[Safety and efficacy of dual guiding catheter kissing technique in the treatment of stent partially dislodgement in coronary artery]

Objective: To investigate the safety and efficacy of dual guiding catheter kissing technique (DCK) in the treatment of stent partly dislodgement in coronary artery. Methods: The study retrospectively involved 6 hospitalized patients with coronary artery stent partly dislodgement during PCI at The First Affiliated Hospital of Zhengzhou University from February 2016 to June 2019, DCK was used in these patients. We observe the success rate of stent retrieval, success rate of PCI, incidence of complications and major adverse cardiovascular events in 1 year follow up. Results: 6 patients were involved, of which 3 are male, ages range 49 to 68 years old, 4 patients are diagnosed with unstable angina, the other two are stable angina. All the partially disloged stents in the 6 patients were successfully removed from coronary artery. Except for 1 patient who refused coronary artery stenting again, the other 5 patients were successfully implanted coronary artery stenting. No serious complications occurred, no patients died and no major adverse cardiovascular events happened during 1 year follow up. Conclusions: DCK is safe and effective to remove partially dislodged stent in coronary artery.

[Consistency evaluation between patient-completed and physician-completed Caprini scores]

Objective: To evaluate the consistency of patient-completed and physician-completed Caprini scores. Methods: This study was a diagnostic study. We prospectively recruited 200 inpatients (including respiratory and critical care medicine, rheumatology and immunology, obstetrics and gynecology, and orthopedics). Clinical data of the recruited patients were collected. The Wechat applet was developed based on the Chinese version of the patient-completed Caprini score. Patient could enter the Wechat applet by scanning the QR code, and enter the height, weight and other contents to the Wechat applet. The applet could automatically calculate the score and make the risk stratification according to total score. At the same time, physicians would calculate the traditional Caprini score for the same patient and make risk stratification to evaluate the consistency of scores derived from the two methods. Results: The average age of these 200 patients was (59.6±13.9) years, 112(56.0%) of them were female and 184(92.0%) with high school education or above. There was no significant difference between the patient-completed and physician-completed scores (4.8±2.5 vs. 4.7±2.5,P=0.336). The time of physician-completed score was shorter than that of patient-completed score ((2.0±1.0) minutes vs.(2.4±1.2) minutes, P<0.000 1). There was no significant difference on the number of high-highest venous thromboembolism risk patients assessed by the patient-completed and the physician-completed scores: 84.5% (169/200) vs. 83.0%(166/200)(χ²=0.165, P=0.684).There was strong positive correlations between patient-completed and physician-completed scores (r=0.98, P<0.000 1). Cohen's ĸ evaluation showed that the patient-completed Caprini score was in excellent consistency with physician-completed Caprini score(κ=0.97,P<0.000 1). The result of Bland Altman method showed that only 3.0% (6/200) of the scores biased greatly, which was not within the 95% confidence interval, the result proved that the bias belonged to a small probability event. It was inferred that the scores of patient-completed were consistent with those of the physician-completed. Conclusions: The patient-completed Caprini score is in good agreement with the physician-completed Caprini score in this patient cohort.

[Application and Inspiration of Information System used in National Health and Nutrition Examination Survey of America]

The National Health and Nutrition Examination Survey (NHANES) of America has been running for more than 60 years and has achieved many significant achievements with international influence. The application of modern information technologies in NHANES provides a supplementary tool for the project's high quality and refined implementation. This paper introduces the information system of NHANES from seven aspects: project management, survey participant interview, physical examination, laboratory examination, field follow-up, data sharing, and social services. The construction and application prospects of the China National Health Survey Information System, suitable for China's native conditions, are also discussed in this article.

AB0144 PD-1 DEFICIENCY IN THE REGULATORY T CELL MAY BE INVOLVED IN THE PATHOGENESIS IN TAKAYASU’S ARTERITIS

Background

Regulatory T cell (Treg cell) has been demonstrated decreased in peripheral blood of TAK patients in recent researches. PD-1 may regulate Treg cell differentiation and apoptosis as an important checkpoint molecule.

Objectives

This study aims to investigate whether PD-1 is involved in the abnormal of Treg cell in TAK.

