Effect of COVID-19 on delivery plans and postnatal depression scores of pregnant women

INTRODUCTION

Owing to the coronavirus disease 2019 outbreak Hong Kong hospitals have suspended visiting periods and made mask wearing mandatory. In obstetrics, companionship during childbirth has been suspended and prenatal exercises, antenatal talks, hospital tours, and postnatal classes have been cancelled. The aim of the present study was to investigate the effects of these restrictive measures on delivery plans and risks of postpartum depression.

METHODS

We compared pregnancy data and the Edinburgh Postpartum Depression Scale (EPDS) scores of women who delivered between the pre-alert period (1 Jan 2019 to 4 Jan 2020) and post-alert period (5 Jan 2020 to 30 Apr 2020) in a tertiary university public hospital in Hong Kong. Screening for postpartum depression was performed routinely using the EPDS questionnaire 1 day and within 1 week after delivery.

RESULTS

There was a 13.1% reduction in the number of deliveries between 1 January and 30 April from 1144 in 2019 to 994 in 2020. The EPDS scores were available for 4357 out of 4531 deliveries (96.2%). A significantly higher proportion of women had EPDS scores of ≥10 1 day after delivery in the post-alert group than the pre-alert group (14.4% vs 11.9%; P<0.05). More women used pethidine (6.2% vs 4.6%) and fewer used a birthing ball (8.5% vs 12.4%) for pain relief during labour in the post-alert group.

CONCLUSIONS

Pregnant women reported more depressive symptoms in the postpartum period following the alert announcement regarding coronavirus infection in Hong Kong. This was coupled with a drop in the delivery rate at our public hospital. Suspension of childbirth companionship might have altered the methods of intrapartum pain relief and the overall pregnancy experience.

Apical sparing strain pattern observed in danon disease: insights from a global registry

Background

Danon Disease (DD) is a rare X-linked autophagic disorder due to mutations in the Lysosomal Associated Membrane Protein 2 (LAMP-2) gene and causes severe cardiac manifestations. Measurement of longitudinal strain (LS) has been shown to provide diagnostic insights into different etiologies of hypertrophic cardiomyopathies compared to conventional echocardiographic parameters.

Purpose

The aim of this study was to describe the pattern of global and regional LS in DD.

Methods

A retrospective, international registry, using medical records provided by patients, was formed to describe the natural history of DD. Complete echocardiogram images were available for review and LS was analyzed globally and regionally (basal, mid, apex).

Results

A total of eighteen DD patients (male 72%, mean age 17.2±10 years) had sufficient quality echocardiographic images for both traditional and myocardial strain evaluation. Notable traditional echocardiographic parameters included a mean EF of 60±11%, LV mass index 200±159 g/m2, intraventricular septal diameter 17.7±10.3 mm, LV posterior wall diameter 16.1±7.7 mm, LA volume index 21.9±13 mL/m2. Global longitudinal strain was reduced with a mean of −12.1±4.9% with an observed regional strain gradient: apex (−16.6±6.6%), mid (−10.9±4.7%) and basal (−9.2±4.5%). Bull's eye plot patterns reflected an apical sparing pattern that was similar to that described in cardiac amyloidosis.

Conclusion

In this DD cohort, we describe for the first time a strain pattern characterized by reduction in global longitudinal strain with apical sparing, which was originally pathognomonic for cardiac amyloidosis. This strain pattern in conjunction with a paradoxically normal LA volume may discriminate patients with DD from other hypertrophic conditions.

Funding Acknowledgement

Type of funding source: None

Knockdown of long noncoding RNA SNHG7 inhibits the proliferation and promotes apoptosis of thyroid cancer cells by downregulating BDNF

OBJECTIVE

Recently, long noncoding RNAs (lncRNAs) have got much attention for their role in tumor progression. LncRNA small nucleolar RNA host gene 7 (SNHG7) was studied in this research to identify how it affects the development of thyroid cancer (TC).

