Na3Bi(IO3)6: An Alkali-Metal Bismuth Iodate with Intriguing One-Dimensional [BiI6O18] Chains and Pressure-Induced Structural Transition

An alkali-metal bismuth iodate, Na₃Bi(IO₃)₆, was successfully obtained by the hydrothermal method for the first time and contains intriguing one-dimensional [BiI₆O₁₈] chains. High-pressure Raman spectra were carried out to investigate the structural transition of Na₃Bi(IO₃)₆. Electronic states and anisotropic optical responses were also investigated by theoretical calculations.

The risk and impact of organophosphate esters on the development of female-specific cancers: Comparative analysis of patients with benign and malignant tumors

Environmental pollution has become a concern for public health. As endocrine disruptors, organophosphate esters (OPEs) causes many diseases via human exposure. However, there is limited research on the risk of OPE exposure to female-specific cancers. Blood measurements are biomarkers for chemical exposures by their definition. Thus, in the present study, 11 OPEs were analyzed in the plasma of patients with 4 female-specific tumors. 2-Ethylhexyl diphenyl phosphate (EHDPP) was detected at the highest levels in all groups. The Spearman correlation test results showed significantly positive correlations between some OPEs in each group, which indicated that those OPEs had similar sources and/or behaved similarly in the patients of each group. However, compared with different patient groups, obvious differences in the correlation results were noted, implying the differences in the metabolism of OPEs between different groups. The results of the correlation analysis showed that EHDPP concentration was associated with the risk of breast cancer (p < 0.05), while tri-n-butyl phosphate (TNBP), tris (methylphenyl) phosphate (TMPP), triphenyl phosphate (TPHP), and EHDPP concentrations were associated with the risk of cervical cancer (p < 0.05 or p < 0.01). These findings indicated that OPEs were associated with the risk of breast and cervical cancer.

Hypoxia-Induced LXRα Contributes to the Migration and Invasion of Gastric Cancer Cells

Gastric cancer is characterized by the presence of high invasion ability, hypoxia and chemoresistance. Previous studies reported that liver X receptor α (LXRα) was involved in epithelial-mesenchymal transition (EMT) of gastric cancer cells. However, hypoxia-mediated EMT and the role of LXRα in gastric cancer remained elusive. In this study, we demonstrated that LXRa mRNA and protein levels were up-regulated by hypoxia treatment and LXRα played an important role in HIF-1 dimer induced-EMT. The putative HIF-1α binding site was identified in the LXRa promoter. Expression of LXRα and HIF-1α was significantly up-regulated in gastric cancer tissues compared to that in normal tissues. More importantly, we noticed that the expression of LXRα and HIF-1α was significantly correlated. Taken together, these data suggested that LXRα is regulated by the activity and accumulation of HIF-1α and contributes to EMT of gastric cancer cells. This suggests that targeting LXRα might be a potential approach for improving survival of gastric cancer patients.

BaZnBe2(BO3)2F2: a novel zinc-beryllium borate with SBBO-type structure overcoming the polymorphism problem

A novel zinc-beryllium borate BaZnBe₂(BO₃)₂F₂ was grown for the first time. It was rationally designed to overcome the structural instability problems of Sr₂Be₂B₂O₇ (SBBO) and exhibits a moderate birefringence (Δn = 0.063 at 1064 nm).

[The characteristics and citation analysis of the publications in National Medical Journal of China during 2016]

Objective: To analyze the characteristics and citations of articles in National Medical Journal of China (NMJC) during 2016, and to discuss the academic level and quality of the journal. Methods: All the literature published in NMJC during 2016 were retrieved through the Chinese Medical Citation index, and the citation frequency data in China's core journals of science and technology from January 2017 to December 2018 was obtained through Institute of Scientific and Technical Information of China. The citation status of articles published in NMJC was statistically analyzed by the method of literature metrology. The main indicators included the citation rate of articles published in each year, the citation frequency of all articles, the citation status of individual papers and authors, the regional and high-yield institution distribution of cited authors, and the main citation journals. Results: In 2016, a total of 962 articles were published in 22 columns of NMJC. The total number of published pages was 3 940, and the average number of articles was 4.09 pages. A total of 28 key topics have been published. The total citation was 2 077 times, with 2.16 times per paper. Among them, 322 papers were not cited, accounting for 33.47%. The maximum citation frequency of a single paper was 66 times. There were good citations in the columns of Guidelines, Epidemiology, New technology and methods, Clinical research and Editorial. Oncology, neurology/psychiatry, imaging/ultrasound/radiology, respiratory medicine and orthopedics accounted for a large part [40.43% (389 articles)]. Articles in neurosurgery, respiratory medicine, preventive medicine and gastrointestinal surgery were all cited with high frequency (all ≥2.75 times/article). A total of 483(50.21%) articles had obtained fund support, and the rate (68.12%) of them cited was slightly higher than that of articles without fund support (64.93%). A total of 23 articles were cited ≥10 times, and 16 first authors were cited ≥10 times. In addation, 26 corresponding authors were cited ≥10 times and 10 institutions were cited more than 15 times. The authors of the cited papers were distributed in 29 provinces (autonomous regions, municipalities directly under the central government), and there were more articles and higher total citation frequency in Beijing, Shanghai, Jiangsu and Tianjin. From 2017 to 2018, papers published in NMJC were cited 2 077 times by a total of 490 journals. Conclusions: The guidelines published in NMJC is highly cited. The editorial department should adjust the column setting timely, strengthen the planning of key topic selection and the solicitation and publicity of excellent papers, and further improve the influence of the magazine.

[Current trend of breast cancer neoadjuvant treatment in China: a cross-sectional study]

Objective: To investigate the current trend of breast cancer neoadjuvant therapy and provide reference for the improvement of breast cancer clinical guideline in the future. Methods: Questionnaires of cross-sectional survey were sent to 110 hospitals (breast cancer surgery quantity surpassing 200) between July 2018 and September 2018. The stages and subtypes, therapeutic regimen, treatment assession, operation choice and preforming of patients underwent neoadjuvant therapy were recorded. Results: Neoadjuvant treatment has been performed in all of the 110 hospitals. The total number of breast patients underwent neoadjuvant therapy was about 14 550 (17.0% in surgical patients) in 2017. For all of the neoadjuvant patients, the proportion of stageⅡ patients was less than 30% in 81 hospitals, and the proportion of stage Ⅲ was more than 50% in 84 hospitals. The numbers of estrogen receptor (ER) (+ )/human epidermal growth factor receptor-2 (HER-2) (-), ER (-)/HER-2 (+ ) and triple negative subtype breast cancer patients were 3 550 (24.4%), 6 024 (41.4%) and 4 991 (34.3%), respectively. Patient's scruples of relatively delayed operation and weak will of breast conservation after neoadjuvant therapy were the majority reasons for neoadjuvant therapy restriction. Anthracycline followed by taxane was the most usual neoadjuvant therapeutic regimens in 53.6% hospitals, and anthracycline plus taxane was the first choice in 42.7% hospitals. Chemotherapy with targeting therapy was recommended to HER-2 positive neoadjuvant patients in 80.9% hospitals. To assess treatment outcome of neoadjuvant treatment, 42.7% hospitals used MRI in more than 50% patients while the usage rate of MRI was less than 20% in 37.3% hospitals. The proportions of hospital using repeat-marking, tattoo and metal clip as the first method to identify the primary tumor region and lymph nodes were 60.0%, 29.1% and 10.9%, respectively. Breast-conservation rate after neoadjuvant therapy was less than 20% in 87.3% hospitals. Conclusions: Neoadjuvant therapy for breast cancer is widely performed in most hospitals in China, while the proportion of neoadjuvant treatment in patients with operable breast cancer is still low. Meanwhile, the idea of achieving de-escalation operation through neoadjuvant treatment is not promoted and the therapeutic evaluation method of neoadjuvant treatment needs further studies to improve.

