Whole genome survey and genetic markers development of crocodile flathead Cociella crocodilus

Flatheads in family Platycephalidae are ecologically and commercially important marine fish species in the Indo-West Pacific. Due to similar morphological characters, the taxonomy and phylogenetics of flatheads are in confusion. Studies on phylogenetics and molecular marker development are required to discriminate congeners of flatheads. In the present study, we performed whole genome survey sequencing of crocodile flathead Cociella crocodilus to provide genomic information and genetic markers of this species. In total, 54.03 Gb of clean genomic data were generated. The genome size was estimated to be 732.99 Mb with the heterozygosity ratio of 0.73% and the repeat sequence ratio of 33.48%. The preliminary assembled genome sequences were 794.07 Mb with contig N50 of 1504 bp. We detected 2 624 875 genome-wide SNPs with transition/transversion ratio of 1.422. A total of 313 842 microsatellite motifs were identified, most of which were dinucleotide motifs with a frequency of 74.89%. In addition, we assembled the complete mitogenome of C. crocodilus and subsequent phylogenetic analysis were performed. Phylogenetic analyses revealed numbers of polyphyletic groups in family Platycephalidae. The reported genomic data and genetic markers in our study should be useful in further phylogeny and phylogenomics studies of flathead species.

Water-Soluble Humic Materials Modulating Metabolism and Triggering Stress Defense in Sinorhizobium fredii

Bacteria have evolved a series of mechanisms to maintain their survival and reproduction in changeable and stressful environments. In-depth understanding of these mechanisms can allow for better developing and utilizing of bacteria with various biological functions. In this study, we found that water-soluble humic materials (WSHM), a well-known environment-friendly plant growth biostimulant, significantly promoted the free-living growth and survival of Sinorhizobium fredii CCBAU45436 in a bell-shaped, dose-dependent manner, along with more-efficient carbon source consumption and relief of medium acidification. By using RNA-Seq analysis, a total of 1,136 genes significantly up-/downregulated by external addition of WSHM were identified under test conditions. These differentially expressed genes (DEGs) were enriched in functional categories related to carbon/nitrogen metabolism, cellular stress response, and genetic information processing. Further protein-protein interaction (PPI) network analysis and reverse genetic engineering indicated that WSHM might reprogram the transcriptome through inhibiting the expression of key hub gene rsh, which encodes a bifunctional enzyme catalyzing synthesis and hydrolysis of the "magic spot" (p)ppGpp. In addition, the root colonization and viability in soil of S. fredii CCBAU45436 were increased by WSHM. These findings provide us with new insights into how WSHM benefit bacterial adaptations and demonstrate great application value to be a unique inoculant additive. IMPORTANCE Sinorhizobium fredii CCBAU45436 is a highly effective, fast-growing rhizobium that can establish symbiosis with multiple soybean cultivars. However, it is difficult to maintain the high-density effective viable cells in the rhizobial inoculant for the stressful conditions during production, storage, transport, and application. Here, we showed that WSHM greatly increased the viable cells of S. fredii CCBAU45436 in culture, modulating metabolism and triggering stress defense. The root colonization and viability in soil of S. fredii CCBAU45436 were also increased by WSHM. Our results shed new insights into the effects of WSHM on bacteria and the importance of metabolism and stress defense during the bacteria's whole life. In addition, the functional mechanism of WSHM may provide candidate genes for improving environmental adaptability and application potential of bacteria through genetic engineering.

POS0905 ACHIEVEMENT OF PARTIAL REMISSION AND INACTIVE DISEASE IN UPADACITINIB-TREATED PATIENTS WITH ANKYLOSING SPONDYLITIS

Background:

Assessment of SpondyloArthritis international Society (ASAS) response criteria and AS Disease Activity Score (ASDAS) are both commonly used, rigorous composite indices consisting of components with relevance to patients. Clinically meaningful thresholds for these measures have been defined to reflect partial remission (PR), inactive disease (ID), and low disease activity (LDA).

Objectives:

To study the association of ASAS PR and ordinal ASDAS disease categories (including ASDAS ID, which is the most stringent category of this composite score) in upadacitinib (UPA)-treated patients with AS.

Methods:

In the SELECT-AXIS 1 (NCT03178487) study, biologic DMARD naïve-patients (pts; ≥18 y) with active AS and intolerance/contraindication or inadequate response to ≥2 NSAIDs were randomized 1:1 to UPA 15 mg once daily (QD) or placebo (PBO).1 At wk 14, pts entered an open-label extension (OLE) of UPA 15 mg QD; pts randomized to PBO were switched to UPA. This post hoc analysis assessed the responsiveness of individual ASAS and ASDAS core components among pts who achieved ASAS PR. The association of ASAS PR with achievement of ASDAS ID (ASDAS <1.3), ASDAS LDA (ASDAS <2.1 but ≥1.3) or ASDAS high disease activity (HDA)/very HDA (VHDA) (ASDAS ≥2.1 for HDA/VHDA) was also assessed by measures including Youden index, distance to perfect point, and sensitivity/specificity equality. These evaluations were performed in pts randomized to UPA from baseline (BL; continuous UPA, assessed at wk 14) and those who were randomized to PBO and switched to UPA upon entry in the OLE (PBO to UPA; re-baselined at wk 14 and assessed at wk 32, representing 18 wks of UPA exposure).