Methods

This study enrolled 49 patients with TAK and 23 healthy controls. Treg cell related serum cytokines IL-10, IL-7, IL-2 and IL-15, as well as serum chemokines CCL2, CCL3 and CXCL10 were detected using cytokine cytometric bead array. The expression of PD-1 in CD4+Foxp3- T cells and Treg cells were analyzed by flow cytometry analysis in 15 patients with TAK and 18 healthy controls.

Results

Mean fluorescence intensity of PD-1 in CD4+PD-1+ cells decreased in TAK patients [72.2 (45.8, 84.7) vs. 363.00(335, 431), P = 0.000]. The frequency of CD4+Foxp3-PD-1+ cells in CD4+T cells decreased in peripheral blood（9.05 ± 1.06% vs. 12.61 ± 1.17%，P = 0.034）of TAK patients. The percentage of CD4+CD25+Foxp3+PD-1+ cells in CD4+CD25+T cells（0.40 ± 0.05% vs. 0.63 ± 0.09%，P = 0.047）is lower in TAK patients than healthy controls. Higher serum levels of IL-10[4.84（0.07,409.57）vs.3.16（0,69.15）, P = 0.004] and IL-7[10.05（2.68,227.2）vs. 7.4（2.68,16.77）, P = 0.014] level were observed in TAK patients. Compared to healthy controls, serum CCL2[30.64（0，686.84）vs. 10.31（0，32.92），P = 0.000] and CCL3[3.01(0.69,19.24)vs.1.84（0.87，4.6），P = 0.000] increased obviously.

Conclusion

The frequency of CD4+Foxp3-PD-1+/CD4+T cells and CD4+CD25+Foxp3+PD-1+/CD4+CD25+T cells decreased. This study suggested that PD-1 may contribute to the imbalance of regulatory T cell in TAK.

References

[1]Tombetti E, Mason JC. Takayasu arteritis: advanced understanding is leading to new horizons. Rheumatology (Oxford). 2019;58(2):206–219.

[2]Gao N, Cui W, Zhao LM, Li TT, Zhang JH, Pan LL. Contribution of Th2-like Treg cells to the pathogenesis of Takayasu’s arteritis. Clin Exp Rheumatol. 2020; 38 Suppl 124(2):48-54.

[3]Patsoukis N, Wang Q, Strauss L, Boussiotis VA. Revisiting the PD-1 pathway. Sci Adv. 2020;6(38):eabd2712.

[4]Zhang S, Wang L, Li M, Zhang F, Zeng X. The PD-1/PD-L pathway in rheumatic diseases. J Formos Med Assoc. 2021;120(1):48-59.

[5]Le Burel S, Champiat S, Routier E, Aspeslagh S, Albiges L, Szwebel TA, et al. Onset of connective tissue disease following anti-PD1/PD-L1 cancer immunotherapy. Ann Rheum Dis. 2018;77(3):468–470.

[6]Daxini A, Cronin K, Sreih AG. Vasculitis associated with immune checkpoint inhibitors-a systematic review. Clin Rheumatol. 2018;37(9):2579–2584.

[7]Zhang H, Watanabe R, Berry GJ, Vaglio A, Liao YJ, Warrington KJ, et al. Immunoinhibitory checkpoint deficiency in medium and large vessel vasculitis. Proc Natl Acad Sci U S A. 2017;114(6):E970–E979.

[8]Kermani TA. Takayasu arteritis and giant cell arteritis: are they a spectrum of the same disease? Int J Rheum Dis. 2019;22 Suppl 1:41–48.

[9]Kong X, Sun Y, Ma L, Chen H, Wei L, Wu W, et al. The critical role of IL-6 in the pathogenesis of Takayasu arteritis. Clin Exp Rheumatol. 2016;34(3 Suppl 97):S21–S27.

[10]Samson M, Bonnotte B. Pathogenesis of large vessel vasculitis. Rev Med Interne. 2016;37(4):264–273.

[11]Rosenzwajg M, Lorenzon R, Cacoub P, Pham HP, Pitoiset F, El Soufi K, et al. Immunological and clinical effects of low-dose interleukin-2 across 11 autoimmune diseases in a single, open clinical trial. Ann Rheum Dis. 2019;78(2):209–217.

[12]Saraiva M, Vieira P, O’Garra A. Biology and therapeutic potential of interleukin-10. J Exp Med. 2020;6;217(1):e20190418.