Association of C1q/TNF-related protein-9 (CTRP9) level with obstructive sleep apnea in patients with coronary artery disease

Background

Obstructive sleep apnea (OSA) is closely related to the incidence and progression of coronary artery disease (CAD), but the mechanisms linking OSA and CAD are unclear. C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that protects the heart against ischemic injury and ameliorates cardiac remodeling.

Purpose

We aimed to ascertain the clinical relevance of CTRP9 with OSA prevalence in patients with CAD.

Methods

From August 2016 to March 2019, consecutive eligible patients with CAD (n=154; angina pectoris, n=88; acute myocardial infarction [AMI], n=66) underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index (AHI) ≥15 events h–1. Plasma CTRP9 concentrations were measured by ELISA method.

Results

OSA was present in 89 patients (57.8%). CTRP9 levels were significantly decreased in the OSA group than in the non-OSA group (4.7 [4.1–5.2] ng/mL vs. 4.9 [4.4–6.0] ng/mL, P=0.003). The difference between groups was only observed in patients with AMI (3.0 [2.3–4.9] vs. 4.5 [3.2–7.9], P=0.009), but not in patients with AP (5.0 [4.7–5.3] ng/mL vs. 5.1 [4.7–5.9] ng/mL, P=0.571) (Figure 1). Correlation analysis showed that CTRP9 levels were negatively correlated with AHI (r=−0.238, P=0.003) and oxygen desaturation index (r=−0.234, P=0.004), and positively correlated with left ventricular ejection fraction (r=0.251, P=0.004) in all subjects. Multivariate analysis showed that male gender (OR 3.099, 95% CI 1.029–9.330, P=0.044), body mass index (OR 1.148, 95% CI 1.040–1.268, P=0.006), and CTRP9 levels (OR 0.726, 95% CI 0.592–0.890, P=0.002) were independently associated with the prevalence of OSA.

Conclusions

Plasma CTRP9 levels were independently related to the prevalence of OSA in patients with CAD, suggesting that CTRP9 might play a role in the pathogenesis of CAD exacerbated by OSA.

Figure 1. CTRP9 levels in OSA and non-OAS groups

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China

MiR-200c regulates apoptosis of placental trophoblasts in preeclampsia rats through Wnt/β-catenin signaling pathway

OBJECTIVE

To investigate the influence of micro ribonucleic acid 200c (miR-200c) on the apoptosis of placental trophoblasts in a rat model of preeclampsia (PE).

MATERIALS AND METHODS

PE model in rats was established for extracting placental trophoblasts. Overexpression or knockdown of miR-200c was achieved by transfection of miR-200c mimics or inhibitor. Flow cytometry was carried out to detect the apoptotic rate of placental trophoblasts. Dual-luciferase reporter gene assay was performed to detect the interaction of miR-200c with WNT1. Western blotting was applied to determine the changes of protein levels in placental trophoblasts.

RESULTS

The expression level of miR-200c in placental trophoblasts of PE group was significantly higher than that in control group. The apoptosis rate was (22.45 ± 2.62)%, (6.58 ± 1.28)%, and (9.57 ± 1.35)% in miR-200c mimic group, miR-200c inhibitor group, and control group, respectively, showing statistically significant differences. MiR-200c overexpression downregulated the expression level of anti-apoptotic protein B-cell lymphoma 2 (Bcl-2), but upregulated expression levels of apoptotic proteins Bcl-2-associated X protein (Bax) and active Caspase-3. MiR-200c suppressed WNT1 expression through the interaction with the 3'-untranslated region (3'-UTR) of WNT1. The expressions of WNT1 and β-catenin were up-regulated after miR-200c overexpression, which was reversed by the Wnt/β-catenin pathway activator.

CONCLUSIONS

MiR-200c is involved in the development and progression of PE through the Wnt/β-catenin signaling pathway.

Characterization and health risk assessment of organophosphate esters in indoor dust from urban and rural domestic house and college dormitory in Nanjing, China

Indoor dust is an important route of exposure for organophosphate esters (OPEs), which are associated with adverse health effects. In the present study, the pollution occurrence and potential health risks of 13 OPEs in indoor dust from urban homes, college dormitories, and rural homes in Nanjing were investigated. Most OPEs were detected in the tested samples. College dormitories dust samples showed significantly higher OPEs concentrations (132.31-1.61 × 10³ ng/g), followed by that in urban homes (31.42-49.84 ng/g) and rural homes (51.19-309.75 ng/g). The Mann-Whitney U test found no significant difference in the total concentrations of OPEs except for some individual OPEs between urban and rural homes. Tris (2-chloroisopropyl) phosphate (TCPP) was the most abundant compound in all tested areas. Spearman correlation coefficients and principal component analysis indicated that OPEs might originate from different sources in three microenvironments. Estimated exposures for adults and children in all indoor dust were below the relevant reference doses. Additionally, TCPP was the primary contributors to the non-carcinogenic risk, ranging from 1.07 × 10^-6 to 2.20 × 10^-5. Tris (2,3-dibromopropyl) phosphate was the dominant carcinogenic risk contributor in indoor dust, with a range of 1.33 × 10^-11 to 8.74 × 10^-10. These results suggested that the health risk of OPEs was within acceptable limits in the tested areas.

The association of hematuria on kidney clinicopathologic features and renal outcome in patients with diabetic nephropathy: a biopsy-based study

PURPOSE

To investigate the relationships between hematuria, clinicopathological features and renal outcomes in patients with biopsy-proven diabetic nephropathy (DN).

METHODS

This cohort study included 261 patients with DN. Participants were divided into two groups according to number of red blood cells per high-power field (RBC/hpf) in urine sediment: the hematuria (-) group (≤ 3 RBC/hpf) and the hematuria (+) group (> 3 RBC/hpf). Basic clinical parameters were measured at the time of renal biopsy; relationships between hematuria and clinicopathological features and renal outcomes were analyzed.

RESULTS

Patients in the hematuria (+) group often had overt proteinuria. Interstitial inflammation was more severe in the hematuria (+) group than in the hematuria (-) group. Glomerular arteriolar hyalinosis, interstitial fibrosis and tubular atrophy were comparable between groups. For patients with early DN (eGFR ≥ 60 ml/min/1.73 m²), urinary RBC/hpf at baseline was positively correlated with glomerular classification, interstitial fibrosis/tubular atrophy scores and interstitial inflammation scores. In prognostic analysis, hematuria was associated with a higher risk of progression to end-stage renal disease. Hematuria remained an independent predictor after adjustment for confounding factors such as sex, age, duration of diabetes, serum glucose level, hypertension, cholesterol, eGFR and urine protein excretion, especially in patients with early DN and in male patients.

CONCLUSION

In this study, hematuria was associated with more severe renal pathologic lesions in patients with DN. The presence of hematuria could be an independent predictor of renal outcome in patients with early DN.