Results:

At wk 14, for the continuous UPA group, 16 pts (19%) achieved ASAS PR. At wk 32, following 18 wks of UPA exposure for the PBO-to-UPA group, 28 pts (33%) achieved ASAS PR. Among both groups (continuous UPA and PBO-to-UPA), improvements were seen across all core components (Figure 1). Of the 44 total pts who achieved ASAS PR, 91% achieved either ASDAS ID or LDA. The majority of patients who achieved ASAS PR achieved ASDAS ID in the continuous UPA and PBO-to-UPA groups: 11/16 (69%) and 16/28 (57%), respectively. For the continuous UPA group, the remaining 5 pts who achieved ASAS PR also achieved ASDAS LDA (Table 1). ASAS PR was associated with ASDAS categories in the following manner: the highest rate of ASAS PR was achieved for ASDAS ID followed by ASDAS LDA followed by ASDAS HDA/VHDA. The cutoff of 1.3 (the upper threshold for ASDAS ID) was a better discrimination threshold for ASAS PR than the cutoff of 2.1 (the upper threshold for ASDAS LDA).

Conclusion:

Nineteen percent of pts receiving UPA from BL achieved ASAS PR after 14 wks of treatment, with similar results seen in pts who were originally randomized to PBO and switched to UPA at wk 14. A consistent improvement was seen across all core components of ASAS among those who achieved ASAS PR with UPA treatment. The achievement of ASAS PR was most closely associated with the achievement of ASDAS ID, providing further clarity on the reduction of disease activity in AS pts treated with UPA.

References:

[1]van der Heijde, et al. Lancet. 2019;394(10214):2108-2117.

Table 1.

Association Between ASAS PR and ASDAS Clinical Thresholds (ID/LDA/HDA or VHDA)

ASDAS ID(<1.3)ASDAS LDA(1.3 to <2.1)ASDAS HDA or VHDA(≥2.1)Continuous UPA Groupn=15n=31n=39 ASAS PR Responders (n=16)1150 ASAS PR Non-responders (n=69)42639PBO to UPA Groupn=25n=35n=25 ASAS PR Responders (n=28)1684 ASAS PR Non-responders (n=57)92721

P<0.001 for association of ASAS PR with the ordered ASDAS categories of ID-LDA-HDA, for both Continuous UPA Group and PBO to UPA Group. P-value calculated from Cochran-Armitage trend test for association of ordinal categories.

ASAS, Assessment of SpondyloArthritis international Society response criteria; ASDAS, AS Disease Activity Score; HDA, high disease activity; ID, inactive disease; LDA, low disease activity; PBO, placebo; PR, partial remission; UPA, upadacitinib; VHDA, very high disease activity.

Acknowledgements:

AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing support was provided by J Urbanik of AbbVie and M Hovenden and J Matsuura of Complete Publication Solutions, LLC (funded by AbbVie).

Disclosure of Interests:

Atul Deodhar Speakers bureau: Novartis and Pfizer, Consultant of: Novartis, Pfizer, AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Galapagos, Janssen, Boehringer Ingelheim and Celgene, Amgen., Grant/research support from: AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Andrew Ostor Consultant of: AbbVie, BMS, Roche, Janssen, Lilly, Novartis, Pfizer, UCB, Gilead, and Paradigm, anna maniccia Shareholder of: AbbVie, Employee of: AbbVie, Fabiana Ganz Shareholder of: AbbVie, Employee of: AbbVie, Tianming Gao Shareholder of: AbbVie, Employee of: AbbVie, Alvina Chu Shareholder of: AbbVie, Employee of: AbbVie, Denis Poddubnyy Speakers bureau: AbbVie, BMS, Lilly, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Biocad, Gilead, GSK, Lilly, MSD, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Lilly, MSD, Novartis, and Pfizer

POS0924 PREDICTORS OF 1-YEAR TREATMENT RESPONSE AMONG UPADACITINIB-TREATED PATIENTS WITH ANKYLOSING SPONDYLITIS: A POST HOC ANALYSIS OF SELECT-AXIS 1

Background:

Upadacitinib (UPA) is an oral Janus kinase inhibitor that has demonstrated efficacy and safety among patients with ankylosing spondylitis (AS) in the phase 2/3 SELECT-AXIS 1 study.1 If identified, early predictors of treatment response may inform treat-to-target strategies and optimize patient outcomes in AS.

Objectives:

To determine whether baseline (BL) characteristics or early responses predict clinical response at 1 year in UPA-treated patients with AS.

Methods:

In the double-blind, randomized, placebo (PBO)-controlled SELECT-AXIS 1 study, patients received UPA 15 mg once daily or PBO until Week 14.1 At Week 14, PBO-treated patients switched to UPA 15 mg; patients originally randomized to UPA continued UPA therapy. Data from patients in the PBO and UPA arms were combined based on overall exposure to UPA; in the switch arm, exposure was defined as current visit minus 14 weeks (time of switch). The following outcomes were assessed at 1 year: Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS[CRP]) inactive disease (ID; <1.3) and low disease activity (LDA; <2.1), Assessment of SpondyloArthritis International Society (ASAS) partial remission (PR), and ≥40% improvement in ASAS criteria (ASAS40) response. The ability of BL characteristics, efficacy at Week 12, and back pain at Week 12 to predict 1-year outcomes was assessed using a univariable logistic regression model generating odds ratios (ORs; 95% confidence intervals). LASSO regression was used to select the best-fitted multivariable model at Week 12 for each outcome measure.

Results:

Among 187 patients who received or switched to UPA 15 mg, 70 (37.4%), 134 (71.7%), 73 (39.0%), and 131 (70.1%) achieved ASDAS(CRP) ID, ASDAS(CRP) LDA, ASAS PR, and ASAS40, respectively, following 1 year of UPA treatment. No meaningful predictors of 1-year efficacy outcomes were identified based on BL demographics (including disease duration, gender, and human leukocyte antigen B27 status) or BL disease characteristics (including ASDAS, Bath Ankylosing Spondylitis Disease Activity Index, and CRP levels). In univariable analyses, Week 12 responses based on several disease activity measures and patient-reported outcomes (PROs), including reductions (much better improvement [MBI], ≥30/≥50/≥70% reduction, or improvement) in back pain score, along with lower scores for back pain at Week 12, were associated with the achievement of ASDAS(CRP) ID, ASDAS(CRP) LDA, ASAS PR, and ASAS40 at 1 year (Figure 1). In a multivariable analysis, improvement from BL to Week 12 in back pain score consistently predicted several efficacy outcomes at 1 year.