PATIENTS AND METHODS

SNHG7 expression was detected by quantitative Real-time polymerase chain reaction (qRT-PCR) in both TC cells and tissue samples. Pearson's Chi-square test was used to determine the association of SNHG7 expression with several clinicopathological factors. Moreover, colony formation assay, cell proliferation and cell apoptosis assay were conducted. In addition, by performing qRT-PCR and Western blot assay, the underlying mechanism was explored.

RESULTS

SNHG7 expression level was higher in TC samples than that in corresponding ones. The SNHG7 expression was associated with tumor size and TNM stage. Moreover, TC cell proliferation was inhibited, and TC cell apoptosis was induced after SNHG7 was knocked down in vitro. Moreover, the mRNA and protein expressions of brain-derived neurotrophic factor (BDNF) were downregulated after knockdown of SNHG7. Furthermore, the expression level of BDNF was positively related to the expression of SNHG7 in TC tissues.

CONCLUSIONS

These results suggested that knockdown of SNHG7 could inhibit TC cell proliferation and induce cell apoptosis via downregulating BDNF, which might be a potential therapeutic target in TC.

Replacing true unenhanced imaging in renal carcinoma with virtual unenhanced images in dual-energy spectral CT: a feasibility study

AIM

To investigate the clinical value of virtual unenhanced (VNC) spectral computed tomography (CT) images to replace the conventional true unenhanced spectral CT images (TNC) in diagnosing renal carcinoma.

MATERIALS AND METHODS

Fifty-six cases of renal carcinoma confirmed by histopathology underwent conventional plain CT and contrast-enhanced spectral CT at arterial phase (AP) and venous phase (VP). VNC images were generated on an AW4.6 workstation. The CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-noise-ratio (SNR) of the renal lesions and normal kidneys, long and short axis diameters of the lesion were measured from the three image sets and analysed using one-way analysis of variance (ANOVA). Two radiologists evaluated image quality subjectively using a five-point score, and lesion signature using a three-point score. Image quality scores were compared statistically and tested for consistency.

RESULTS

The two reviewers had good agreement for subjective evaluation (Kappa>0.70) and there was no difference in the quality of the scores among the three image groups. The lesion signature scores were all above the acceptable level. The CNR and SNR values in VNC were significantly higher than in TNC (p<0.05). VNC images had lower renal noise than in TNC (p<0.05). There was no difference in the long and short axis diameters of the lesion among the three image groups. VNC had higher CT attenuation values for the lesion and kidney than TNC (p<0.05), but the differences were <5 HU.

CONCLUSION

VNC images in spectral CT may be used to replace the conventional plain CT to reduce imaging duration and radiation dose in diagnosing renal carcinoma.

Current research and prevention of aflatoxins in China

Since their discovery in the 1960s, aflatoxins were found to have a considerable impact on the health of humans and animals as well as the country’s economy and international trade. Aflatoxins are often found in nuts, cereals and animal feeds, which has a significant danger to the food industry. Over the years, several steps have been undertaken worldwide to minimise their contamination in crops and their exposure to humans and animals. China is one of the largest exporters and importers of food and animal feed. As a result, many studies have been carried out in China related to aflatoxins, including their distribution, pollution, detection methods, monitoring, testing and managing. Chinese scientists studied aflatoxins in microbiological, toxicological, ecological effects as well as policies relating to their controlling. China has thus put into practice a number of strategies aiming at the prevention and control of aflatoxins in order to protect consumers and ensure a safe trade of food and feed, and the status and enlargement of these strategies are very important and useful for many consumers and stakeholders in China. Therefore, this article aims at the detriment assessments, regulations, distribution, detection methods, prevention and control of aflatoxins in China. It equally provides useful information about the recent safety management systems in place to fight the contamination of aflatoxins in food and feed in China.