Characterization of on-target adverse events caused by TRK inhibitor therapy

BACKGROUND

The tropomyosin receptor kinase (TRK) pathway controls appetite, balance, and pain sensitivity. While these functions are reflected in the on-target adverse events (AEs) observed with TRK inhibition, these AEs remain under-recognized, and pain upon drug withdrawal has not previously been reported. As TRK inhibitors are approved by multiple regulatory agencies for TRK or ROS1 fusion-positive cancers, characterizing these AEs and corresponding management strategies is crucial.

PATIENTS AND METHODS

Patients with advanced or unresectable solid tumors treated with a TRK inhibitor were retrospectively identified in a search of clinical databases. Among these patients, the frequency, severity, duration, and management outcomes of AEs including weight gain, dizziness or ataxia, and withdrawal pain were characterized.

RESULTS

Ninety-six patients with 15 unique cancer histologies treated with a TRK inhibitor were identified. Weight gain was observed in 53% [95% confidence interval (CI), 43%-62%] of patients and increased with time on TRK inhibition. Pharmacologic intervention, most commonly with glucagon-like peptide 1 analogs or metformin, appeared to result in stabilization or loss of weight. Dizziness, with or without ataxia, was observed in 41% (95% CI, 31%-51%) of patients with a median time to onset of 2 weeks (range, 3 days to 16 months). TRK inhibitor dose reduction was the most effective intervention for dizziness. Pain upon temporary or permanent TRK inhibitor discontinuation was observed in 35% (95% CI, 24%-46%) of patients; this was more common with longer TRK inhibitor use. TRK inhibitor reinitiation was the most effective intervention for withdrawal pain.

CONCLUSIONS

TRK inhibition-related AEs including weight gain, dizziness, and withdrawal pain occur in a substantial proportion of patients receiving TRK inhibitors. This safety profile is unique relative to other anticancer therapies and warrants careful monitoring. These on-target toxicities are manageable with pharmacologic intervention and dose modification.

Mechanism analysis for the process-dependent driven mode of NaHCO3 in algal antibiotic removal: efficiency, degradation pathway and metabolic response

This work provided a comprehensive perspective to investigate the performance of NaHCO₃-driving effect and mechanism including the antibiotic removal, degradation pathway and metabolites analysis, and the algal physiological response during the removal process. Cefuroxime sodium was selected as the target antibiotic. Our results showed that NaHCO₃ did not facilitate self-decomposition of the target antibiotic, while drove the improvement on the removal capacity of every algal cell, which then attributed to the total removal efficiency. After 24 h, there was an improvement on the removal rate of the target antibiotic (from 10.21% to 92.89%) when NaHCO₃ was added. The degradation pathway of the target antibiotic was confirmed by the formation of three main products (M1, M2 and M3), and the degradation process, that from M1 to M2 and M2 to M3, was accelerated by the existence of NaHCO₃. Besides, a 4-stage model illustrated the relationship between NaHCO₃ and antibiotic removal process. Moreover, algal culture that supplemented with NaHCO₃ demonstrated a better growth capacity. A large increase in the content of chlorophyll a and a moderate increase in the activity of two carbon metabolic enzymes (RuBisCO and CA) might be viewed as a positive response of the algae during the NaHCO₃-driving process.

Biodegradation of bisphenol compounds in the surface water of Taihu Lake and the effect of humic acids

Bisphenol analogues (BPs) pollution in the aquatic environment is increasingly a worldwide concern. There is an urgent need to understand the fate of BPs in the aquatic environment. In this study, we studied the biodegradation of eight BPs in Taihu Lake and discussed the effect of humic acid (HA), which was extracted from Taihu Lake sediment, on the disappearance of BPs. Under aerobic conditions, bisphenol AF (BPAF) and bisphenol S (BPS) were recalcitrant to biodegradation in the lake water. The half-lives for bisphenol F (BPF), bisphenol A (BPA), bisphenol B (BPB), bisphenol E (BPE), bisphenol Z (BPZ), and bisphenol M (BPM) ranged from 34 to 75 days in the Taihu Lake water collected in October 2018 and 12-72 days in that collected in May 2019. The biodegradation of BPs in summer was significantly higher than that in autumn. The presence of HA promoted the disappearance of BPs from Taihu Lake water by adsorbing and binding BPs. The disappearance rate of BPs accelerated with increasing concentrations of HA. However, the presence of HA decreased the biodegradation of BPs. When the concentration of HA was 10 mg/L, the single-adsorption capacities for BPS, BPA, BPB, BPM and BPAF were 3.18-10.33 mg/g in the Taihu Lake water with little desorption. BP adsorption and desorption in the BP mixtures were different from that in the single BPs. Competitive desorption occurred among the mixtures. The results of this study are the first to indicate the biodegradation of eight BPs in natural lake water and the possible effect of HA on the fate of BPs in the environment.

[Efficacy and safety of early initiation of sacubitril-valsartan therapy in patients with acute decompensated heart failure]

Objective: To assess the efficacy and safety of the initiation of sacubitril-valsartan （ARNI） therapy, as compared with ACEI therapy, after hemodynamic stabilization among patients hospitalized for acute decompensated heart failure （ADHF）. Methods: A total of 199 hospitalized patients for ADHF in our department from January 2017 to June 2019 were included in this retrospective analysis. According to the medication early after hemodynamic stabilization, patients were divided into ARNI group (n=92) and ACEI group (n=107). Among the included patients, 61 patients with newly diagnosed heart failure at the time of admission were also divided into ARNI group (n=30) and ACEI group (n=31) according to the applied medication. Clinical baseline data and follow-up results of enrolled patients were collected through the electronic medical records at admission, outpatient and telephone follow-up. The primary effectiveness observation index was left ventricular ejection fraction (LVEF) and left ventricular end diastolic dimension (LVEDD) measured by echocardiography; the secondary observation index was death from any causes and hospitalization for heart failure. Safety outcomes were the incidences of symptomatic hypotension, worsening renal function, hyperkalemia, and angioedema. Results: The clinical baseline characteristics were similar between ARNI group and ACEI group（all P>0.05）. The duration of follow up was (15.2±6.5) months in all patients enrolled, (12.3±5.0) months in ARNI group, and (18.2±6.5) months in ACEI group. At the end of follow-up, prevalence of an absolute LVEF increase of more than 5% was 48.9% (45/92) in ANRI group and 25.2% (27/107) in ACEI group (P=0.001). Percent of LVEF increase to more than 50% was 17.4% (16/92) in ANRI group and 3.7% (4/107) in ACEI group (P=0.001). Percent of patients with more than 10 mm LVEDD reduction was 14.1% (13/92) in ANRI group and 3.7% (4/107) in ACEI group (P=0.009). All-cause mortality rate was 5.7% (5/88) in ARNI group and 15.3% (13/85) in ACEI group (P=0.038). Rate of re-hospitalization due to heart failure was 50% (46/92) in ARNI group and 71% (76/107) in ACEI group（P=0.002）.The rates of symptomatic hypotension, worsening renal function, hyperkalemia, and angioedema were similar between ARNI group and ACEI group (all P>0.05). In patients with first diagnosed heart failure，percent of LVEF increase to more than 50% was 30% (9/30) in ANRI group and 6.5% (2/31) in ACEI group (P=0.017). Percent of more than 10 mm LVEDD reduction was 26.7%(8/30) in ANRI group and 3.2%(1/31) in ACEI group (P=0.012). Percent of an absolute LVEF increase of more than 5% was 53.3% (16/30) in ANRI group and 51.6% (16/31) in ACEI group (P=0.893). Re-hospitalization due to heart failure was 23.3% (7/30） in ARNI group and 73.3% (11/31) in ACEI group（P<0.01）. Rate of all-cause death tended to be lower in patients receiving ARNI (3.4% (1/29)) as compared to patients receiving ACEI (13.0% (3/23), P=0.197）. Conclusions: Among patients with heart failure with reduced ejection fraction hospitalized for ADHF, the initiation of ARNI therapy after hemodynamic stabilization is associated with a more significant improvement of cardiac remodeling and pump function than ACEI therapy and satisfactory safety. In ADHF patients with first diagnosed heart failure, initiation of ARNI therapy after hemodynamic stabilization can more effectively improve cardiac remodeling and pump function than treatment with ACEI.