Conclusion:

In upadacitinib-treated patients with AS, improvement in PROs and reduction in back pain score at 12 weeks predicted clinical outcomes at 1 year.

References:

[1]van der Heijde D, et al. Lancet 2019;394:2108–17.

Figure 1.

Association between Week 12 response or back pain at Week 12 and achievement of efficacy outcomes at 1 year (univariable analysis)

All ASDAS scores are calculated using C-reactive protein

ASDAS CII: change from BL ≥1.1; ASDAS MI: change from BL ≥2.0; MBI back pain: ≥2-point reduction in absolute score and ≥33% reduction from BL on a 0–10 NRS

ASAS, Assessment of SpondyloArthritis International Society; ASAS40, ≥40% improvement in ASAS criteria; ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI50, ≥50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index; BL, baseline; CI, confidence interval; CII, clinically important improvement; ID, inactive disease; LDA, low disease activity; MBI, much better improvement; MI, major improvement; NRS, numeric rating scale; OR, odds ratio; PR, partial remission

Acknowledgements:

AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Laura Chalmers, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.

Disclosure of Interests:

Marina Magrey Consultant of: Consultant for Janssen and Novartis; member of advisory boards for Eli Lilly, Janssen, Novartis, and UCB, Grant/research support from: AbbVie, Sofia Ramiro Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Sanofi, and UCB, Grant/research support from: MSD, Marcelo Pinheiro Consultant of: AbbVie, Eli Lilly, Janssen, and Novartis, Tianming Gao Employee of: AbbVie employee and may own stock or options, Fabiana Ganz Employee of: AbbVie employee and may own stock or options, In-Ho Song Employee of: AbbVie employee and may own stock or options, Ana Biljan Employee of: AbbVie employee and may own stock or options, Nigil Haroon Consultant of: AbbVie, Amgen, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Martin Rudwaleit Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, and UCB

POS0923 INFLUENCE OF BASELINE DEMOGRAPHICS ON IMPROVEMENTS IN DISEASE ACTIVITY MEASURES IN PATIENTS WITH ANKYLOSING SPONDYLITIS RECEIVING UPADACITINIB: A POST HOC SUBGROUP ANALYSIS OF SELECT-AXIS 1

Background:

Upadacitinib (UPA), an oral Janus kinase inhibitor, has demonstrated efficacy and safety through 14 weeks in the SELECT-AXIS 1 study in biologic disease-modifying antirheumatic drug-naïve patients with active ankylosing spondylitis (AS).1

Objectives:

To evaluate the efficacy of UPA 15 mg once daily (QD) in selected subgroups of patients with AS based on different baseline characteristics.

Methods:

In SELECT-AXIS 1, patients were randomized to 14 weeks of blinded treatment with UPA 15 mg QD or placebo (PBO). This post hoc analysis evaluated the proportions of patients achieving ≥40% improvement in Assessment of SpondyloArthritis International Society criteria (ASAS40), ≥50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50), and change from baseline in Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS[CRP]) at Week 14 across subgroups based on the following baseline patient characteristics: gender, age, body mass index, AS symptom duration, C-reactive protein (CRP) levels, Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging index, and human leukocyte antigen B27 status. For missing data, non-responder imputation analysis was used for ASAS40 and BASDAI50, and mixed model repeated measures analysis was used for ASDAS(CRP).

Results:

Baseline disease characteristics were balanced between the treatment groups at randomization, as previously reported.1 ASAS40 and BASDAI50 response rates at Week 14 were numerically higher with UPA 15 mg versus PBO across the demographic and disease characteristic subgroups evaluated (Figure 1), including some subgroups with small sample sizes, such as patients with disease duration <5 years and female patients. Improvements from baseline in ASDAS(CRP) were also consistently greater with UPA 15 mg versus PBO across the subgroups evaluated (Table 1).

Conclusion:

Within subgroups evaluated, most patients with active AS receiving UPA 15 mg demonstrated greater improvements versus PBO in disease activity measures assessed by ASAS40, BASDAI50, and change from baseline in ASDAS(CRP). There was some evidence that gender, AS symptom duration, and baseline CRP levels seemed to influence outcomes, though results should be interpreted with caution due to small sample sizes for some subgroups.

References:

[1]van der Heijde D, et al. Lancet 2019;394:2108–17.

Table 1.

PBO-corrected mean change from baseline (95% CI) in ASDAS(CRP) at Week 14 in patients receiving UPA 15 mg by baseline subgroups (MMRM)

nASDAS(CRP)SubgroupUPA15 mgPBOPBO-corrected mean change from baseline (95% CI)GenderMale5862–1.11 (–1.37, –0.84)Female2622–0.44 (–0.92, 0.03)Age<40 years2436–1.00 (–1.42, –0.58)40–<65 years5146–0.88 (–1.17, –0.59)Body mass index<25 kg/m23237–0.92 (–1.30, –0.55)≥25 kg/m25247–0.89 (–1.20, –0.59)AS symptom duration<5 years1617–0.90 (–1.46, –0.34)≥5 years6867–0.92 (–1.18, –0.66)Baseline hsCRP≤2.8 mg/L2319–0.59 (–1.02, –0.15)>2.8–<10 mg/L3934–0.59 (–0.95, –0.23)≥10 mg/L2231–1.64 (–2.01, –1.27)Inflammation based on SPARCC MRI scoresPositivea5657–0.98 (–1.27, –0.69)Negativeb2116–0.60 (–1.08, –0.12)HLA-B27 statusPositive6266–0.97 (–1.24, –0.71)Negative2017–0.73 (–1.28, –0.17)

aSpine SPARCC score ≥2 or sacroiliac joint SPARCC score ≥2. bSpine SPARCC score <2 and sacroiliac joint SPARCC score <2

ASDAS(CRP), Ankylosing Spondylitis Disease Activity Score with C-reactive protein; CI, confidence interval; HLA-B27, human leukocyte antigen B27; hsCRP, high-sensitivity C-reactive protein; MMRM, mixed model repeated measures; MRI, magnetic resonance imaging; PBO, placebo; SPARCC, Spondyloarthritis Research Consortium of Canada; UPA, upadacitinib

Acknowledgements:

AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Laura Chalmers, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.

