[Correlation between peripheral venous oxygen saturation and hemodynamic parameters in patients with pulmonary hypertension]

Objective: To investigate the correlation of peripheral venous oxygen saturation (SpvO(2)) with mixed venous oxygen saturation (SvO(2)), pulmonary vascular resistance (PVR) and cardiac index (CI) in patients with pulmonary hypertension (PH), in order to predict these parameters using SpvO(2) and assess the prognosis of patients. Methods: Hospitalized patients diagnosed with PH by right heart catheterization in the Guangzhou Institute of Respiratory Diseases from July 2015 to October 2016 were retrospectively analyzed. Parameters during the right heart catheterization, including SvO(2,)SpvO(2,)cardiac output (CO) and mean pulmonary arterial pressure (mPAP) were recorded, while CI, PVR and other parameters were indirectly calculated. The correlation between SpvO(2) and SvO(2,)CO, CI, mPAP, PVR and other parameters were respectively analyzed and compared between groups. Results: A total of 77 PH patients were selected, which comprised of 39 males and 38 females. The results revealed that SpvO(2) was correlated positively with SvO(2,)CI and PaO(2) (P<0.05), but negatively with PVR, total pulmonary resistance (TPR), systemic vascular resistance, right atrial diameter and right ventricular diameter (P<0.05). In the group with SpvO(2) <65%, the dilation of the right atrium and right ventricle was more significant, the WHO heart function grade was worse, CI, systemic systolic pressure and mean systemic pressure were lower, and PVR and TPR were higher, as compared to those in the group with SpvO(2) ≥65%. (P<0.05). Conclusions: There was good consistency between SpvO(2) and SvO(2). Furthermore, SpvO(2) could indirectly reflect the CI, PVR and changes in right heart structure of PH patients, providing reference for the clinical prediction of CI and PVR, as well as the prognosis of PH patients, through the use of SpvO(2). Low SpvO(2) indicated a severe condition and poor prognosis.

[Outcomes of severe primary fetal hydrothorax treated by prenatal intervention]

Objective: To investigate the effect of intrauterine intervention on severe primary fetal hydrothorax. Methods: Twelve cases with severe fetal primary hydrothorax who underwent prenatal intervention from January 2014 to December 2017 in Guangdong Women and Children Hospital were retrospectively reviewed. Results: The median gestational age of prenatal diagnosis was 30.8 weeks (24.0-33.0 weeks) . All cases were excluded congenital chromosomal abnormalities by prenatal diagnosis, and had no complications of pregnancy during prenatal diagnosis and had hydrothorax. Three cases (3/12) were right hydrothorax, the other 9 cases (9/12) were bilateral. Thoracoamniotic shunting was performed in 7 cases (7/12) . Thoracentesis was performed in 5 cases (5/12) , and the hydrothorax reappeared soon after operation in 4 cases, shunt placement was performed again. The hydrothorax was dissolved in 2 cases, released in 6 cases.Tube falling off occurred in 1 case,treatment was abandoned in 1 case and intrauterine fetal death happened in 1 case, and 1 case wasn't rechecked by ultrasonic due to premature birth following thoracentesis. In 10 cases who had deliveries, 5 newborns (5/10) were premature, 6 newborns (6/10) underwent assisted mechanical ventilation, 8 newborns (8/10) underwent thoracic close drainage, all of them were discharged when hydrothorax resolved. Conclusions: Antenatal intervention may improve the chance of survival in severe primary fetal hydrothorax. Thoracoamniotic shunting is the first-choice for the primary severe fetal hydrothorax.

Cryo-EM analysis of the T3S injectisome reveals the structure of the needle and open secretin

The bacterial type III secretion system, or injectisome, is a syringe shaped nanomachine essential for the virulence of many disease causing Gram-negative bacteria. At the core of the injectisome structure is the needle complex, a continuous channel formed by the highly oligomerized inner and outer membrane hollow rings and a polymerized helical needle filament which spans through and projects into the infected host cell. Here we present the near-atomic resolution structure of a needle complex from the prototypical Salmonella Typhimurium SPI-1 type III secretion system, with local masking protocols allowing for model building and refinement of the major membrane spanning components of the needle complex base in addition to an isolated needle filament. This work provides significant insight into injectisome structure and assembly and importantly captures the molecular basis for substrate induced gating in the giant outer membrane secretin portal family.