Distribution and potential risk assessment of antibiotic pollution in the main drinking water sources of Nanjing, China

The distribution character of 41 antibiotics belonging to 6 groups, sulfonamides (SAs), quinolones (QUs), tetracyclines (TCs), macrolides (MLs), penicillins (PLs), and chloramphenicol (CHL), was investigated in drinking water sources of Nanjing during 2017-2019. MLs (42.98%) were the most abundant category, followed by SAs (25.94%) and QUs (22.52%). The dominant antibiotic was ofloxacin (OFX) in Dec. 2017 (average concentration, 3.14 ng/L; range, ND-35.20 ng/L) and Nov. 2018 (2.16 ng/L, ND-12.26 ng/L), and sulfadiazine (SDZ) in Mar. 2019 (16.37 ng/L, ND-25.90 ng/L). For Dec. 2017, the total concentrations in Zhongshan Waterworks (S15) and Jinniushan Reservoir (S16) were significantly higher than the other sampling sites, which may be attributed to point source pollution. The ecological and human risk of the main antibiotics was assessed by risk quotients (RQs) and target hazard quotient (THQ), respectively. Most of the RQ values were below 0.1, except enrofloxacin (ERX, 0.11) and enoxacin (ENX, 0.62) in Dec. 2017, lomefloxacin (LOM, 0.14) in Nov. 2018, and LOM (0.28) and ERX (0.10) in Mar. 2019. This indicated that the risk of the target antibiotics to aquatic organisms in the 3 years was moderate or low level. Meanwhile, results of the THQ values showed that antibiotic exposure caused no risk to human health. This research provides scientific information for antibiotic pollution control and enriches environmental monitoring data in the drinking water sources.

The bioaccumulation, elimination, and trophic transfer of BDE-47 in the aquatic food chain of Chlorella pyrenoidosa-Daphnia magna

As a persistent organic pollutant, 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) has been widely detected in aquatic environments. However, studies on the fate and transfer of BDE-47 in the aquatic food chain remain scarce. In this study, we investigated the bioaccumulation and elimination of BDE-47 in Chlorella pyrenoidosa, as well as the trophic transfer and biomagnification of BDE-47 in the "C. pyrenoidosa-Daphnia magna" food chain, using C-14 radioactive tracer technology. After 96 h of BDE-47 exposure, the algae accumulated 88.98% ± 0.59% of the initial radioactivity from the medium, and 36.09% ± 9.22% of the accumulated residues in the algae occurred in the form of bound residues. During 96 h of elimination, only 13% ± 0.50% of accumulated radioactivity in the algae was released into the medium. After 24 h of exposure, D. magna accumulated 35.99% ± 2.55% of the initial radioactivity via water filtration from the medium, and 31.35% ± 1.92% of the accumulated radioactivity in D. magna occurred as bound residues. However, D. magna accumulated 66.89% ± 2.37% of the accumulated radioactivity in the algae via food uptake from the contaminated algae, with a high portion of radioactivity observed as bound residues (83.40% ± 0.97% of accumulated radioactivity in D. magna). This indicated a reduction in the environmental risk of BDE-47. There was obvious biomagnification in the food chain between C. pyrenoidosa and D. magna (biomagnification factors, BMFs>1), resulting in environmental hazard transfer in the aquatic food chain. However, no metabolite was found during the exposure experiment, and further studies should be carried out to investigate the intrinsic mechanisms of the trophic transfer of BDE-47, especially in multilevel food chains. Therefore, this study elucidated the effect of dietary uptake on the bioaccumulation of BDE-47 in D. magna and provided new insight for future analysis regarding the bioaccumulation and biomagnification of organic pollutants in the food chain.

THE PI3K/Akt/mTOR Signaling Pathway Plays a Role in Regulating Autophagy in Mouse Oocytes During Vitrification-warming and in vitro Maturation

BACKGROUND

It has been shown that vitrified-warmed oocytes exhibit autophagic activation. However, its regulatory molecular mechanism of autophagy needs to be clarified.

OBJECTIVE

To determine the role of signaling pathway of PI3K/Akt/mTOR in the regulation of autophagy in oocytes during vitrification-warming and IVM.

MATERIALS AND METHODS

Oocytes from mice were vitrified-warmed and IVM. The expressions of LC3-II, Beclin-1, PI3K, Akt, and mTOR protein were determined. Moreover, the ATP level, viability of vitrified-warmed oocytes, and their developmental potential were measured.

RESULTS

At 6 h of incubation of warmed oocytes, the LC3-II and Beclin-1 expressions were markedly up-regulated, whereas PI3K, Akt, and mTOR proteins expressions were significantly down-regulated. In addition, autophagy inhibition significantly decreased ATP level, viability of oocytes, and their developmental potential.

CONCLUSION

Autophagy plays a protective role in the oocytes during vitrification-warming and IVM. The PI3K/Akt/mTOR pathway participated in regulating autophagy activity in oocyte during vitrification-warming and IVM.

Circular RNA circ-NT5C2 acts as a potential novel biomarker for prognosis of osteosarcoma

OBJECTIVE

Recent evidence suggests that circular RNAs (circRNAs) play important roles in multiple diseases, including cancer. Circ-NT5C2 was reported to be up-regulated in osteosarcoma. However, the clinical significance of circ-NT5C2 remains largely unclear. The aim of the current study was to investigate the value of circ-NT5C2 for the prognosis of patients with osteosarcoma.

PATIENTS AND METHODS

the expression of circ-NT5C2 in osteosarcoma tissues and corresponding normal tissues were explored by quantitative real-time polymerase chain reaction (qRT-PCR) experiments. The association of circ-NT5C2 expression with clinicopathological factors or the prognosis of osteosarcoma patients was also analyzed. Kaplan-Meier survival analysis was performed to analyze the association of circ-NT5C2 expression with overall survival (OS) and disease-free survival (DFS) of patients. Univariate and multivariate Cox-regression analyses were used to identify risk factors for poor prognosis.

RESULTS

Our data showed a significant increase of circ-NT5C2 expression in osteosarcoma tissues compared with adjacent normal bone tissues (p < 0.01). In addition, we found that the level of circ-NT5C2 in osteosarcoma was strongly correlated with clinical stage (p = 0.006) and distant metastasis (p = 0.001). Importantly, patients with high expression of circ-NT5C2 had a shorter OS (p = 0.006) and DFS (p = 0.001) than those with low expression of circ-NT5C2. Finally, Cox regression analyses showed that high circ-NT5C2 expression might be an independent prognostic parameter to predict poor prognosis.