Disclosure of Interests:

Filip van den Bosch Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Janssen, and UCB, Denis Poddubnyy Speakers bureau: AbbVie, Celgene, Eli Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, Celgene, Eli Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Jayne Stigler Employee of: AbbVie employee and may own stock or options, Andrew Ostor Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Salvatore D’Angelo Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Victoria Navarro-Compán Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, and UCB, In-Ho Song Employee of: AbbVie employee and may own stock or options, Tianming Gao Employee of: AbbVie employee and may own stock or options, Fabiana Ganz Employee of: AbbVie employee and may own stock or options, Lianne S. Gensler Consultant of: AbbVie, Eli Lilly, Gilead, GSK, Novartis, Pfizer, and UCB, Grant/research support from: Pfizer and UCB

POS0235 COMPARISON OF AXIAL AND PERIPHERAL MANIFESTATIONS IN PATIENTS WITH PSORIATIC ARTHRITIS AND ANKYLOSING SPONDYLITIS IN UPADACITINIB CLINICAL TRIALS

Background:

Axial, peripheral, and other disease manifestations often overlap between psoriatic arthritis (PsA) and ankylosing spondylitis (AS). Upadacitinib (UPA) is an oral Janus kinase inhibitor under evaluation for the treatment of PsA and AS.

Objectives:

To describe and compare baseline characteristics and UPA efficacy across 4 subgroups of patients (pts) from clinical trials: active PsA (with/without axial involvement) and active AS (with/without peripheral involvement).

Methods:

Baseline characteristics and efficacy of UPA in reducing axial and peripheral signs and symptoms were assessed via an integrated analysis across the 4 pt subgroups from the SELECT-PsA 1,1 SELECT-PsA 2,2 and SELECT-AXIS3 studies. Analyses of baseline characteristics included pts in the UPA 15 mg once daily (QD), UPA 30 mg QD, and placebo (PBO) groups; efficacy analyses included pts in the UPA 15 mg QD group only. Axial involvement in PsA (axial PsA) was determined by investigator assessment. Peripheral involvement in AS was defined based on presence of tender or swollen joints (TJC68 >0 or SJC66 >0), or presence of enthesitis at baseline (Maastricht Ankylosing Spondylitis Enthesitis Score >0).

Results:

2102 pts (UPA 15 mg; UPA 30 mg; PBO) were evaluated across the 4 subgroups (PsA [with/without axial involvement]: 626/1289; AS [with/without peripheral involvement]: 135/52). 33% of pts with PsA had axial PsA; 72% of pts with AS had peripheral symptoms. Pts with axial PsA had higher peripheral joint (TJC68 and SJC66) and skin (psoriasis) burden than pts with AS with peripheral involvement (p<0.0001). Pts with AS with peripheral involvement had significantly greater overall pain (pt’s assessment of pain; p=0.0002) and back pain (BASDAI Q2; p<0.0001) scores, and higher total BASDAI (p=0.0076) and ASDAS (p=0.0351) scores than pts with axial PsA; physician’s global assessment of disease activity, and peripheral pain and tenderness (BASDAI Q3 and Q4) were numerically similar for these 2 subgroups (Table 1). The efficacy of UPA 15 mg (measured using ASDAS and BASDAI) was generally consistent across the 4 pt subgroups regardless of peripheral or axial involvement (Figure 1).

Table 1.

Baseline demographics, medical history, and disease characteristics

Mean (SD), unless otherwise specifiedPsA with axial involvementn=626PsA without axial involvementn=1289AS with peripheral involvementn=135AS without peripheral involvementn=52p-value(PsA with axial involvement versus AS with peripheral involvement)Male, n (%)300 (47.9)583 (45.2)88 (65.2)44 (84.6)0.0003Age, years50.7 (12.6)52.0 (12.0)46.6 (12.7)42.2 (11.4)0.0008Body mass index, kg/m230.3 (7.1)30.7 (6.8)a26.7 (4.9)26.8 (5.2)*Duration of disease symptoms, years11.2 (9.3)b10.4 (9.5)a14.6 (10.9)14.0 (10.6)0.0009Duration of disease since diagnosis, years7.7 (8.0)7.3 (8.0)7.0 (9.2)6.8 (8.4)0.3738TJC6823.6 (16.4)20.6 (14.6)5.3 (8.2)0*SJC6611.9 (9.0)11.2 (8.2)1.5 (3.2)0*Psoriasis, n (%)616 (98.4)1269 (98.4)7 (5.2)0*Uveitis, n (%)1 (0.2)5 (0.4)3 (2.2)1 (1.9)0.0191Inflammatory bowel disease, n (%)10 (1.6)13 (1.0)2 (1.5)2 (3.8)1.0000PhGA6.7 (1.7)6.5 (1.7)6.7 (1.5)c6.9 (1.7)b0.6960Pain, VAS 0–106.3 (2.0)b6.1 (2.2)d6.9 (1.6)a6.8 (1.7)a0.0002ASDAS(CRP)3.4 (1.0)e3.1 (1.0)f3.5 (0.7)a3.7 (0.8)a0.0351BASDAI (Total score)6.0 (2.1)e5.5 (2.2)f6.4 (1.6)6.3 (1.8)a0.0076BASDAI Q2 (Back pain)6.1 (2.7)e4.8 (3.2)f7.2 (1.7)7.2 (1.6)a*BASDAI Q3 (Peripheral pain/ swelling)6.3 (2.4)e6.0 (2.6)f5.9 (2.4)5.5 (2.4)a0.0747BASDAI Q4 (Tenderness)5.8 (2.6)e5.6 (2.7)f6.1 (2.5)5.7 (2.4)a0.3196