KMT2D and TP53 mutation status improve the prognostic value of the International Prognostic Index (IPI) stratification in ENKTL patients

Extranodal NK/T-cell lymphoma nasal type (ENKTL) is a subtype of T cell lymphoma with poor prognosis. In this study, we designed a new prognostic model specifically for ENKTL to improve the risk stratification. In 29 ENKTL patients, we screened mutations in 9 ENKTL-associated genes using next-generation sequencing (NGS). We have found that mutated KMT2D was associated with the inferior overall survival (OS) and progression free survival (PFS) and KMT2D or TP53 mutations were associated with a higher mortality rate. Moreover, the difference in PFS among different stratifications was not significant using the International Prognostic Index (IPI) alone but was significant after the mutation status of KMT2D and TP53 were incorporated into the IPI model, forming a harmonious risk stratification reflecting the clinical features and genetic information of ENKTL. In summary, we demonstrate that the prognostic value of the IPI system can be enhanced by integrating the status of genetic mutations.

Roles of entropic and solvent damping forces in the dynamics of polymer tethered nanoparticles and implications for single molecule sensing

Tethering a particle to a surface with a single molecule allows detection of the molecule and analysis of molecular conformations and interactions.

Tethering a particle to a surface with a single molecule allows detection of the molecule and analysis of molecular conformations and interactions. Understanding the dynamics of the system is critical to all applications. Here we present a plasmonic imaging study of two important forces that govern the dynamics. One is entropic force arising from the conformational change of the molecular tether, and the other is solvent damping on the particle and the molecule. We measure the response of the particle by driving it into oscillation with an alternating electric field. By varying the field frequency, we study the dynamics on different time scales. We also vary the type of the tether molecule (DNA and polyethylene glycol), size of the particle, and viscosity of the solvent, and describe the observations with a model. The study allows us to derive a single parameter to predict the relative importance of the entropic and damping forces. The findings provide insights into single molecule studies using not only tethered particles, but also other approaches, including force spectroscopy using atomic force microscopy and nanopores.

Overexpression of UBE2C correlates with poor prognosis in gastric cancer patients

OBJECTIVE

The ubiquitin-conjugating enzyme E2C (UBE2C) has been known as a crucial factor upregulated in various tumors. The functions of UBE2C is mainly involved in the pathway protein ubiquitination. This study investigates the expression of UBE2C in gastric cancers and its correlation with overall survival rate.

MATERIALS AND METHODS

Real-time PCR (RT-PCR) and Western blotting were performed to determine the expression of UBE2C in gastric cancer samples and adjacent normal tissues. Immunohistochemical staining was used to assess the expression of UBE2C in 216 paraffin-embedded gastric cancer tissues.

RESULTS

The mRNA and relevant protein levels of UBE2C in gastric cancer tissues are significantly greater than those in the adjacent normal tissues. Also, the expression of UBE2C is found to correlate with lymphatic metastasis, serosa invasion, TNM (Malignant Tumors) staging and Lauren's classification (p<0.05). The univariate analysis shows that the overexpression of UBE2C associates with poor prognosis (p=0.001). The multivariate analysis demonstrates that expression of UBE2C, lymphatic metastasis, and TNM staging are independent prognostic indicators.

CONCLUSIONS

This study shows that overexpression of UBE2C contributes to the development of gastric cancer, and UBE2C has the potential to be exploited as a therapeutic target.

Quantifying Ligand-Protein Binding Kinetics with Self-Assembled Nano-oscillators

Measuring ligand-protein interactions is critical for unveiling molecular-scale biological processes in living systems and for screening drugs. Various detection technologies have been developed, but quantifying the binding kinetics of small molecules to the proteins remains challenging because the sensitivities of the mainstream technologies decrease with the size of the ligand. Here, we report a method to measure and quantify the binding kinetics of both large and small molecules with self-assembled nano-oscillators, each consisting of a nanoparticle tethered to a surface via long polymer molecules. By applying an oscillating electric field normal to the surface, the nanoparticle oscillates, and the oscillation amplitude is proportional to the number of charges on the nano-oscillator. Upon the binding of ligands onto the nano-oscillator, the oscillation amplitude will change. Using a plasmonic imaging approach, the oscillation amplitude is measured with subnanometer precision, allowing us to accurately quantify the binding kinetics of ligands, including small molecules, to their protein receptors. This work demonstrates the capability of nano-oscillators as an useful tool for measuring the binding kinetics of both large and small molecules.