[13]Barata JT, Durum SK, Seddon B. Flip the coin: IL-7 and IL-7R in health and disease. Nat Immunol. 2019;20(12):1584-1593.

[14]Luo CT, Liao W, Dadi S, Toure A, Li MO. Graded Foxo1 activity in Treg cells differentiates tumour immunity from spontaneous autoimmunity. Nature. 2016;28;529(7587):532-6.

[15]Postow MA, Sidlow R, Hellmann MD. Immune-related adverse events associated with immune checkpoint blockade. N Engl J Med. 2018;378(2):158–168. doi:10.1056/NEJMra1703481.

Disclosure of Interests

None declared

POS0724 RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER, RETROSPECTIVE, COHORT STUDY

Background

Coronary artery disease (CAD) not only has an increased prevalence but also is a major cause of premature mortality in systemic lupus erythematosus (SLE) [1, 2]. However, information is limited regarding the risk factors for CAD in Chinese patients with SLE.

Objectives

To assess the risk factors for CAD in Chinese patients with SLE.

Methods

This multi-center, retrospective, cohort study included 3778 consecutive SLE patients, with CAD (CAD group) or without a medical history of CAD (control group). CAD was defined as a coronary stenosis ≥50% in any major epicardial coronary vessel detected by coronary angiography or a history of myocardial infarction confirmed by medical records. General parameters, clinical features, laboratory tests and medical therapies were compared between groups, and the risk factors for CAD in SLE were analyzed by logistic regression analysis.

Results

The age at baseline was older, male ratio was higher and body mass index was greater in CAD group (all P<0.001). Traditional CAD risk factors including diabetes mellitus, hypertension, dyslipidemia, family history of CAD and smoking were more common in CAD group (all P<0.001) (Figure 1). SLE Disease Activity Index 2000 was greater (P=0.012), hyperuricemia and elevated C-reactive protein (CRP) were more prevalent (both P<0.001), and an increased corticosteroids’ usage (P=0.018) was detected in CAD group (Table 1). Binary logistic regression analysis showed hyperuricemia (odds ratio: 3.082, 95% confidence interval: 1.283-7.403; P=0.012) and CRP (odds ratio: 7.248, 95% confidence interval: 2.931-17.925; P<0.001) were independent risk factors for CAD in SLE patients.

Table 1.

Comparison of clinical features in SLE patients between CAD group and control group.

ParametersControl group (n=3732)CAD group (n=46)PAge at baseline [years, median (P25, P75)]35.00 (29.00, 45.00)59.50 (50.25, 67.75)<0.001Male, n (%)296 (7.94)11 (23.91)<0.001Disease duration [years, median (P25, P75)]8.00 (4.00, 12.00)10.00 (4.00, 19.00)0.173Body mass index [kg/m2, median (P25, P75)]21.77 (19.63, 24.16)23.50 (22.09, 25.36)<0.001Renal disorder, n (%)1737 (46.57)9 (19.57)<0.001Neurologic disorder, n (%)595 (15.95)3 (6.52)0.082Thrombocytopenia, n (%)859 (23.03)8 (17.39)0.366SLEDAI-2K [median (P25, P75)]3.00 (0.00, 8.00)5.50 (1.50, 14.00)0.012Elevated creatinine, n (%)295 (7.91)10 (21.74)0.002Hyperuricemia, n (%)209 (5.60)16 (34.78)<0.001Elevated ESR, n (%)951 (25.5)22 (47.83)0.001Elevated CRP, n (%)210 (5.63)15 (32.61)<0.001Positive aPL, n (%)734 (19.68)11 (23.91)0.474Corticosteroids, n (%)2752 (73.78)41 (89.13)0.018Immunosuppressants, n (%)2950(79.09)37 (80.43)0.823

Abbreviations: aPL, antiphospholipid antibody; CAD, coronary artery disease; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; SLE, systemic lupus erythematosus; SLEDAI-2K, SLE Disease Activity Index 2000. P <0.05 are shown as italics and bold.

Figure 1.

Comparison of traditional risk factors in SLE patients between CAD group and control group. Abbreviations: CAD, coronary artery disease; SLE, systemic lupus erythematosus. All P<0.001.

Conclusion

Hyperuricemia and CRP are independent risk factors for CAD in SLE patients. This study highlights the association between hyperuricemia, CRP and CAD burden in SLE, and might provide a modifiable perspective on improving SLE outcomes.