*p<0.0001

Data missing for an=1, bn=3, cn=6, dn=11, en=4, fn=14

Conclusion:

Pts with PsA with axial involvement and pts with active AS showed some differences in baseline characteristics but similar improvements versus placebo with UPA 15 mg QD.

References:

[1]McInnes I, et al. Ann Rheum Dis 2020;79(Suppl 1):16–17; 2. Genovese MC, et al. Ann Rheum Dis 2020;79(Suppl 1):139; 3. van der Heijde D, et al. Lancet 2019;394:2108–17.

Acknowledgements:

AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Grant Thomas Kirkpatrick, MSc, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.

Disclosure of Interests:

Xenofon Baraliakos Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Gilead, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Gilead, MSD, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Gilead, MSD, Novartis, Pfizer, and UCB, Atul Deodhar Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GSK, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GSK, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Eli Lilly, GSK, Novartis, Pfizer, and UCB, R Ranza Speakers bureau: AbbVie, Janssen, Novartis, and Pfizer, Consultant of: AbbVie, Janssen, Novartis, and Pfizer, Simona Rednic: None declared, francesco ciccia Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Novartis, Pfizer, UCB, and Werfen, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, MSD, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Celgene, Chugai, Pfizer, and UCB, Fabiana Ganz Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Tianming Gao Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Apinya Lertratanakul Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, In-Ho Song Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Andrew Ostor Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, MSD, Novartis, Pfizer, and Roche, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, MSD, Novartis, Pfizer, and Roche, Laura C Coates: None declared.

OP0233 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH PSORIATIC ARTHRITIS AND AXIAL INVOLVEMENT

Background:

Patients (pts) with psoriatic arthritis (PsA) and axial involvment exhibit greater disease activity and quality of life impairments compared with those without axial involvment.

Objectives:

To characterize PsA pts with and without axial involvement and compare efficacy of UPA vs placebo (PBO) in PsA pts with axial involvement.

Methods:

In SELECT-PsA 1 (NCT03104400; N=1705, non-biologic DMARD IR) and SELECT-PsA 2 (NCT03104374; N=642, biologic DMARD IR), pts with active PsA (≥3 swollen and ≥3 tender joints), active or historical psoriasis, and on ≤2 non-biologic DMARDs were randomized to once daily UPA 15 mg, UPA 30 mg, adalimumab 40 mg every other week (SELECT-PsA 1 only), or PBO. Efficacy was assessed in pts with axial involvement (diagnosed by investigators based on totality of information) pooled from the 2 studies. Assessments included change from BL in BASDAI, BASDAI Q2 (neck/back/hip pain) and Q3 (joint swelling/pain), and the AS Disease Activity Score (ASDAS-CRP), and percentage with BASDAI 50 response, ASDAS inactive disease (ID), ASDAS low disease activity (LDA), ASDAS major improvement (MI), and ASDAS clinically important improvement (CII). Uveitis and inflammatory bowel disease (IBD) adverse events were reviewed. Data on 24-week PBO-controlled period are presented.

Results:

Prevalence of axial involvment was 31.3% in SELECT-PsA 1 and 34.2% in SELECT-PsA 2 (Table). Treatment with UPA 15 mg and 30 mg resulted in significantly greater improvements from BL in the BASDAI, BASDAI Q2 (neck/back/hip pain) and Q3 (joint swelling/pain) and ASDAS-CRP at weeks 12 and 24 vs PBO (Figure). Similarly, significantly higher percentages of pts on UPA 15 mg and 30 mg achieved BASDAI 50, ASDAS ID, LDA, MI, and CII at weeks 12 and 24 vs PBO (Figure). One pt on UPA 30 mg had incident uveitis, and no IBD was reported on UPA.

Table 1.

Demographics and Baseline Characteristics

SELECT-PsA 1SELECT-PsA 2Parameter, mean (SD)With Psoriatic Spondylitis(n=534)Without Psoriatic Spondylitis(n=1170)Pvalue*With Psoriatic Spondylitis(n=219)Without Psoriatic Spondylitis(n=421)Pvalue*BMI (kg/m2)29.9 (6.5)30.5 (6.9).081031.6 (8.0)31.3 (6.9).6226TJC6821.6 (15.1)19.2 (13.5).002227.5 (18.0)23.3 (16.2).0027SJC6611.7 (9.4)11.0 (7.9).118412.9 (9.2)11.7 (8.7).0804Physician’s Global Assessment (NRS 0–10)6.7 (1.6)6.5 (1.7).04376.6 (1.8)6.5 (1.7).1897HAQ-DI1.2 (0.6)1.1 (0.6).01701.2 (0.6)1.2 (0.7).2049n=531n=1164n=218n=416Presence of dactylitis, n (%)†188 (35.2)328 (28.0).002869 (31.5)100 (23.8).0348Presence of enthesitis, n(%)‡432 (80.9)884 (75.6).0147189 (86.3)337 (80.0).0125ASDAS–CRP3.4 (0.9)3.1 (1.0)<.00013.3 (1.0)3.2 (1.1).1032n=530n=1161n=217n=416BASDAI5.8 (2.0)5.3 (2.2)<.00016.2 (2.2)5.8 (2.2).0673n=530n=1161n=217n=416Morning Stiffness Duration (NRS 0–10; BASDAI Q6)5.0 (3.0)4.7 (3.0).03685.6 (3.2)5.1 (3.0).0454n=530n=1161n=217n=416Patient’s Assessment of Inflammatory Neck, Back, or Hip Pain (NRS 0–10; BASDAI Q2)5.8 (2.7)4.6 (3.2)<.00016.4 (2.8)5.4 (3.1).0001n=530n=1161n=217n=416

*Calculated by t-test for continuous variables and chi-square test for categorical values. Bolded if <0.05.