Twist2 and CD24 expression alters renal microenvironment in obesity associated kidney cancer

OBJECTIVE

Obesity emerged as a major public health problem worldwide, and prolonged condition with increased BMI causes various metabolic disorders include the development of kidney cancer. The metabolic changes alter the renal microenvironment and thereby promoting tumor. Hence, detailed studies of genes that regulate these this changes are keen to understand.

MATERIALS AND METHODS

Initially, we successfully initiate kidney tumor using prolonged intake of a high-fat diet in Wistar rats, which are confirmed with pathological changes observed through histological sectioning. The expression of Twist2 and CD24 was assessed using Immunohistology and Western Blotting in a different time interval of kidney cancer.

RESULTS

The rats fed with high-fat diet for 8 months shows 1.5 times increased in body mass whereas rats fed with high-fat diet for 16 months shows triple the size when compared with controls. Histological sectioning confirms the development of lesions and proteinaceous casts in 8 months high-fat fed rats, whereas we observed the high proliferative mass of cells in 16 months high-fat fed rats. Interestingly, we also observed elevated expression of Twist2 in initial stages of kidney cancer, which are down-regulated in the latter stages of kidney cancer. The experiments with CD24 shows the gradual increase of the expression of CD24 as a tumor develops to the next level.

CONCLUSIONS

The correlation between Twist2 and CD24 expression conclude that Twist2 overexpression in initial stage augments CD24 to express more in the latter stage of kidney cancer. Reversely, the overexpression of CD24 and down-regulation of Twist2 in later stages of kidney cancer suggest the CD24 expression is dependent on Twist2 expression level.

P902Danon disease: clinical features and outcomes

Background

Danon Disease (DD) is a rare X-linked autophagic vacuolar myopathy, characterized by high penetrance and severe cardiomyopathy; cognitive, skeletal muscle and vision impairment may occur as well. Due to its rarity, clinical presentation and outcomes are still uncertain.

Purpose

To describe clinical features and outcomes of DD in female and male patients

Methods

Individuals and families from United Kingdom, Australia, and United States were recruited through via advertisements on Facebook groups related to DD. Participants completed a survey about symptoms and medical history and provided their medical records to the research team.

Results

A total of 44 patients (54.5% female) with positive genetic testing for DD were included. De novo mutations occurred in one out of four patients. Cardiomyopathy occurred in 86.3% of patients (18/24 females, 20/20 males) at a mean age of 7.3 years for males and 19.4 years for females (p=0.001). Females presented with either hypertrophic cardiomyopathy (HCM, 66.7%) or dilated cardiomyopathy (DCM, 8.3%) whereas males presented with HCM 90% of the time. 34.2% of patients were diagnosed with Wolff-Parkinson-White syndrome.

Twelve patients (7 females, 5 males) underwent cardiac magnetic resonance (CMR) Out of the 9 cases, 8 (88.9%) exhibited extensive patchy late gadolinium-enhancement (LGE) in multiple segments of the left ventricle; 3 cases also had right ventricular LGE. Median cardiac mass index was 155 g/m2 (Q1-Q3: 70–237; v.n. 31–79 g/m2). Overall, 17 (38.6%) patients died or required or heart transplant (HTx). Median age at the time of death or HTx was 17 years and 42 years in males and females, respectively (p=0.025 by the log-rank test)

Cognitive impairment, mainly described as learning disabilities, was diagnosed in 90.0% of males (18/20) and 79.2% (19/24) of females; intelligence quotient (IQ) measurement was reported in 8 patients (3 females, 5 males) and 7 of them showed IQ below the average. Symptomatic skeletal myopathy was present in 28 (63.3%) of patients, with a higher prevalence in males (85% vs. 45.8%; p<0.01). Retinopathy was reported in 14 (31.2%) patients and occurred equally in both genders (p=0.34).