References

[1]Gonzalez LA, Alarcon GS. The evolving concept of SLE comorbidities [J]. Expert Rev Clin Immunol, 2017, 13(8): 753-768.

[2]Kostopoulou M, Nikolopoulos D, Parodis I, et al. Cardiovascular Disease in Systemic Lupus Erythematosus: Recent Data on Epidemiology, Risk Factors and Prevention [J]. Curr Vasc Pharmacol, 2020, 18(6): 549-565.

Disclosure of Interests

None declared

AB0598 ASSOCIATION OF PROLONGED DISEASE DURATION AND TG/HDL-C RATIO IN ACCELERATING ATHEROSCLEROSIS IN PATIENTS WITH TAKAYASU’S ARTERITIS

Background

Takayasu’s arteritis (TA) is an autoimmune vasculitis that frequently occur in young women.Multiple previous studies have demonstrated that accelerated atherosclerotic changes were commonly found in TA patients[1-4].More specifically, data indicated that as much as 27% of all TA patients developed carotid artery plaque, while which was only 2% in the age- and sex-matched healthy individuals[1]. In addition, up to 20% of TA patients developed stroke and/or transient ischemic attack(TIA), which both have been known to be associated with atherosclerotic lesions[1-3]. Inflammation of the vascular wall may promotes atherosclerosis (As) in TA,which accelerates the development of As.Higher triglyceride (TG)/HDL-C ratio was found to be associated with presence of endothelial dysfunction and As[5].

Objectives

This study aimed to identify the risk factors associated with the development of atherosclerosis in TA.

Methods

This retrospective study enrolled a total of 101 TA patients. All patients were divided into two groups according to the absence or presence of atherosclerosis(43 vs 58). Baseline demographic features and clinical characteristics were compared between two groups. A logistic model was applied to determine the risk factors associated with the development of atherosclerosis.

Results

Our data suggested that the disease duration of patients in the atherosclerosis group was significantly longer than that of patients in the non-atherosclerosis group [96(18.00,180.00) vs 48.00(12.00,111.00) months] (p=0.015). In addition, the average age of patients with atherosclerosis was significantly older compared to patients without atherosclerosis [44.00（38.00，48.00）vs 28.50（24.00，37.00）years] (p<0.001). Logistic regression analysis showed that the risk of developing atherosclerosis increased by 9.2% per 1 year increase in thedisease duration(p=0.005, OR 1.092,95%CI:1.027-1.162).Patients with TG/HDL-C ratio more than 0.8875 were associated with a 5.861fold increase of risk developing atherosclerosis(p<0.001, 95%CI:2.299-14.939).

Conclusion

Our study indicated that prolonged disease duration and elevated TG/HDL-C ratio are associated with the development of atherosclerosis in TA patients.

References

[1]Seyahi E, Ugurlu S, Cumali R, Balci H, Seyahi N, Yurdakul S, et al. Atherosclerosis in Takayasu arteritis. Ann Rheum Dis. 2006;65(9):1202-7.

[2]Numano F, Okawara M, Inomata H, Kobayashi Y. Takayasu’s arteritis. Lancet. 2000;356(9234):1023-5.

[3]Park KC, Kim JH, Yoon SS, Heo SH. Takayasu’s disease presenting with atherothrombotic ischaemic stroke. Neurol Sci. 2008;29(5):363-6.

[4]Seyahi E, Ucgul A, Cebi Olgun D, Ugurlu S, Akman C, Tutar O, et al. Aortic and coronary calcifications in Takayasu arteritis. Semin Arthritis Rheum. 2013;43(1):96-104.

[5]Keles N, Aksu F, Aciksari G, et al. Is triglyceride/HDL ratio a reliable screening test for assessment of atherosclerotic risk in patients with chronic inflammatory disease?:[J]. Northern Clinics of Istanbul, 2016, 3(1):39-45.

Figure 1.