CONCLUSIONS

Our findings indicated that circ-NT5C2 is significantly up-regulated in osteosarcoma tissues. Circ-NT5C2 may represent a new marker of prognosis in osteosarcoma.

Bio-processing of algal bio-refinery: a review on current advances and future perspectives

Microalgae biomass contains various useful bio-active components. Microalgae derived biodiesel has been researched for almost two decades. However, sole biodiesel extraction from microalgae is time-consuming and is not economically feasible due to competitive fossil fuel prices. Microalgae also contains proteins and carbohydrates in abundance. Microalgae are likewise utilized to extract high-value products such as pigments, anti-oxidants and long-chain polyunsaturated fatty acids which are useful in cosmetic, pharmaceutical and nutraceutical industry. These compounds can be extracted simultaneously or sequentially after biodiesel extraction to reduce the total expenditure involved in the process. This approach of bio-refinery is necessary to promote microalgae in the commercial market. Researchers have been keen on utilizing the bio-refinery approach to exploit the valuable components encased by microalgae. Apart from all the beneficial components housed by microalgae, they also help in reducing the anthropogenic CO2 levels of the atmosphere while utilizing saline or wastewater. These benefits enable microalgae as a potential source for bio-refinery approach. Although life-cycle analysis and economic assessment do not favor the use of microalgae biomass feedstock to produce biofuel and co-products with the existing techniques, this review still aims to highlight the beneficial components of microalgae and their importance to humans. In addition, this article also focuses on current and future aspects of improving the feasibility of bio-processing for microalgae bio-refinery.

Degradation of Bisphenol S by a Bacterial Consortium Enriched from River Sediments

The widespread use of bisphenol S (BPS) as a bisphenol A substitute increases its potential of release into the aquatic environments. However, the degradation of BPS in aquatic systems is largely unknown, which will dictate its fate and toxicity. In this study, a bacterial consortium was enriched from river sediments and the dynamic changes of community structure during bacterial acclimation were studied. BPS degrading bacterial strains isolated from the consortium were identified by 16S rRNA analysis. The efficiency of the consortium and strains for BPS degradation were further evaluated. After 28 days of acclimation, the microbial diversity decreased significantly and four bacterial genera Hyphomicrobium, Pandoraea, Rhodococcus, and Cupriavidus with relative abundances of 5.1%-52.8% became dominant in the consortium. Total of two pure strains including Terrimonas pekingensis and Pseudomonas sp. were isolated from the consortium, using BPS as the sole carbon source. The consortium was highly efficient to degrade BPS, and 99% of BPS with an initial concentration of 50 mg/L was removed within 10 days at pH 7 and 30°C. In comparison with the consortium, a single strain cultures had lower BPS degradation efficiency. These findings indicate that BPS will degrade rapidly under aerobic conditions in river sediments and have implication for BPS-contaminated site remediation using the enriched consortium.

[A single-center retrospective study on axillary evaluation in 1 557 breast ductal carcinoma in situ patients between 2006 and 2016]

Objectives: To examine the influence factors on axillary evaluation in ductal carcinoma in situ (DCIS) patients, and the prognosis of different choices of axillary evaluation in a single-center retrospective study. Methods: Totally 1 557 DCIS patients admitted in Department of Breast Surgery, Fudan University Shanghai Cancer Center from January 2006 to November 2016 were retrospectively enrolled. All patients were female. The median age was 49 years (range: 21 to 85 years). Surgical methods included modified radical mastectomy, simple mastectomy (with or without axillary evaluation) and breast conservation surgery (with or without axillary evaluation). Axillary evaluation included axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). T tests, χ(2) test and Logistic regression analysis was used to analyze influence factors on axillary evaluation, respectively. Kaplan-Meier curve and Log-rank analysis were used to evaluate recurrence-free survival (RFS) and loco-regional recurrence-free survival (LRRFS) in patients with different surgical methods. Results: Among the 1 557 DCIS patients, there were 1 226 cases received axillary evaluation, while 331 cases not received axillary evaluation. Patients were separated into 3 groups by different axillary evaluation choices: SLNB group (957 cases, 61.46%), ALND group (197 cases, 12.65%) and no evaluation group (403 cases, 25.88%). The patients in SLNB group increased significantly (P=0.000), from 3.85% (60/1 557) in 2006 to 75.19% (1 170/1 557) in 2016. The independent influence factors of receiving axillary evaluation were high nuclear grade (OR=3.191, 95%CI: 1.722 to 5.912, P=0.001) and tumor size>15 mm (OR=1.698, 95%CI: 1.120 to 2.573, P=0.012). Also, patients received breast conservation surgery were more likely to refuse axillary evaluation (OR=0.155, 95%CI: 0.103 to 0.233, P=0.000). There were no significant differences in RFS and LRRFS in patients with different axillary evaluation choices. Conclusions: The investigation in trends and influence factors of different axillary evaluation choices provided basis on surgical precision medicine in DCIS patients. Patients received SLNB increased significantly. The independent influence factors of axillary evaluation were nuclear grade, tumor size and surgical methods. There was no significant differences in prognosis among the groups receiving different axillary evaluations.

[Current practice of implant-based breast reconstruction: results from China national practice questionnaire survey]

Objective: To explore the current clinical practice of implant-based breast reconstruction (IBBR) in China. Methods: The current survey was sponsored by Chinese Anti-Cancer Association, Committee of Breast Cancer Society and Chinese Society of Breast Surgeons. A survey was mailed to 110 hospitals in China, which have more than 200 breast cancer operations performed in 2017. The survey mainly included questions on the clinical practice of IBBR, sociodemographic and geographical factors associated with IBBR practice, reasons and concerns for selecting IBBR, type and timing of breast reconstruction, and the complications of IBBR. Data were analyzed using χ(2) test, Fisher's exact test or Kruskal-Wallis rank sum test. Results: IBBR was available in 86.4% (95/110) included hospitals. It was predominantly performed breast reconstruction surgery, the proportion of IBBR in all the breast reconstruction was 65.75% (4 296/6 534). However, the rate of IBBR in all the patients received mastectomy was only 7.06% (4 296/60 877). Among all the included hospitals, the number of implant reconstructions performed in 2017 was 24 (57.5) cases (M(Q(R)), range: 2-565 cases). Factors associated with the performance of IBBR including regional per capita gross domestic product (H=10.47, P=0.005) and annual surgery volume (H=8.30, P=0.016). The main reasons for choosing IBBR were relatively simple surgical procedure, short learning curve and short operation time. The effects of adjuvant radiotherapy on prosthesis, postoperative complications and patient satisfaction were the main concerns for implant reconstruction. Compared with delay reconstruction, a higher proportion of IBBR was observed in immediate reconstruction (83.1% vs. 62.0%, χ(2)=12.522, P=0.000). In all, 10.5% (10/95) hospitals reported more than 10% grade Ⅲ to Ⅳ capsular contracture. The incidence of infections need surgical intervention was reported between 10% and 20% by 4.2% (4/95) hospitals. Hospitals with 6% to 10% implant rupture and 6% to 15% implant removal were 1.1% (1/95) and 4.2% (4/95) respectively. Conclusions: IBBR was the most common used surgery in breast reconstruction after mastectomy. However, the proportion of IBBR in patients after mastectomy was still low. Reginal economy, surgery volume of hospitals, lack of specialty training program and the concern about complications and patient's satisfaction were the factors affecting the development of IBBR.