Aster Proteins Facilitate Nonvesicular Plasma Membrane to ER Cholesterol Transport in Mammalian Cells

The mechanisms underlying sterol transport in mammalian cells are poorly understood. In particular, how cholesterol internalized from HDL is made available to the cell for storage or modification is unknown. Here, we describe three ER-resident proteins (Aster-A, -B, -C) that bind cholesterol and facilitate its removal from the plasma membrane. The crystal structure of the central domain of Aster-A broadly resembles the sterol-binding fold of mammalian StARD proteins, but sequence differences in the Aster pocket result in a distinct mode of ligand binding. The Aster N-terminal GRAM domain binds phosphatidylserine and mediates Aster recruitment to plasma membrane-ER contact sites in response to cholesterol accumulation in the plasma membrane. Mice lacking Aster-B are deficient in adrenal cholesterol ester storage and steroidogenesis because of an inability to transport cholesterol from SR-BI to the ER. These findings identify a nonvesicular pathway for plasma membrane to ER sterol trafficking in mammals.

[Analysis of the characteristics of electrocardiogram in patients of different genders with pulmonary hypertension]

Objective: To analyze the characteristics of ECG in patients with pulmonary hypertension(PH) and explore their correlation with pulmonary vascular resistance(PVR), mean pulmonary arterial hypertension(mPAP) and cardiac index(CI). Methods: A total of 186 patients with right heart catheterization were enrolled in the Department of Respiratory of the First Affiliated Hospital of Guangzhou Medical University from August 2015 to October 2017. Patients with normal pulmonary artery pressure, incomplete clinical data and repeated examinations were excluded and there were 101 patients with pulmonary hypertension included. The results of ECG parameters and right heart catheterization were collected to analyze the ECG characteristics of patients with different genders and their correlation with PVR, mPAP and CI. Results: Among all PH patients, the duration of QRS axial in male group was significantly longer than that of the female group [(110.38±15.829) vs. (98.63±18.041) ms, P<0.001], and the S wave amplitude in V5 was significantly higher compared to female group [(1.304±1.356) vs. (0.648±0.663) mv, P<0.001]. Their heart rate-corrected QT interval (QTc), QRS axis, S wave amplitude in Ⅰ, S and R wave amplitude in V1, R/S ratio in V1, S wave amplitude V5, all had a correlation with their PVR and the S wave amplitude in V1 was negatively correlated with PVR (r=-0.441, P<0.001). In the male group, PVR was not correlated with R/S ratio in V1 and S wave amplitude in V5. While PVR in the female group was significantly correlated with QTc, R wave amplitude in V1, R / S ratio in V1. In all PH patients, their P wave duration in Ⅱ, QRS axis and S wave amplitude in Ⅰ, S wave and R wave amplitude in V1, S wave amplitude in V5, QTc, R/S ratio in V1, all had correlations with mPAP (P<0.05). In male group, mPAP was not correlated with QTc, P wave duration in Ⅱ, and the S wave amplitude in V5 (P>0.05). The mPAP in the female group was only related to the S wave and R wave amplitude in V1, and S amplitude in Ⅰ and S wave amplitude in V5 (P<0.05). The CI was positively correlated with the S wave amplitude in V1 (r=0.34, P<0.001), and negatively correlated with the QRS axis (r=-0.219, P=0.04); CI in male group was not correlated with QRS axis(P=0.073), but correlated with QTc (r=-0.296, P=0.044). Conclusion: There were gender differences in QRS duration and S wave amplitude in V5 in patients with pulmonary hypertension. The QRS axis and the S wave amplitude in V1 were related to the heart index. There was a difference in the correlation between ECG and PVR, mPAP and CI in patients of different genders with pulmonary hypertension.

Evaluation of the 3dMDface system as a tool for soft tissue analysis

OBJECTIVES

To evaluate the accuracy of three-dimensional stereophotogrammetry by comparing values obtained from direct anthropometry and the 3dMDface system. To achieve a more comprehensive evaluation of the reliability of 3dMD, both linear and surface measurements were examined.

SETTING AND SAMPLE POPULATION

UCLA Section of Orthodontics. Mannequin head as model for anthropometric measurements.

MATERIAL AND METHODS

Image acquisition and analysis were carried out on a mannequin head using 16 anthropometric landmarks and 21 measured parameters for linear and surface distances. 3D images using 3dMDface system were made at 0, 1 and 24 hours; 1, 2, 3 and 4 weeks. Error magnitude statistics used include mean absolute difference, standard deviation of error, relative error magnitude and root mean square error. Intra-observer agreement for all measurements was attained.

RESULTS

Overall mean errors were lower than 1.00 mm for both linear and surface parameter measurements, except in 5 of the 21 measurements. The three longest parameter distances showed increased variation compared to shorter distances. No systematic errors were observed for all performed paired t tests (P<.05). Agreement values between two observers ranged from 0.91 to 0.99.

CONCLUSIONS

Measurements on a mannequin confirmed the accuracy of all landmarks and parameters analysed in this study using the 3dMDface system. Results indicated that 3dMDface system is an accurate tool for linear and surface measurements, with potentially broad-reaching applications in orthodontics, surgical treatment planning and treatment evaluation.