Disclosure of Interests

None declared

AB0600 ANALYSIS OF RISK FACTORS AND PROGNOSIS IN PATIENTS OF TAKAYASU’S ARTERITIS WITH CORONARY ARTERY LESIONS

Background

Takayasu’s arteritis（TA）can involve coronary artery lesions. The pathogenesis is complex and lacks the best treatment strategy.The coronary artery lesions were typical seen in the ostia of the left and right coronary arteries which were major risk factors for sudden death and ischemia heart failure[1-2].Coronary artery lesions is an important predictor of poor prognosis in TA patients.The incidences of coronary artery lesions were more common in type V TA patients [3-4].The prevalence of metabolic syndrome and its related characteristics (including dyslipidemia, diabetes and hyperinsulinemia) in TA patients are higher compared with healthy people[5].Thus，under the action of vascular inflammation and traditional risk factors, coronary artery stenosis or even occlusion occurs earlier, which can lead to MACE events.

Objectives

The aim of our study is to investigate the risk factors and prognosis of coronary artery lesions in TA patients.

Methods

This retrospective study enrolled a total of 120 TA patients.All patients were divided into two groups according to the absence or presence of coronary artery lesions in TA patients (61 vs 59). A logistic model was applied to determine the risk factors associated with the incidence of coronary artery lesions in TA patients.According to the before and after imaging comparison of TA with coronary artery lesions, the influencing factors of improving TA with coronary artery lesions were analyzed.

Results

The incidence of coronary artery lesions in TA patients increased by 1.618 times for each additional year (p=0.034, OR1.618,95%CI: 1.036-2.529). History of hyperlipidemia indicated 10.124 fold higher risk of coronary artery lesions in TA patients(p=0.003, OR10.124,95%CI: 2.159-47.483).In the follow-up of TA with coronary artery lesions, 27 patients had coronary CTA results before and after comparison. It was found that 11 patients had remission of coronary artery lesions and 16 patients had no remission of coronary artery lesions. The age in the group with improved coronary imaging was significantly younger than that in the group without improved coronary imaging[（39.00±9.81 vs (47.44±10.06) years,p=0.041)].TNF-α and interleukin-6 were significantly higher in the group with improved coronary imaging than in the group without improved coronary imaging[（26.40(10.08，165.90) vs 7.80(6.73，21.70)pg/dl,p=0.047;12.50(5.83，19.30) vs3.71(2.80，4.40)pg/dl,p<0.001].Numano type V (75.00% vs 27.27%, p = 0.022) and vascular calcification (56.25% vs 9.09%, p= 0.018) were significantly higher than those in the group without improved coronary imaging, while numano type IIb in the group with improved coronary imaging was significantly higher than that in the group without improved coronary imaging(45.45% vs 6.25%，p=0.027).

Conclusion

Hyperlipidemia and age are the risk factors of coronary artery lesions in Takayasu arteritis.Numano type V and vascular calcification are not conducive to the improvement of TA with coronary artery lesions.All patients with TA of numano type IIb should be screened for coronary artery. Early control of inflammation is more conducive to the imaging improvement of arteritis coronary lesions.

References

[1]Matsubara, O, Kuwata, T, Nemoto, T, et al., Coronary artery lesions in Takayasu arteritis: pathological considerations, Heart and vessels. Supplement, 1992;7:26-31.

[2]Wang H, Liu Z, Shen Z, et al. Impact of coronary involvement on long-term outcomes in patients with Takayasu’s arteritis. Clin Exp Rheumatol 2020;38:1118-26.

[3]LiJ,et al.. (2017) Clinical characteristics of heart involvement in Chinese patients with Takayasu arteritis. J Rheumatol 44:1867–1874.

[4]Li T, Du J, Gao N, et al. Numano type V Takayasu arteritis patients are more prone to have coronary artery involvement. Clin Rheumatol 2020;39:3439-47.

[5]Soto ME, et al..(2011) Coronary CT angiogra- phy in Takayasu arteritis. JACC Cardiovasc Imaging 4(9):958–966

Figure 1.

Disclosure of Interests

None declared

[The correlation of physical activity and sedentary leisure time with low muscle mass, strength, and quality in Chinese adults]

Objective: To explore the relationship of physical activity and sedentary leisure time with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of physical activity and sedentary leisure time with low muscle mass, grip strength, and muscle quality. Results: A total of 24 245 participants were included in the analysis. The average daily physical activity level was (18.3±13.8) MET-h/d, and the sedentary leisure time was (4.4±1.9) hours. We took the lowest physical activity quartile as the reference and found that the participants' physical activity was negatively correlated to low muscle mass, strength, and quality. The ORs (95%CIs) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low arm muscle quality (AMQ) were 0.68 (0.60-0.77), 0.66 (0.58-0.75), 0.82 (0.72-0.94) and 0.84 (0.74-0.95), respectively. The subtypes of physical activity, including those related to work, transportation, housework, and leisure, also showed negative correlations with low muscle mass, strength, and quality to varying degrees. Compared with participants with the shortest sedentary leisure time, those who had the longest were more likely to have low TSMI (OR=1.13, 95%CI: 0.99-1.30). Conclusions: Physical activity was negatively correlated with a lower risk of low muscle mass and strength, while longer sedentary leisure time positively correlated with low muscle mass.