[Current trends of breast reconstruction after mastectomy in China: a cross-sectional study]

Objective: To investigate the current trends of breast reconstruction(BR) after mastectomy in China. Methods: A list of hospitals with more than 200 cases of breast cancer surgery per year nationwide was obtained, and 110 institutions were selected according to the geographical distribution. The research was conducted in the form of a questionnaire survey, and 92.3% (169/183) of the questions were single-choice questions. Information such as demographics of surgeons and hospitals, number of mastectomy and BR, type and timing of BR was included in the survey. Survey formal notification letter was issued by the China Anti-Cancer Association Breast Cancer Committee and Chinese College of Surgeons, Committee of Mammary Surgeons. Questionnaires were sent to the respondents of each center by email. The survey time range was from January 1, 2017 to December 31, 2017. All data were completely collected before September 7, 2018. Results: A total of 110 units participated in the survey. In total, 87.3% (96/110) of the hospitals have conducted BR surgery. The BR after mastectomy was 10.7% (6 534/61 099), among this, implant BR accounted for 65.7%(4 296/6 534), autologous BR accounted for 20.1% (1 312/6 534), and autologous combined implant BR accounted for 14.2% (927/6 534). Immediate reconstruction accounted for 67.6% (4 417/6 534) of BR, while delayed BR accounted for 32.4% (2 097/6 534). In 2017, 77.8% (35/45) of the plastic surgery departments cooperated with general surgery departments. General BR could be conducted after mastectomy accounted for 83.6% (92/110). The proportion of reconstruction was positively correlated with the gross domestic product (GDP) per capita (r=0.311, P=0.002). The one-step implant-based BR(IBBR) was the most preferred type in immediate BR. Two-step IBBR was the most preferred method in delayed BR. Hospitals that routinely evaluated aesthetics after BR accounted for 64.6% (62/96), while only 16.7% (16/96) of hospitals used patient-reported outcome measure (PROM). The most commonly used PROM tool was BREAST-Q. Conclusions: The overall BR in China is on upward trend, but gap between China and the developed countries still exists. Breast surgery departments should strengthen further cooperation with plastic surgery departments. Simultaneously, the aesthetics evaluation and PROM after BR should be put a high premium.

A novel cadmium-containing wastewater treatment method: Bio-immobilization by microalgae cell and their mechanism

Heavy metal cadmium (Cd) has drawn tremendous comcern due to its rigorous environmental and health hazards. Herein, we have presented an efficient and economical strategy for the removal and recycling of hazardous Cd ions using microalgae cells as the bioreactors. Remarkably, the green bio-platform for the bioproduction of CdSe nanoparticles (NPs) was developed depending on their orderly regulated and sustainable cellular environment. The biofabricated CdSe NPs manifested favorable photoluminescence properties, and presented well monodispersed spherical morphology and certain crystallinity structure with mean size of smaller than 7 nm. Especially, the fluorescence "turn off" sensing system based on the CdSe NPs was established to detect Hg²⁺. The nanosensor enables the quantitative analyses of Hg²⁺ with a linear range of 0-2.0 μM and a detection limit of 0.021 μM. Furthermore, it was preliminarily speculated that the reducing biomolecules in the algae cells could be involved in the formation of CdSe NPs. This work not only provides new insights into the removal and recycling of hazardous Cd ions, but also brings a promising route for biosynthesis of CdSe NPs.

Urinary levels, composition profile and cumulative risk of bisphenols in preschool-aged children from Nanjing suburb, China

Due to the extensive use in consumer products, the bisphenols (BPs) pollution in the environments has aggravated and people are frequently exposed to BPs. In this research, four BPs, i.e., bisphenol A (BPA), bisphenol F (BPF), bisphenol S (BPS) and bisphenol AF (BPAF), were determined in urine samples collected from Gaochun District preschool-age children and the concentrations, distribution profiles, potential sources and cumulative risk assessment of the target compounds were studied. Total concentrations of 4 BPs ranged from 2 to 3113.1 ng/L, with the average concentration of 648.6 ng/L. BPA was the predominant congener (accounting for 94%), followed by BPS. Correlation analysis indicated a negative relationship between BPA and BPAF (R = -0.273, p < 0.05). The estimated daily intakes suggested that young females were more sensitive to BPs. Moreover, the cumulative risk for hazard quotient (HQ) of BPA has been evaluated and the results showed that no high risk had occurred. It provided basic information on the occurrence and human exposure to urinary BPs of preschool aged children from Gaochun District.

Evaluation of the novel nanoparticle material - CdSe quantum dots on Chlorella pyrenoidosa and Scenedesmus obliquus: Concentration-time-dependent responses

Quantum dots (QDs), as a kind of novel nanomaterial, have the extensive applications in various fields, inevitably leading to increasing risks for the ecological environment. The mobilization of cadmium including metal smelting and subsequent machining for multifarious applications has caused the release of cadmium element into the environment. In this study, we evaluated the potential toxicity of a novel nanoparticle material CdSe QDs, using two green algae Chlorella pyrenoidosa and Scenedesmus obliquus. The impact of CdSe QDs and cadmium ions on algae and the sensitivity of the two algae on target compounds were also considered and compared. Our results showed the algal growth rates and chlorophyll content decreased with increasing exposure concentrations and durations. Moreover, the glutathione levels were decreased while the activities of superoxide dismutase increased, exhibiting their pivotal functions in defeating toxic stress. The increment of malondialdehyde levels revealed that the stresses of CdSe QDs and cadmium ions were contributed to the occurrence of oxidative damage. Our study also indicated that the impact of CdSe QDs was stronger than that of cadmium nitrate and the algal response was also species-specific. In addition, the TEM photographs of the algal ultrastructure showed the presence of surface attachment and uptake of QDs.

Food up-take and reproduction performance of Daphnia magna under the exposure of Bisphenols

Because the application of Bisphenol A (BPA) was restricted, many substitutes, such as Bisphenol F (BPF) and Bisphenol S (BPS), were developed as BPA substitutes. Therefore, environmental impacts of BPA and its substitutes on aquatic organisms should be concerned, especially their combined toxicity. In this study, the impacts of BPA, BPF, BPS and their mixture on the feeding behavior, reproduction and physiological function of daphnids were synthetically evaluated, involving the duration and mode of exposure. In short-term exposure tests, feeding rates of D. magna decreased after exposure to BPA, BPF, BPS and their mixture, while the inhibition reversed into stimulation in the recovery period. It may benefit from overcompensation of D. magna. In long-term exposure tests, the inhibition effect on the reproduction and growth of the exposed D. magna was difficult to recover, and only some experimental groups have a certain recovery. In conclusion, environmental risk of BPA, BPF, BPS and their mixture on the behavior of D. magna increased with prolonged exposure time. Moreover, relative activities of trypsin, amylase (AMS), acetylcholinesterase (AChE), carbonic anhydrase (CA), glutathione peroxidase (GPx) and super oxidase dimutase (SOD) of the exposed daphnids decreased in most treatment groups, indicating the disorder of digestive, nervous and antioxidative system of D. magna. Interestingly, inhibition of enzymes activities decreased with the increase of the exposure time, which implied the tolerance may be occurred.