Estimation of dispersion curves of water-loaded structures by using approximated acoustic mass

For coupled structures surrounded by heavy fluids, it is difficult to obtain dispersion curves from an eigenvalue analysis, because the external fluid term in the coupled equation includes transcendental functions for frequency and wavenumber. Thus, in this study, the acoustic mass of the external fluid was approximated as a function of frequency or wavenumber only. The coupled equation can then be used to calculate eigenvalues, and can estimate dispersion curves from an eigenvalue analysis. Because of this assumption, those dispersion curves will contain errors. Accordingly, those errors were evaluated in this study through a comparison with a dispersion curve derived from forced responses. The acoustic mass was also evaluated for a water-loaded plate; this can be formulated theoretically. As a result, the acoustic mass is less sensitive to frequency changes than wavenumber changes, and using the fluid term defined at a low frequency has advantages when estimating the dispersion curve. Finally, the generality of the proposed method was identified through the application for a submerged cylindrical shell.

IL-10 Signaling Remodels Adipose Chromatin Architecture to Limit Thermogenesis and Energy Expenditure

Signaling pathways that promote adipose tissue thermogenesis are well characterized, but the limiters of energy expenditure are largely unknown. Here, we show that ablation of the anti-inflammatory cytokine IL-10 improves insulin sensitivity, protects against diet-induced obesity, and elicits the browning of white adipose tissue. Mechanistic studies define bone marrow cells as the source of the IL-10 signal and adipocytes as the target cell type mediating these effects. IL-10 receptor alpha is highly enriched in mature adipocytes and is induced in response to differentiation, obesity, and aging. Assay for transposase-accessible chromatin sequencing (ATAC-seq), ChIP-seq, and RNA-seq reveal that IL-10 represses the transcription of thermogenic genes in adipocytes by altering chromatin accessibility and inhibiting ATF and C/EBPβ recruitment to key enhancer regions. These findings expand our understanding of the relationship between inflammatory signaling pathways and adipose tissue function and provide insight into the physiological control of thermogenesis that could inform future therapy.

Abstract 42: Control of Macrophage Cholesterol Efflux and Atherogenesis by the Noncoding RNA MeXis

The ligand-dependent nuclear receptor LXR regulates the expression of genes involved in responses to excess cholesterol including Abca1. Macrophage-specific cholesterol efflux driven by Abca1 has been causally linked to the prevention and reversal of heart disease, but therapeutic strategies for targeting efflux pathways in macrophages have been elusive. Here, we define a novel regulatory axis controlling macrophage responses to cholesterol overload. We identify the lncRNA MeXis as an amplifier of LXR-dependent Abca1 gene transcription in macrophages. MeXis interacts with and guides the promoter binding of nuclear receptor transcriptional coactivators. Loss of MeXis in murine immune cells has a marked impact on chromosome architecture at the Abca1 locus, impairs cellular responses to cholesterol overload, and accelerates the development of atherosclerosis. Our findings identify MeXis as a transcriptional gatekeeper that modifies the actions of LXR in lipid-dependent control of macrophage gene expression. It is conceivable that therapeutic approaches that enhance MeXis activity might augment reverse cholesterol transport and reduce foam cell formation.

[Oncomelania hupensis status monitoring in Changzhou City, Jiangsu Province from 2013 to 2016]

Objective To analyze the Oncomelania hupensis snail distribution and the changes of snail situation in Changzhou City from 2013 to 2016, so as to provide the evidence for formulating the schistosomiasis prevention and control interventions. Methods The data of snail monitoring in Changzhou City from 2013 to 2016 were collected and statistically analyzed. Results The total area with snails was 40.17 hm² and the newly discovered area was 30.63 hm² in Changzhou City from 2013 to 2016. In the four years, 3 454 snails were dissected, and no schistosome infected snails were found. There were totally 51 spots with snails, and the areas with snails of different types of marshland, inland and mountain were 12.13 (30.19%), 25.54 hm² (63.57%) and 2.51 hm² (6.24%), respectively. In the newly discovered snail environment, the areas of types of marshland and inland were 8.00 hm² (26.12%) and 22.63 hm² (73.88%), respectively. The main causes for snail existence were external input and adjacent diffusion. In the past four years, the total snail control area with molluscicides was 71.74 hm², the consolidated snail control area with molluscicides was 155.15 hm², and the total environmental modification areas in the current snail spots and historic snail spots were 15.90 hm² and 11.30 hm² respectively. Conclusion The diffusion of snails in inland rivers is the key of the newly discovered snail areas in Changzhou City in recent years, and the snail monitoring and control measures should be strengthened in the future.

CPT1A methylation is associated with plasma adiponectin

BACKGROUND AND AIMS

Adiponectin, an adipose-secreted protein that has been linked to insulin sensitivity, plasma lipids, and inflammatory patterns, is an established biomarker for metabolic health. Despite clinical relevance and high heritability, the determinants of plasma adiponectin levels remain poorly understood.