[The correlation of sleep duration and insomnia with low muscle mass, strength and quality in Chinese adults]

Objective: To explore the relationship of sleep duration and insomnia with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of sleep duration, insomnia, and its duration with low muscle mass, handgrip strength, and muscle quality. Results: The average sleep duration of the study population was (7.4±1.5) hours. Morbidities of short sleep duration (<6 hours), long sleep duration (≥9 hours), and insomnia were 9.3%,17.4%,and 29.9%,respectively. Compared with those who slept for 7- hours, those who slept for ≥9 hours were more likely to have low muscle mass, low handgrip strength,and low arm muscle quality (AMQ), and the OR (95%CI) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low AMQ were 1.32 (1.18-1.48),1.26 (1.13-1.41), 1.33 (1.18-1.49) and 1.16 (1.03-1.30), respectively. Compared with participants without insomnia, insomnia patients were more likely to have low muscle mass,and the longer the duration of insomnia,the higher the risk (P for trend <0.001). Participants who reported <6 hours sleep duration and insomnia had a higher proportion of low ASMI and low TSMI,compared with those who slept for 7- hours and without insomnia, the OR (95%CI) were 1.26 (1.08-1.47) and 1.25 (1.07-1.46), respectively. Conclusions: Participants who reported ≥9 hours sleep duration were more likely to have low muscle mass,low handgrip strength,and low AMQ. Participants with insomnia had lower muscle mass, and the longer the duration of insomnia, the higher the proportion of low ASMI and low TSMI.

Sodium MRI at 7T for Early Response Evaluation of Intracranial Tumors following Stereotactic Radiotherapy Using the CyberKnife

BACKGROUND AND PURPOSE

Conventionally, early treatment response to stereotactic radiotherapy in intracranial tumors is often determined by structural MR imaging. Tissue sodium concentration is altered by cellular integrity and energy status in cells. In this study, we aimed to investigate the feasibility of sodium MR imaging at 7T for the preliminary evaluation of radiotherapeutic efficacy for intracranial tumors.

MATERIALS AND METHODS

Data were collected from 16 patients (12 men and 4 women, 24-75 years of age) with 22 intracranial tumors who were treated with stereotactic radiation therapy using CyberKnife at our institution between December 1, 2016, and August 15, 2019. Sodium MR imaging was performed at 7T before and 48 hours, 1 week, and 1 month after CyberKnife radiation therapy. Tissue sodium concentration (TSC) was calculated and analyzed based on manually labeled regions of tumors.

RESULTS

Ultra-high-field sodium MR imaging clearly showed the intratumoral signal, which is significantly higher than that of normal tissue (t = 5.250, P <.001)., but the edema zone has some influence. The average TSC ratios of tumor to CSF in the 22 tumors, contralateral normal tissues, edema zones, frontal cortex, and frontal white matter were 0.66 (range, 0.23-1.5), 0.30 (range, 0.15-0.43), 0.58 (range, 0.25-1.21), 0.25 (range, 0.17-0.42), and 0.30 (range, 0.19-0.49), respectively. A total of 12 tumors in 8 patients were scanned at 48 hours, 1 week, and 1 month after treatment. The average TSC at 48 hours after treatment was 0.06 higher than that before treatment and began to decrease at 1 week. The TSC ratios of 10 continued to decline and 2 tumors increased at 1 month, respectively. Tumor volume decreased by 2.4%-99% after 3 months.

CONCLUSIONS

Changes in the TSC can be quantified by sodium MR imaging at 7T and used to detect radiobiologic alterations in intracranial tumors at early time points after CyberKnife radiation therapy.