Defined as †LDI>0 and ‡total enthesitis count >0

Conclusion:

PsA pts with axial involvement had higher BL disease burden compared with those without axial involvement. UPA was efficacious in treating axial symptoms in pts with psoriatic spondylits.

References:

[1]van der Heijde D, et al. Lancet. 2019;394(10214):2108-2117.

Acknowledgements:

Abbvie funded the study. AbbVie participated in study design, research, analysis, data collection, interpretation of the data, reviewing, and approval. All authors had access to the relevant data and participated in the drafting, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by M Mehta, and J Matsuura of ICON plc (North Wales, PA) and was funded by AbbVie.

Disclosure of Interests:

Atul Deodhar Speakers bureau: Novartis and Pfizer, Consultant of: Novartis, Pfizer, AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Galapagos, Janssen, Boehringer Ingelheim and Celgene, Grant/research support from: Novartis, Pfizer, AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, R Ranza Speakers bureau: AbbVie, Janssen, Lilly, Novartis, and Pfizer, Consultant of: AbbVie, Janssen, Lilly, Novartis, and Pfizer, Grant/research support from: AbbVie, Janssen, Fabiana Ganz Shareholder of: AbbVie, Employee of: AbbVie, Tianming Gao Shareholder of: AbbVie, Employee of: AbbVie, Jaclyn Anderson Shareholder of: AbbVie, Employee of: AbbVie, Andrew Ostor Consultant of: AbbVie, BMS, Roche, Janssen, Lilly, Novartis, Pfizer, UCB, Gilead, and Paradigm

MicroRNA-338 in MSCs-derived exosomes inhibits cardiomyocyte apoptosis in myocardial infarction

OBJECTIVE

Myocardial infarction (MI) is caused by myocardial ischemia and hypoxia, which causes irreversible damage to the myocardium and seriously endangers human health. Exosomes are small, monolayer-structured extracellular vesicles that transport proteins, lipids, mRNAs, and miRNAs between cells. Mesenchymal stem cells (MSCs) can secrete a large number of exosomes and play a role in many pathophysiological processes. The purpose of this paper was to investigate the role of exosomal microRNA-338 (miR-338) in MI and its underlying mechanism of action.

MATERIALS AND METHODS

We transfected rat bone marrow-derived MSCs with miR-338 mimic or negative control and extracted exosomes secreted by MSCs. Expression of miR-338 in MSCs, exosomes, and H9c2 cells co-cultured with exosomes was detected by PCR. Then, we treated H9c2 cells with H2O2. We transfected miR-338 inhibitor into H9c2 cells co-cultured with exosomes to further study the function of miR-338. Apoptosis of H9c2 cells were observed by Western blot, flow cytometry, and cell staining. We also established a MI rat model to study the function in vivo and injected exosomes in the myocardium. Seven days later, we used echocardiography to detect the heart function of rats.

RESULTS

MiR-338 was upregulated in MSCs transfected with miR-338 mimic, exosomes, and H9c2 cells co-cultured with exosomes. When H9c2 cells were co-cultured with exosomes overexpressing miR-338, the expression of Bax was decreased while the expression of Bcl-2 was increased, and the apoptosis rate was also decreased as shown in flow cytometry, and the amount of caspase3 fluorescence was also decreased. Cardiac function was markedly improved after intramyocardial injection of exosomes overexpressing miR-338 in rats. It was demonstrated using computational tools, Western blot, and Luciferase reporter gene experiments that miR-338 could regulate JNK pathway via targeting MAP3K2.

CONCLUSIONS

Exosomal miR-338 can inhibit cardiomyocyte apoptosis and improve cardiac function in rats with myocardial infarction by regulating MAP3K2/JNK signaling pathway.

Effects of hsa_circ_0000711 expression level on proliferation and apoptosis of hepatoma cells

OBJECTIVE

To investigate the role of human serum albumin (hsa)_circular (circ)_0000711 in hepatocellular carcinoma (HCC). Circular ribonucleic acids (circRNAs) are proven in numerous studies to play crucial role in tumor biology, but their roles in HCC remain unknown to a great extent.

PATIENTS AND METHODS

The circRNA expression profile microarray was employed to screen differentially expressed circRNAs in tumor tissues and adjacent tissues from HCC patients, and Reverse Transcription-quantitative Polymerase Chain Reaction (RT-qPCR) assay was performed for further verification. Next, the target micro RNAs (miRNAs) and their messenger RNAs (mRNAs) of key circRNAs were predicted by bioinformatics software, and a circRNA-miRNA-mRNA regulatory network was constructed. Subsequently, KEGG and GO enrichment analyses were applied to predict the possible biological processes regulated by hsa_circ_0000711 and relevant signaling pathways. The miRNAs playing a key role in the circRNA-miRNA-mRNA regulatory network were then selected as the objects, and their direct binding to hsa_circ_0000711 was confirmed via luciferase reporter gene assay. Thereafter, hsa_circ_0000711 was overexpressed or knocked out, and the biological function of hsa_circ_0000711 was detected by cell counting kit-8 (CCK-8) assay, apoptosis detection, and 5-Ethynyl-2'-deoxyuridine (EdU) staining assay in vitro.