Fate of 14C-bisphenol F isomers in an oxic soil and the effects of earthworm

Bisphenol F (BPF) pollution in environment increased, but the studies on its fate and uptake in soil-earthworm systems were limited. Using ¹⁴C-tracers, environmental fate of BPF isomers in an oxic rice soil with/without earthworm Metaphire guillelmi was studied. After 59 days of incubation, mineralization increased in the order of 2,2'-BPF (18.7% ± 0.3% of the initial amount) < 2,4'-BPF (21.7% ± 0.2%) < 4,4'-BPF (26.9% ± 0.1%). About 70% was converted to bound residues (BRs) and most of the BRs resided in the humin fraction by physical entrapment and ester-linkages. M. guillelmi decreased the mineralization and BRs of 4,4'-BPF in soil, indicating that earthworm increased the ecological risk of 4,4'-BPF. About 5.2% ± 0.1% of the initial amount was accumulated in M. guillelmi and mostly in gut. Considerable amounts of the accumulated 4,4'-BPF were present as earthworm-bound residues (earthworm-BRs). The elimination of 4,4'-BPF from M. guillelmi was very slow, and there was still 96.2% of the initial accumulated radioactivity presented in earthworm after 5 days of depuration. The results of this study firstly provide the isomer - specific partitioning of three BPF isomers in an oxic soil and the uptake and depuration of 4,4'-BPF in earthworm during soil incubation.

[Magnetic resonance imaging findings and differential diagnosis of renal epithelioid angiomyolipoma comparing with renal no-epithelioid angiomyolipoma]

Objective: To investigate whether MRI findings can differentiate renal epithelioid angiomyolipoma (EAML) from renal no-epithelioid (typical) angiomyolipoma. Methods: A total of 44 patients were collected from General Hospital of PLA.These cases were obtained from January 2009 to June 2015.To retrospectively analyze these mainly MRI findings among 12 cases of EAML (age from 27 to 61 years, male 2 cases, female 10 cases, mean age was 46.7 years); 32 cases of renal no-epithelioid AML (age from 34 to 70 years old, male 9 cases, female 23 cases, mean age was 53.4 years old) as case control study. MRI findings included gender, T(2)WI, the signal on gross fat, pseudocapsle, necrosis or cystic degeneration, DWI, hemorrhage and the peak in three phases of dynamic enhancement.All data were analyzed statistically using SPSS version 19.0 (IBM, Armonk, NY, USA). χ(2) test and a single order chart were used to analyze the enumeration data. Results: Comparing with renal no-epithelioid angiomyolipoma, minimal fat, necrosis or cystic degeneration and hemorrhage were statistical significance. P values were 0.002, 0.007, 0.025, respectively.Gender, solid components of tumors on T(2)WI, the signal of DWI, pesudocapsule and the peak of enhancement had no statistical significance. P values were 0.863, 0.053, 0.479, 0.460, respectively. Conclusion: Comparing with renal no-epithelioid AML, necrosis or cystic degeneration and hemorrhage with minimal fat are characteristic MRI findings of EAML.

Correlation between antibiotic-induced feeding depression and body size reduction in zooplankton (rotifer, Brachionus calyciflorus): Neural response and digestive enzyme inhibition

The study analyzed the correlation between the antibiotic-induced feeding depression and body size reduction in rotifer, Brachionus calyciflorus, involving exposure, post-exposure and re-exposure periods. The filtration and ingestion rates of the rotifers were inhibited in these three exposure periods at any given concentration of the antibiotic sulfamethazine (SMZ). As food for rotifer, the cell size of the green algae was unchanged, which indicated that it could not drive feeding depression. Secondly, several corresponding physiological responses were considered. Reactive oxygen species (ROS) levels increased in the post-exposure and the re-exposure; acetylcholinesterase (AChE) activity was significantly decreased in the exposure and the re-exposure, whereas it was induced in the post-exposure. The activities of amylase and lipase were always inhibited in these three exposure periods. Additionally, significant decreases in lorica length, width and biovolume of rotifers occurred after the feeding depression. Statistical analysis indicated a positive correlation between the activity of the digestive enzyme and the body size. Our results demonstrated that SMZ could influence the neurotransmission, inhibit the activity of the digestive enzyme, and finally result in body size reduction. These results provided an integrated perspective on assessing the toxicity effects of antibiotic in non-lethal dosage on the feeding behavior of non-target aquatic organisms.

Abstract P5-16-08: Applications of rib sparing technique in internal mammary vessels exposure of abdominal free flap breast reconstructions

Background:

Internal mammary vessels (IMVs) are widely used recipient vessels in abdominal free flaps breast reconstructions. Exposure of IMVs usually needs to resect a segment of costal cartilage or rib during the operations. The rib sparing technique is an alternative method with less damage. This study aims to analysis the applicability and advantages of rib sparing technique of IMVs exposure in breast reconstruction.

Methods:

medical records of 215 patients who underwent abdominal free flap reconstruction from November 2006 to December 2017 were analyzed. The factors influencing the choice of vessels and rib sparing were analyzed. The outcomes of rib sparing were assessed. Intercostal space (ICS) width and other related data were measured by the preoperative thin slice chest computed tomography (CT) scan images.

Results:

Among all 215 patients with 218 flaps, 172 flaps used IMVs as the recipient vessels while 13 used thoracodorsalvessels and 33 used subscapular vessels. The proportion of IMVs as recipient vessels showed a rising trend in general and remained over 90% for the last three years in our center. Patients with immediate reconstruction (p=0.005) and axillary lymph nodes dissection(ALND) (p&lt;0.001) were less likely to use IMVs, both in univariate and multivariate logistic regression analysis. Patients' BMI and radiotherapy history showed no statistically significant differences between the IMVs group and the other vessels group (p=0.338 and 0.811). The rib sparing rate in IMVs exposure increased yearly and exceeded 40% in 2013, now it maintained more than 60% during the recent 3 years. Additionally, among the patients who received rib sparing IMVs exposure in 2017, the mean ICS width was relatively smaller than that in 2013 (2.54cm V.S 2.93cm, p=0.124). Compared with rib resection group, patients with rib sparing were higher (163.57 ± 4.44 cm vs. 161.83 ± 4.30 cm, p=0.047) and with a wider ICS (2.65 ± 0.54 cm vs. 2.25± 0.38 cm, p&lt;0.01), while the depth from the surface of the pectoralis major muscle to the IMVs and distance between the parasternal line and IMVs had no difference between the two groups. Rib sparing group has a shorter surgery and hospitalization time, as well as a lower severe complication rate, but the differences were not statistically significant (p= 0.120, 0.450 and 0.296).

Conclusion:

IMVs were used more frequently as the recipient vessels in abdominal free flap breast reconstructions, especially when axillary operation was not carried out at the same time. Rib sparing technique had the potential to decrease surgery time and hospitalization days, as well as the severe complications rate. It could be used in most of patients received free flap reconstruction when IMVs were used, particularly in higher patients and patients with a wider ICS. Preoperative slice chest CT scan can be used to measure the ICS width to provide suggestions for dealing with the ribs.

Citation Format: Zhang Q, Xiao Q, Guo R, Wu J, Gu Y, Xiu B. Applications of rib sparing technique in internal mammary vessels exposure of abdominal free flap breast reconstructions [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-08.