Conclusions

DD causes significant cardiac morbidity with the need for transplant at a young age; in 25% of cases DD is due to a de novo mutation. While in males DD is more frequently multisystemic with a more rapid clinical deterioration, in females the clinical presentation is variable. However, the presence of severe cases in females warrant the clinicians to screen for DD in both sexes with clinical manifestations or positive family history

Acknowledgement/Funding

Rocket Pharmaceuticals

P1216Evaluation of alphavbeta3 integrin-targeted positron emission tomography and photoacoustic tracer for imaging of carotid plaque in apoE–/– mice

Background

Cardiovascular disease is the leading cause of death in the world. The majority of cardiovascular events result from the rupture of vulnerable atherosclerotic plaques, which are characterized by high and active macrophage content. The integrin αVβ3 is expressed by activated macrophages and endothelial cells in atherosclerotic lesions and thus is a marker of high-risk plaques. Therefore, 89Zr-RGD-melanin nanoparticle (MNP) positron emission tomography (PET)/photoacoustic imaging (PAI) imaging of αVβ3 expression in plaques might provide a novel noninvasive biomarker of plaque vulnerability.

Purpose

In this study, the intrinsic photoacoustic signals and the native strong chelating properties with metal ions of MNP, positron-emitting metal ions 89Zr and αVβ3 integrins targeting ability of cyclic c (RGDfC) peptide was employed to construct an efficient nanoplatform. And we evaluated the feasibility of 89Zr-RGD-MNP PET/PAI of αVβ3 expression in vivo and in vitro.

Methods

We conjugated αVβ3 integrins, cyclic c (RGDfC) peptide, to MNP and chelated the long-lived positron-emitting nuclide 89Zr. The bio-stability and targeting action was detected in macrophages. And the PET/PAI imaging was performed in apoE−/− mice with partial carotid ligation leading to atherosclerosis. In PET imaging, tracer uptake was measured in the stenotic areas of the carotid arteries, as well as on the contralateral side at different time points in vivo. In PAI, photoacoustic signal was measured in the atherosclerosis of the carotid arteries in vivo. Melanin staining and immunohistochemistry of αVβ3 expression were detected in atherosclerosis of the carotid arteries.

Results

89Zr-RGD-MNP showed excellent bio-stability and targeting action. PET imaging showed specific tracer accumulation at plaques in the left carotid artery, confirmed by competitive receptor blocking studies and the contrast in the right carotid artery. In the biodistribution studies, the left carotid (5.29%±0.78%) showed higher uptake than the right carotid (2.11%±1.55%). PAI showed the PA signal in the surgery group (452±85 a.u.) were stronger than the control (156±45 a.u.) and blocking group (254±66 a.u). The result was consistent with PET imaging and the presence of nanoparticles, as indicated by pathological examinations. These results presented good in vivo multimodality imaging (PET/PAI) properties.

Conclusions

We have developed 89Zr-labeled atherosclerotic plaques imaging agents based on the natural melanin nanoparticle. 89Zr-RGD-MNP demonstrates specific tracer accumulation in mice atherosclerotic carotid plaques. In this model, its uptake was associated with αVβ3 expression. 89Zr-RGD-MNP is a potential tracer for noninvasive imaging in atherosclerosis.

Acknowledgement/Funding

National Natural Science Foundation of China 81770452, 81470401

Time-Resolved Digital Immunoassay for Rapid and Sensitive Quantitation of Procalcitonin with Plasmonic Imaging

Timely diagnosis of acute diseases improves treatment outcomes and saves lives, but it requires fast and precision quantification of biomarkers. Here, we report a time-resolved digital immunoassay based on plasmonic imaging of binding of single nanoparticles to biomarkers captured on a sensor surface. The real-time and high contrast of plasmonic imaging lead to fast and precise counting of the individual biomarkers over a wide dynamic range. We demonstrated the detection principle, evaluated the performance of the method using procalcitonin (PCT) as an example, and achieved a limit of detection of ∼2.8 pg/mL, dynamic range of 4.2-12500 pg/mL, for a total detection time of ∼25 min.