RESULTS

The results of expression profile screening revealed that there was a significant difference in the expression profile of circRNAs between tumor tissues and adjacent tissues in HCC patients. Based on the circRNA expression profile and RT-qPCR results, the expression level of hsa_circ_0000711 was overtly reduced in HCC tissues. In addition, miR-103a-3p had the highest eigenvector centrality in the circRNA-miRNA-mRNA regulatory network, suggesting that miR-103a-3p is a vital participant in the pathological mechanism of hsa_circ_0000711. The KEGG enrichment analysis results pointed out that the target genes regulated by hsa_circ_0000711 were clearly enriched in the tumor-associated signaling pathways. Besides, the results of GO enrichment analysis demonstrated that the biological processes regulated by hsa_circ_0000711 were mainly related to cell cycle regulation, so cell proliferation might be affected. The results of luciferase reporter gene and RT-qPCR assays showed that hsa_circ_0000711 directly bound to has-miR-103a-3p to serve as a molecular sponge. The results of CCK-8 and EdU staining assays revealed that the proliferation of hepatoma cells in hsa_circ_0000711 overexpression group was evidently enhanced. In addition, it was further found via flow cytometry that the apoptosis rate of cells was significantly raised in hsa_circ_0000711 low-expression group and dramatically declined in hsa_circ_0000711 overexpression group.

CONCLUSIONS

Overexpression of hsa_circ_0000711 promoted the proliferation and inhibited the apoptosis of hepatoma cells via targeting has-miR-103a-3p.

[Influence of glottal stops on nasalance and velopharyngeal closure status after cleft palate surgery]

Objective: To investigate the influence of glottal stops for the relationship between nasalance and velopharyngeal closure status of cleft palate patients after surgery. Methods: A total of 71 patients with postoperative cleft palate speech disorders treated in the Department of Oral and Maxillofacial surgery, School of Stomatology, Peking University from August 2004 to August 2010 were included. The compensated speech evaluation of cleft palate with or without glottic occlusion was performed in 50 males and 21 females with an average age of (15.9±6.2) years old. The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual analog scale (VAS) of the patients. According to the results of glottic plug speech evaluation, the patients were divided into three groups: whole group (without glottic plug), glottic plug group and silent glottic plug group. The nasal phonation rate values and VAS values of 11 speech samples (unit vowel No. 1-3, continuous syllable No. 4-9, sentence 10-11) of the three groups were compared by Pearson analysis. Results: There were 71 patients in the whole group, 34 patients in the glottic plug group and 37 patients in the silent glottis group. There was a negative correlation between nasal phonetic rate and VAS of 11 speech samples in the whole group, however there were no significant difference (r>-0.179 and<-0.017, P>0.017) and no significant correlation between nasal phonetic rate and VAS in glottic occlusion group (r>-0.196 and<-0.017, P>0.05). There was a significant negative correlation between nasal phonetic rate and VAS value of all but No. 1, 3 and 11 speech samples in silent door plug group (P<0.05), among which No. 7 speech sample was the most sensitive sample (r=-0.557, P<0.05). Conclusions: The present study showed the glottal stops could affect the evaluation of the velopharyngeal closure function by using nasometer. Glottal stops should be considered as one important factor for the nasalance.

Protective effect of overexpression of PrxII on H2O2-induced cardiomyocyte injury

OBJECTIVE

Oxidative stress is one of the main factors leading to myocardial cell damage, and the redox imbalance promotes apoptosis. Therefore, the purpose of this study was to explore the protective effect of PrxII on H2O2-induced H9c2 cell injury.

MATERIALS AND METHODS

The overexpressed PrxII cell model was constructed by virus. The H9c2 cells were treated with H2O2, and the supernatant and cells were collected. Then, the chymotrypsin-like activity, caspase-like activity, and trypsin-like activity were detected by the kit, and the expressions of P21, P27, and P53 were detected by the ELISA method. Finally, the expressions of antioxidant factors, apoptosis-related factors, and AMPK/Sirt1 signaling pathway were detected by Western blot and Real-time polymerase chain reaction (PCR).

RESULTS

Overexpression of PrxII inhibited the decrease of enzyme activity induced by H2O2, promoted the expressions of anti-oxidation factors GPX1, GPX2, and GSX, and inhibited the expressions of apoptosis-related factors P21, P27, and P53, and activated AMPK/Sirt1 pathway.

CONCLUSIONS

Overexpression of PrxII can activate the AMPK/Sirt1 pathway, thereby inhibiting H2O2-induced oxidative stress and slowing apoptosis.

The use of mindfulness-based intervention to improve bracing compliance for AIS patients

Introduction

Despite good bracing compliance is crucial to prevent curve progression among braced AIS patients, only few interventions were suggested to improve bracing compliance. This study examined the effect of MBI on bracing compliance for AIS patients.

Methods

116 eligible AIS patients were randomized and 86 participants were enrolled in intervention. Patients in the MBI group joint weekly sessions, which is an adapted version of mindfulness-based stress reduction (MBSR) program, for 8 weeks. Control group consisted of an 8-week PE intervention that is recommended according to the SOSORT 2011 guideline. The primary outcome is the 6-month post-intervention bracing compliance. The secondary outcomes include quality of life and psychosocial measurements. Primary analysis was ANCOVA with treatment as covariate. Trend analysis was conducted using Linear Mixed effect model.

