We found that the ATAL is mostly composed of sulfates, surface-emitted organics, and secondary organics; the NATAL is mostly composed of sulfates and secondary organics. The model also suggests that emission increases in Asia between 2000 and 2010 led to an increase of aerosol optical depth of the ATAL by 0.002 on average which is consistent with observations.

KEY POINTS

The Asian Tropopause Aerosol Layer is composed of sulfate, primary organics, and secondary organics The North American Tropospheric Aerosol Layer is mostly composed of sulfate and secondary organics Aerosol Optical Depth of Asian Tropopause Aerosol Layer increases by 0.002 from 2000 to 2010.

Dopamine D1 and D5 receptors differentially regulate oxidative stress through paraoxonase 2 in kidney cells

BACKGROUND

The renal dopaminergic system plays an important role in the pathogenesis of hypertension. Dopamine D1-like receptors (D1R and D5R) decrease reactive oxygen species (ROS) production via inhibition of pro-oxidant enzymes such as NADPH oxidase. Paraoxonase 2 (PON2) is also involved in the inhibition of NADPH oxidase activity. Therefore, we tested the hypothesis that D1R and D5R inhibit ROS production by increasing the expression of PON2, including those in membrane microdomains.

METHODS AND RESULTS

PON2 colocalized with D1R and D5R in mouse renal proximal tubules (RPTs), human RPT (hRPT) cells, and HEK293 cells heterologously expressing human D1R (HEK-hD1R) or D5R (HEK-hD5R). Fenoldopam, an agonist for both D1R and D5R, increased PON2 co-immunoprecipitation with D1R and D5R in HEK-hD1R and HEK-hD5R cells, respectively. Silencing PON2 increased ROS production and NADPH oxidase activity, and impaired the inhibitory effect of fenoldopam. Fenoldopam increased PON2 protein in both lipid rafts (LRs) and non-LRs in HEK-hD1R cells, but only in non-LRs in HEK-hD5R and hRPT cells. Long-term (hrs) fenoldopam stimulation increased PON2 protein in a time-dependent manner in HEK-hD5R, but not in HEK-hD1R cells. Because the effects of fenoldopam on non-LR and total PON2 expressions were similar in HEK-hD5R and hRPT cells, additional studies were performed to determine the relationship between D5R and PON2. Renal PON2 protein was decreased in D5(-/-) mice. In hRPT cells, silencing D5R decreased PON2 expression and increased ROS production.

CONCLUSIONS

We conclude that D1-like receptors inhibit ROS production by altering PON2 distribution in membrane microdomains in the short-term, and by increasing PON2 expression in the long-term.

MYH9 gene polymorphisms may be associated with cerebrovascular blood flow in patients with type 2 diabetes

Genetic factors play an important role in type 2 diabetes (T2D) complications. Alteration of cerebrovascular blood flow (CBF) is a direct result of cerebrovascular diseases. However, few studies have reported the role of genetics on CBF in patients with T2D. We investigated whether single-nucleotide polymorphisms (SNPs) in metabolic disease genes are associated with CBF in patients with T2D. CBF velocities of CBF were measured in 337 Han Chinese patients with T2D using transcranial Doppler sonography, with 54 cerebrovascular blood flow parameters documented. Fifty-two SNPs from 31 metabolic disease candidate genes were genotyped in patients. Quantitative allelic association and haplotype analyses were performed for candidate gene SNPs and CBF phenotypes. Spearman correlation was used to determine the relationship between CBF parameters and basic clinical characteristics, particularly, body mass index, lipids, fibrinogen, and GHbA1c. MYH9 gene SNPs (rs875726 and rs735853) may be associated with the peak velocity of the right-middle cerebral artery. SNPs rs875726, rs2009930, and rs375246 of the MYH9 gene may be associated with the mean velocity of the right-anterior and posterior cerebral artery. The haplotype G-C-A (rs2239782-rs3752462- rs2269532) of MYH9 may be associated with CBF. MYH9 gene polymorphisms may be associated with multiple CBF phenotypes in Chinese patients with T2D. However, whether MYH9 is a candidate gene for cerebrovascular diseases in Chinese patients with T2D remains unknown.