Development and application of a high-content virion display human GPCR array

Human G protein-coupled receptors (GPCRs) respond to various ligands and stimuli. However, GPCRs rely on membrane for proper folding, making their biochemical properties difficult to study. By displaying GPCRs in viral envelopes, we fabricated a Virion Display (VirD) array containing 315 non-olfactory human GPCRs for functional characterization. Using this array, we found that 10 of 20 anti-GPCR mAbs were ultra-specific. We further demonstrated that those failed in the mAb assays could recognize their canonical ligands, suggesting proper folding. Next, using two peptide ligands on the VirD-GPCR array, we identified expected interactions and novel interactions. Finally, we screened the array with group B Streptococcus, a major cause of neonatal meningitis, and demonstrated that inhibition of a newly identified target, CysLTR1, reduced bacterial penetration both in vitro and in vivo. We believe that the VirD-GPCR array holds great potential for high-throughput screening for small molecule drugs, affinity reagents, and ligand deorphanization.

Plasma cell-free DNA integrity plus circulating tumor cells: a potential biomarker of no distant metastasis breast cancer

Cell-free DNA integrity (cfDI) is a promising diagnostic and prognostic biomarker in breast cancer. However, no specific study has evaluated the diagnostic ability of cfDI in patients with no distant metastasis breast cancer (no-MBC) and benign breast tumor (BBT) to date. We assessed the plasma cfDI of 84 patients with no-MBC and 30 patients with BBT using quantitative PCR and compared it with circulating tumor cells (CTCs) and carbohydrate antigen 153 (CA153). The no-MBC group had significantly lower mean cfDI (0.58) than the BBT group (0.74, p = 0.004). Subgroup analysis showed that decreased cfDI seem to be associated with risk factors such as age 14% (mean cfDI = 0.57), tumor size > 2 cm (mean cfDI = 0.58), and positive lymph node status (mean cfDI = 0.56), but had no statistical significance. McNemar's test suggested that cfDI had stronger diagnostic power than CTCs, cfDNA concentration, or CA153 (p < 0.001). Spearman's rho showed that the correlation coefficient between cfDI and CTCs was 0.278 (p = 0.04) in the no-MBC group. Receiver operating characteristic curve analysis also suggested that cfDI was superior to CTCs or CA153. Combined with CTCs, cfDI reduced the false positive rate from 50% to 10.71% and increased the area under the curve value from 0.66 to 0.68. Our results suggest that cfDI is a potential diagnostic biomarker of no-MBC. Using cfDI and CTCs as a combined diagnostic tool for no-MBC could improve diagnostic sensitivity and specificity but more samples will be needed.

Aβ1-42 increases the expression of neural KATP subunits Kir6.2/SUR1 via the NF-κB, p38 MAPK and PKC signal pathways in rat primary cholinergic neurons

ATP-sensitive potassium channels (KATP) may mediate a potential neuroprotective role in Alzheimer's disease (AD). Given that exposure to Aβ1-42 in cultured primary cholinergic neurons for 72 h significantly upregulates the expression of KATP subunits Kir6.2/SUR1, we aim to study the underlying signal transduction mechanisms that are involved in Aβ_1-42-induced upregulation of KATP subunits Kir6.2/SUR1. In the present study, we first identified the primary cultured rat cortical and hippocampal neurons using immunocytochemistry. 0.5 μM NF-κB inhibitor SN-50, 2 μM p38MAPK inhibitor SB203580 or 2 μM PKC inhibitor Chelerythrine chloride (CTC) were then added in three separate groups, followed by 2 μM Aβ_1-42 30 min later in all 3 groups. Western Blot was performed 72 h later to detect the expression of KATP subunits Kir6.2/SUR1. We found that Aβ_1-42 significantly increased the level of KATP subunits Kir6.2/SUR1 expression at 72 h when compared with the control group ( p < 0.05). However, when compared with the Aβ_1-42 group, the level of KATP subunits Kir6.2/SUR1 expression at 72 h significantly decreased in the SN50 + Aβ_1-42 group, SB203580 + Aβ_1-42 group, and the CTC + Aβ_1-42 group ( p < 0.05). Our findings suggest that the NF-κB, p38 MAPK, and PKC signal pathways are partially involved in the upregulation of KATP subunits Kir6.2/SUR1 expression induced by Aβ_1-42 cytotoxicity in neurons, which supports a potential theoretical basis of targeting these signal pathways in the treatment of AD.