Abstract P6-05-01: A novel cleaved cytoplasmic lncRNA LacRNA interacts with PHB2 and suppresses breast cancer metastasis via repressing MYC targets

Long noncoding RNAs (lncRNAs) have been implicated in breast cancer metastases through largely unknown mechanisms. In this study, we used microarray analysis to compare lncRNAs expression levels between matched pairs of breast lymph node metastatic tissues and primary tumors. We discovered that lncRNA LINC00478 was substantially downregulated in the metastatic tumor samples. Interestingly, we found that LINC00478 could be cleaved by RNase to simultaneously generates the mature 5' ends of cytoplasmic RNA and 3' ends of nuclear RNA by polyadenylation. We named 5' ends 791-nt RNA as LacRNA (LINC00478-assciated cytoplasmic RNA). Over expression of full-length LINC00478 and LacRNA, but not LINC00478 3' RNA, significantly inhibited breast cancer proliferation, invasion and metastasis in vitro and in vivo.We used CRISPR-dCas9 complex to mediate efficient transcriptional activation of LacRNA at endogenous genomic loci followed by RNA-seq analyses. Gene set enrichment analysis (GSEA) showed that the MYC pathway/targets were prominent gene sets negatively enriched in LacRNA-activated cells. Further study revealed that LacRNA exerted its tumor suppressive activity by directly binding with prohibitin2(PHB2) to enhance its protein stability, which promoted PHB2 competing with MYC for transcriptionally suppressing the MYC target genes (e.g., CDC20, CDC45, CCNA2 and MAD2L1). Mechanistically, LacRNA inhibits breast cancer invasion and metastasis by interacting with PHB2 through LacRNA's 1-300nt region. In addition, taking advantage of CRISPR system to knock-out and activate the expression of LacRNA, as well as rescue experiment, we uncovered the positive correlation between LacRNA and PHB2 and their role in suppressing MYC target genes and cancer metastasis. At the same time, LacRNA can attenuated the MYC induced activation of MYC targets through binding with PHB2, indicating that LacRNA plays a central role in the suppression of MYC target genes. We further explored the role of LacRNA in inhibiting lung metastasis by implanting LacRNA-activated LM2 cells into the mammary fat pads of NOD-SCID mice. Luciferase imaging and histological analysis were used to detect lung metastasis and found that LacRNA significantly suppressed lung metastasis. Immunohistochemistry were used to detect the expression of PHB2 and MYC targets in both orthotopic tumors and lung metastasis and verified their correlation in vivo. Extensive analyses of clinical data indicated that LacRNA level was substantially downregulated in metastases tumors accompanied by enrichment of MYC targets. The robustness value of LacRNA expression was further verified in two independent patient cohorts, including 530 invasive breast cancer tumors in Fudan University Shanghai Cancer Center (FUSCC) and 819 breast patients' data from TCGA. High LacRNA expression level had a significantly better clinical outcome in both cohorts and represented an independent prognostic predictor for DFS (HR=0.48, P=0.006, multivariate analysis) and OS (HR=0.32, P=0.009, multivariate analysis) in FUSCC cohort. Collectively, LacRNA functions as a tumor suppressor lncRNA that inhibits breast cancer invasion-metastasis cascade.

Citation Format: Guo R, Su Y-H, Xue J-y, Si J, Chi Y-y, Wu J. A novel cleaved cytoplasmic lncRNA LacRNA interacts with PHB2 and suppresses breast cancer metastasis via repressing MYC targets [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-05-01.

Abstract P3-13-09: Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis

Background: The benefit of repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS) is currently inconclusive. This issue has become even more important as small and isolated recurrent tumors were frequently diagnosed.

Methods: IBTR patients with definitive surgery were identified in the Surveillance, Epidemiology, and End Results registry between 1973 and 2013. The effect of different IBTR surgeries on overall and cancer-specific mortality was assessed using risk-adjusted Cox proportional hazard regression modeling and stratified propensity score matching analysis (PSMA).

Results: Based on the selection criteria, 5098 patients were recruited. Of those, 4048 (79.4%) women underwent mastectomy and 1050 (20.1%) underwent repeat lumpectomy after IBTR. Patients who received repeat lumpectomy had lower grade (23.7% vs 15% for well-differentiated) and smaller recurrent tumor (47% vs 36.2% for ≤ 1 cm) but earlier recurrence (23.9% vs 11.2% for interval times &lt; 48 months) than those who underwent mastectomy. A minority of each group (24.7% of those undergoing repeat lumpectomy and 3% of the mastectomy group) underwent RT after surgery. In multivariable Cox regression analysis, repeat lumpectomy was associated with increased overall mortality (Hazard ratio (HR) = 1.58, 95% CI = 1.353 to 1.844, P &lt; 0.001) and cancer-specific mortality (HR = 1.721, 95% CI = 1.345 to 2.202, P&lt; 0.001). Similar HRs were derived from the PSMA cohort. However, we found no significant difference in overall mortality for women who underwent repeat lumpectomy followed by RT compared with that for those who underwent mastectomy (P= 0.411). Moreover, IBTR patients with small tumors (≤ 1 cm) who underwent repeat lumpectomy with RT rather than without had similar overall and cancer-specific survival rates to those who underwent mastectomy (P= 0.189 and P= 0.604, respectively).

Conclusions: Our investigation suggests that compared with mastectomy, repeat lumpectomy for IBTR is associated with higher overall and cancer-specific mortality under real-world observational conditions. Furthermore, repeat lumpectomy with RT is equivalent to mastectomy with respect to overall mortality and may influence treatment decision making for patients with small IBTR.

Citation Format: Su Y, Guo R, Xue J, Chi Y, Wu J. Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-13-09.

[Investigation of hearing loss and speech recognition ability of the elderly and analysis of its high risk factors]

Objective: To investigate the hearing loss and speech disorders in the elderly, to analyze the risk factors of the elderly deafness, as well as to provide reference for the clinical research of the elderly deafness. Methods: From March 2016 to March 2018, 913 elderly people, who were tested for hearing and speech disorders, were examined by a unified questionnaire to investigate the demographic data of the subjects and the related factors of deafness, and the hearing and speech recognition tests were carried out. According to the hearing loss, the hearing impaired group was divided into the hearing impaired group (500, 1 000, 2 000 and 4 000 Hz, the average hearing threshold>25 dBHL) and the non hearing impaired group (the average hearing threshold of the four frequencies ≤25 dBHL), and then the single factor analysis and the unconditional Logistic regression analysis were used. Finally, the risk factors of senile deafness were analyzed. Results: Of the 913 elderly subjects in the survey, 389 (42.61%, 389/913) had no hearing impaired, 345 (37.79%, 345/913) were mild hearing impaired, and 149 (16.32%, 149/913) had moderate hearing loss. Twenty-six patients were severe hearing loss (2.85%, 26/913); 4 patients had severe hearing loss (0.44%, 4/913). Among the 524 hearing-impaired elderly, there were 244 speech-recognition disorders (46.56%, 244/524), of whom 106 were mild hearing-impaired, accounting for 30.72% (106/345), 108 were moderate hearing loss, accounting for 72.48% (108/149), 26 were severe hearing loss, accounting for 100% (26/26), and 4 were the profound hearing loss, accounting for 100% (4/4). Statistical analysis showed that the age, job status, history of hypertension, history of hyperglycemia, and smoking history were independent risk factors for senile hearing loss (P<0.05). Conclusions: High incidences of hearing and speech recognition obstacle are found in health examination for the elderly patients. Noise exposure, age, history of hypertension, high blood sugar, and smoking history are high-risk factors for senile deafness, therefore, prevention and rehabilitation programs are urgent to be developed.