Classification of eCRS: Based on disease outcome or normal range?: Comment on Toro et al

Undoubtedly, there is a lack of unanimous histopathologic criteria to classify eosinophilic chronic rhinosinusitis (eCRS) worldwide. We read with great interest the recent constructive systematic review by Toro et al.(1). The authors stretched out the current knowledge on the methods of classifying eCRS to determine an optimal cut-off point. While the authors are to be congratulated for their comprehensive overview, a point regarding the disease recurrence as the most relevant parameter to divide eosinophilic and noneosinophilic inflammation in chronic rhinosinusitis (CRS) should be discussed. In order to contribute to an evidence-based standardization of cut-off point to classify eCRS, we would like to share our considerations and approaches in this comment.

Evaluation performance of azobenzene liquid-crystal shape memory polyurethane with photo-thermo-synergy response

This paper aimed to investigate the photo-response performance of a polymeric material using a series of azobenzene liquid-crystal shape memory polyurethane (DB-SMPn) with azobenzene-4,4'-dicarboxylic acid (ADA), N, N-bis (2-hydroxyethyl) isonicotinamine...

Construction and Clinical Translation of Causal Pan-Cancer Gene Score Across Cancer Types

Pan-cancer strategy, an integrative analysis of different cancer types, can be used to explain oncogenesis and identify biomarkers using a larger statistical power and robustness. Fine-mapping defines the casual loci, whereas genome-wide association studies (GWASs) typically identify thousands of cancer-related loci and not necessarily have a fine-mapping component. In this study, we develop a novel strategy to identify the causal loci using a pan-cancer and fine-mapping assumption, constructing the CAusal Pan-cancER gene (CAPER) score and validating its performance using internal and external validation on 1,287 individuals and 985 cell lines. Summary statistics of 15 cancer types were used to define 54 causal loci in 15 potential genes. Using the Cancer Genome Atlas (TCGA) training set, we constructed the CAPER score and divided cancer patients into two groups. Using the three validation sets, we found that 19 cancer-related variables were statistically significant between the two CAPER score groups and that 81 drugs had significantly different drug sensitivity between the two CAPER score groups. We hope that our strategies for selecting causal genes and for constructing CAPER score would provide valuable clues for guiding the management of different types of cancers.

Opa1 Prevents Apoptosis and Cisplatin-Induced Ototoxicity in Murine Cochleae

Optic atrophy1 (OPA1) is crucial for inner mitochondrial membrane (IMM) fusion and essential for maintaining crista structure and mitochondrial morphology. Optic atrophy and hearing impairment are the most prevalent clinical features associated with mutations in the OPA1 gene, but the function of OPA1 in hearing is still unknown. In this study, we examined the ability of Opa1 to protect against cisplatin-induced cochlear cell death in vitro and in vivo. Our results revealed that knockdown of Opa1 affects mitochondrial function in HEI-OC1 and Neuro 2a cells, as evidenced by an elevated reactive oxygen species (ROS) level and reduced mitochondrial membrane potential. The dysfunctional mitochondria release cytochrome c, which triggers apoptosis. Opa1 expression was found to be significantly reduced after cell exposed to cisplatin in HEI-OC1 and Neuro 2a cells. Loss of Opa1 aggravated the apoptosis and mitochondrial dysfunction induced by cisplatin treatment, whereas overexpression of Opa1 alleviated cisplatin-induced cochlear cell death in vitro and in explant. Our results demonstrate that overexpression of Opa1 prevented cisplatin-induced ototoxicity, suggesting that Opa1 may play a vital role in ototoxicity and/or mitochondria-associated cochlear damage.

Metabolite identification in preclinical and clinical phase of drug development

Metabolite identification plays a critical role in the phases during drug development. Drug metabolites can contribute to efficacy, toxicity, and drug-drug interaction. Thus, the correct identification of metabolites is essential to understand the behavior of drugs in humans. Drug administration authorities (e.g., FDA, EMA, and NMPA) emphasize evaluating the safety of human metabolites with exposure higher than 10% of the total drug-related components. Many previous reviews have summarized the various methods, tools, and strategies for the appropriate and comprehensive identification of metabolites. In this review, we focus on summarizing the importance of identifying metabolites in the preclinical and clinical phases of drug development. Summarized scenarios include the role of metabolites in pharmacokinetics/pharmacodynamics (PK/PD) analysis, disproportional exposure of metabolites that contribute to drug toxicity, changes in metabolite exposure in renal-impaired patients, covalent tyrosine kinase inhibitors (anticancer drugs), and metabolite identification of drug candidates from natural medicines. This review is aimed to provide meaningful insight into the significant role of metabolite identification in drug development.