METHODS AND RESULTS

We conducted the first epigenome-wide cross-sectional study of adiponectin levels using methylation data on 368,051 cytosine-phosphate-guanine (CpG) sites in CD4+ T-cells from the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN, n = 991). We fit linear mixed models, adjusting for age, sex, study site, T-cell purity, and family. We have identified a positive association (regression coefficient ± SE = 0.01 ± 0.001, P = 3.4 × 10^-13) between plasma adiponectin levels and methylation of a CpG site in CPT1A, a key player in fatty acid metabolism. The association was replicated (n = 474, P = 0.0009) in whole blood samples from the Amish participants of the Heredity and Phenotype Intervention (HAPI) Heart Study as well as White (n = 592, P = 0.0005) but not Black (n = 243, P = 0.18) participants of the Bogalusa Heart Study (BHS). The association remained significant upon adjusting for BMI and smoking in GOLDN and HAPI but not BHS. We also identified associations between methylation loci in RNF145 and UFM1 and plasma adiponectin in GOLDN and White BHS participants, although the association was not robust to adjustment for BMI or smoking.

CONCLUSION

We have identified and replicated associations between several biologically plausible loci and plasma adiponectin. These findings support the importance of epigenetic processes in metabolic traits, laying the groundwork for future translational applications.

An LXR-Cholesterol Axis Creates a Metabolic Co-Dependency for Brain Cancers

Small-molecule inhibitors targeting growth factor receptors have failed to show efficacy for brain cancers, potentially due to their inability to achieve sufficient drug levels in the CNS. Targeting non-oncogene tumor co-dependencies provides an alternative approach, particularly if drugs with high brain penetration can be identified. Here we demonstrate that the highly lethal brain cancer glioblastoma (GBM) is remarkably dependent on cholesterol for survival, rendering these tumors sensitive to Liver X receptor (LXR) agonist-dependent cell death. We show that LXR-623, a clinically viable, highly brain-penetrant LXRα-partial/LXRβ-full agonist selectively kills GBM cells in an LXRβ- and cholesterol-dependent fashion, causing tumor regression and prolonged survival in mouse models. Thus, a metabolic co-dependency provides a pharmacological means to kill growth factor-activated cancers in the CNS.

Effects of Bioactive Compounds on Odontogenic Differentiation and Mineralization

Direct pulp capping involves the placement of dental materials directly onto vital pulp tissues after deep caries removal to stimulate the regeneration of reparative dentin. This physical barrier will serve as a "biological seal" between these materials and the pulp tissue. Although numerous direct pulp capping materials are available, the use of small bioactive compounds that can potently stimulate and expedite reparative dentin formation is still underexplored. Here, the authors compared and evaluated the pro-osteogenic and pro-odontogenic effects of 4 small bioactive compounds- phenamil (Phen), purmorphamine (Pur), genistein (Gen), and metformin (Met). The authors found that these compounds at noncytotoxic concentrations induced differentiation and mineralization of preosteoblastic MC3T3-E1 cells and preodontoblastic dental pulp stem cells (DPSCs) in a dose-dependent manner. Among them, Phen consistently and potently induced differentiation and mineralization in vitro. A single treatment with Phen was sufficient to enhance the mineralization potential of DPSCs in vitro. More importantly, Phen-treated DPSCs showed enhanced odontogenic differentiation and mineralization in vivo. Our study suggests that these small bioactive compounds merit further study for their potential clinical use as pulp capping materials.

The E3 ubiquitin ligase Idol controls brain LDL receptor expression, ApoE clearance, and Aβ amyloidosis

Apolipoprotein E (ApoE) is an important modifier of Alzheimer's disease (AD) pathogenesis, and its abundance has been linked to the clearance of β-amyloid (Aβ) in the brain. The pathways that control the clearance of ApoE in the brain are incompletely understood. We report that Idol, an E3 ubiquitin ligase that targets the low-density lipoprotein receptor (LDLR) for degradation, is a critical determinant of brain ApoE metabolism and Aβ plaque biogenesis. Previous work has shown that Idol contributes minimally to the regulation of hepatic LDLR expression in mice. By contrast, we demonstrate that Idol is a primary physiological regulator of LDLR protein in the brain, controlling the clearance of both ApoE-containing high-density lipoprotein (HDL) particles and Aβ. We studied the consequences of loss of Idol expression in a transgenic mouse model of Aβ amyloidosis. Idol deficiency increased brain LDLR, decreased ApoE, decreased soluble and insoluble Aβ, reduced amyloid plaque burden, and ameliorated neuroinflammation. These findings identify Idol as a gatekeeper of LDLR-dependent ApoE and Aβ clearance in the brain and a potential enzyme target for therapeutic intervention in AD.