Comparative efficacy of S-1 versus best supportive care in advanced hepatocellular carcinoma

466

Background: S-1, an oral fluoropyrimidine derivative, has been shown to be clinically effective against hepatocellular carcinoma (HCC). We carried out a retrospective study to evaluate the efficacy of S-1, compared to best supportive care (BSC) in patients with advanced hepatocellular carcinoma. Methods: From 2009.12 to 2013.12, 32 cases of advanced hepatocellular carcinoma (the presence of extrahepatic metastasis or locally advanced disease not amenable to surgical resection or other locoregional therapies) were retrospectively analysed. 18 patients received S-1 (80 mg/m2/day, administered during days 1~14 and repeated every 21 days) and 14 patients received best supportive care (BSC). The time to progression (TTP), overall survival (OS) and safety were assessed. Results: 17 of 32 (53.1%) patients had metastatic disease, including the retroperitoneal lymph nodes (7 cases), lung (4 cases), supraclavicular lymph nodes (3 cases), abdominal wall (3 cases), brain (2 cases) and adrenal glands (2 cases). 12 patients (37.5%) had portal vein tumor thrombus. The two groups were well matched at baseline. In S-1 group,a total of 63 cycles were administered with median of 3.5 cycles (range, 2~7).The most common grade 3/4 toxicities were thrombocytopenia (28.1%), neutropenia (21.8%), elevated serum aspartate aminotransferase levels (15.6%) and rash (9.4%). A patient (5.6%) had a partial response,11 (61.1%) had stable disease, and 6 (33.3%) had progressive disease. Median TTP was 4.7 months in the S-1 group compared with 2.3 months in the BSC group (P=0.013). Overall survival was 15.1 months in patients treated with S-1, compared with 8.3 months in those who received BSC (P=0.027). Conclusions: S-1 showed an acceptable safety profile and benefit in survival in patients with advanced HCC.The conclusion needs further evaluation in randomized clinical trials.

Conversion chemotherapy combined with surgical treatment of unresectable advanced gastric cancer

189

Background: Local advanced gastric cancer which could not receive R0 resection, or gastric cancer with single distant metastasis usually received palliative chemotherapy or entered into various clinical trials, and surgery usually roled as a symptomatic treatment. This study is to investigate the efficacy and safety of PCF chemotherapy combined with surgery in the treatment of these patients. Methods: From 2007.8 to 2012.8, 78 cases of local advanced gastric cancer which can not be treated with R0 resection(T4N2~3M0) or gastric cancer with single distant metastases(M1) were prospectively analysed. Patients were treated with 2~4 cycles of combined chemotherapy with paclitaxel (150mg/m2,d1), cisplatin(25mg/m2, d1~3) and 5-fluorouracil (750 mg/m2, d1~3) ( repeated every 3 weeks), and were then treated with cytoreductive surgery: mainly treated with radical resection of gastric tumor, combined with extended lymph node dissection, pancreaticoduodenal resection, colon resection, ovariectomy, liver resection and tumor radio frequency, followed by another 2~4 cycles of postoperative PCF chemotherapy.The treatment completion rate, patients’ tolerance and overall survival time were analyzed. Results: 56 patients (71.8%) accomplished chemotherapy and surgical resection as planned. 47 cases had R0 resection(60.3%). Grade 3/4 toxic effects included bone marrow suppression(24.4%) and gastrointestinal reaction(37.2%), the overall response rate (CR+PR) was 73.1%(CR 2 cases, PR 55 cases). Survival analysis: the median survival time was 23.4 months. 1-year and 3-year survival rate was 68.1% and 33.5%. The OS of patients with surgical resection was much longer than that of the non-surgery group.(36.1 VS 10.0 months, P<0.01). The OS of local advanced group was 38.6 months, and was significantly longer than 20.7 months of the distant metastasis group (P<0.01), however, it had no significant difference compared to 31.3 months of the distant metastasis group with R0 resection. Conclusions: PCF chemotherapy combined with surgical resection were safe and effective, and can make survival benefits for patients with local advanced gastric cancer or gastric cancer with single distant metastasis.