Relationship between the amino acid release kinetics of feed proteins and nitrogen balance in finishing pigs

In current nutrition requirements of swine, although the protein diets are formulated based on the ileal digestibility of protein and amino acid (AA), there is a difference in nitrogen utilisation among various protein diets, which might be related to the AA release kinetics. To evaluate the relationship between AA release kinetics of feed proteins and nitrogen balance in finishing pigs, pigs were fed diets based on casein (CAS) or corn gluten meal (CGM) at normal or low-protein concentrations, and the AA release patterns were assessed. A 2 × 2 full factorial experimental design was used. 24 pigs (Duroc × Landrace × Yorkshire) with an initial weight of 67.0 ± 1.8 kg were randomly assigned to consume a normal-protein casein-based diet (N.CAS, 10% CP), normal-protein corn gluten meal-based diet (N.CGM, 10% CP), low-protein casein-based diet (L.CAS, 8.5% CP), or low-protein corn gluten meal-based diet (L.CGM, 8.5% CP) for 14 days (n = 6 per group; pigs housed and fed separately). The low-protein diets were associated with a more rapid release of AAs in the early stages of gastric digestion than the normal-protein diets. The N.CAS and L.CAS diets were associated with a peak AA release at approximately 4 h during trypsin digestion, whereas N.CGM and L.CGM were at approximately 16 h. The N.CAS diet was associated with the least dispersed release curves and lowest synchronisation indexes, implying that it was associated with the best AA release synchronism, whereas the L.CGM diet was on the contrary. The nitrogen intake (NI), faecal nitrogen, urine nitrogen (UN), total nitrogen, net protein utilisation and apparent biological value (ABV) of protein of pigs fed the L.CAS or L.CGM diets were lower than those fed the N.CAS or N.CGM diets (P < 0.05). Notably, there was a difference in NI (P < 0.05) and trends with respect to UN and ABV (0.05 < P < 0.1), but no differences in retained nitrogen or apparent nitrogen digestibility between pigs fed the N.CAS or L.CAS diets and those fed the N.CGM or L.CGM diets. Pigs fed the N.CAS or N.CGM diets had higher serum concentrations of UN than pigs fed the L.CAS or L.CGM diets (P < 0.05), but there were no differences in serum total protein, albumin, triglyceride, glucose, alanine transaminase, or aspartate aminotransferase between the groups. In addition, there was an interaction between protein level and protein source on serum globulin (P < 0.05). Therefore, the diet with a better AA release synchronism can improve protein utilisation efficiency in finishing pigs and to reduce environmental pollution.

Targeting STING attenuates ROS induced intervertebral disc degeneration

OBJECTIVE

DNA damage induced by ROS is considered one of the main causes of nucleus pulposus (NP) cells degeneration during the progression of intervertebral disc degeneration (IVDD). cGAS-STING pathway acts as DNA-sensing mechanism for monitoring DNA damage. Recent studies have proved that cGAS-STING contributes to the development of various diseases by inducing inflammation, senescence, and apoptosis. This work explored the role of STING, the main effector of cGAS-STING signaling pathway, in NP degeneration.

METHOD

Immunohistochemistry was conducted to measure STING protein levels in the nucleus pulposus tissues from human and puncture-induced IVDD rat models. TBHP induces degeneration of nucleus pulposus cells in vitro. For in vivo experiments, lv-NC or lv-STING were injected into the central intervertebral disc space. The degeneration level of IVDD was assessed by MRI, X-ray, HE, and Safranin O staining.

RESULTS

We found that the expression of STING was upregulated in human and rat degenerated NP tissue as well as in TBHP-treated NP cells. Overexpression of STING promoted the degradation of extracellular matrix; it also promoted apoptosis and senescence of TBHP-treated and untreated NP cells. Knock-down of STING significantly reversed these effects. Mechanistically, STING activated IRF3, whereas blockage of IRF3 attenuated STING-induced apoptosis, senescence and ECM degradation. In vivo experiments revealed that STING knock-down alleviated puncture-induced IVDD development.

CONCLUSION

STING promotes IVDD progress via IRF3, while suppression of STING may be a promising treatment for IVDD.