Results

At the end of intervention, intention-to-treat analysis improved bracing compliance by1.24h/day and 0.08h/day for MBI and PE respectively. MBI group presented an increase in emotional regulation than baseline (ERQ-CCA) (1.92, p = 0.01), especially in Cognitive reappraisal sub-scale (1.00, p = 0.05). Bracing Specific Quality of Life (SRS-22) reduced significantly in both groups, but MBI group decreased less (MBI: -3.08, p = 0.00, PE -4.47, p = 0.00). Effect at six months for compliance progressed negatively but favoured MBI group (MBI: -1.16, p = 0.13, PE: -1.84, p = 0.06) although there was no significant difference between groups (p = 0.78). The Perception of stress (PSS) decreased significantly in PE group (-3,53, p = 0.01) rather than MBI (1.53, p = 0.22), however the between-group difference isn't significant (p = 0.62).

Conclusions

It is alarming that patients in both interventions group progressed with poorer compliance and worsen QoL. These progressions were less severe in the MBI group than in the PE group, but the differences did not reach statistical significant.

Key messages

Both groups decreased in compliance and QoL but MBI group reduced less. MBI wasn't more effective in improving participants’ compliance and other measurements.

Thin superficial inferior epigastric artery perforator flap for reconstruction of the tongue

The superficial inferior epigastric artery (SIEA) flap is widely used in the repair of large soft tissue defects of the extremities and in breast reconstruction. Because of the high fat content of the abdomen, it has been less used for glossectomy reconstruction. Here we present a series of seven patients who each underwent reconstruction with a thin SIEA flap after resection of the tongue. There were six men and one woman (mean age 48, range 24-66 years). All patients underwent preoperative computed tomographic (CT) angiography, and colour Doppler ultrasound (US) was used to select and map the most suitable SIEA. The flap was raised above the Scarpa's layer while adjusted the plane of dissection according to the specific needs for bulk in each case. All the flaps survived; one flap required a secondary anastomosis because of a venous anastomotic embolus. The size of flap used was 5.0cm×6.0cm - 7.0cm×9.0cm, and the flap was 0.8cm-1.4cm thick. The functional outcome was evaluated at 6 - 18 months follow up, when speech and swallowing were both good in all cases. The dissection above the pubic symphysis is an important refinement of the SIEA flap, and we conclude that the thin SIEA flap is a good choice for reconstruction after excision of cancer of the tongue.

AB0243 THE SHORT DISEASE DURATION IS ASSOCIATED WITH WORSE MOOD DISORDER IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Rheumatoid arthritis (RA) is commonly associated with mood disorders, especially depression and anxiety. But the status of mood disorders in RA patients with different courses is unknown.

Objectives:

The aims of this study were to investigate the frequencies of depression and anxiety in patients with early RA and non-early RA, and further to identify the risk factors for mood disorders.

Methods:

Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were applied to all enrolled RA patients to assess their corresponding status of anxiety and depression. Besides clinical assessment, power Doppler and grey-scale ultrasound of 22 joints were also performed. The status of mood disorder was studied in early RA patients compared to non-early RA patients. Multivariate regression was used to identify the risk factor for mood disorders.

Results:

201 RA patients were enrolled, with 76 early RA (disease duration≤2 years) and 125 non-early RA (disease duration > 2 years) patients. Mood disorder (depression and/or anxiety) was found in 20.9% (42/201) patients. Depression was more often observed in early RA patients than non-early RA patients (26.3% vs. 14.4%,P=0.036). The similar trend for anxiety was observed also in early RA patients compared to non-early RA patients, although the difference was insignificant (13.2% vs. 5.6%,P=0.062). Multivariate logistic regression analysis showed that disease duration (OR 0.991 [95% CI 0.985-0.998]), rheumatoid factor concentration (OR 2.697 [95% CI 1.165-6.241]), Health Assessment Questionnaire Disability Index (HAQ-DI) (OR 1.045 [95% CI 1.001-1.091]) and grey-scale synovitis score (GS score) (OR 1.092 [95% CI 1.032-1.156]) were independent risk factors for predicting depression in RA. Disease duration (OR 0.983 [95% CI 0.970-0.997]), HAQ-DI (OR 1.069 [95% CI 1.002-1.141]) and GS score (OR 1.073 [95% CI 1.005-1.141]) were independent risk factors for predicting anxiety in RA patients.

Conclusion:

Mood disorders were almost doubled in frequency in early RA patients than non-early RA patients. RA Patients with short disease duration, high HAQ-DI and high GS score were more likely to be in depression and anxiety. More attention is needed to the psychological status of RA patients, especially those at an early stage, with poor physical function and severe synovitis.

References:

[1]Sturgeon JA, Finan PH, Zautra AJ. Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nat Rev Rheumatol 2016;12(9):532-42.

[2]Bacconnier L, Rincheval N, Flipo RM, et al. Psychological distress over time in early rheumatoid arthritis: results from a longitudinal study in an early arthritis cohort. Rheumatology (Oxford) 2015; 54(3): 520-7.

Acknowledgments:

The authors thank all the colleagues in our department.

Disclosure of Interests:

None declared

[Features of gut microbiota in patients with idiopathic Parkinson's disease]

Objectives: To investigate whether the fecal microbiome of Parkinson's disease patients differs from that of healthy population and explore the pathogenesis and new treatment of idiopathic Parkinson's disease. Methods: A total of 30 patients diagnosed as idiopathic Parkinson disease (PD group) in Beijing Friendship Hospital between April 2017 and June 2018 were enrolled and 30 healthy controls (NC group) were recruited at the same time.Medical records and score of unified Parkinson's disease rating scale (UPDRS) were collected and fresh fecal samples were obtained and stored in refrigerator (-80℃). The microbial compositions of fecal samples were investigated by 16S rRNA gene sequencing targeting the V3-V4 region. The taxa abundance and microbial composition were tested. Results: There was no difference of age and sex in PD and NC groups. Chao1 and Shannon indexes tended to be higher in PD group, yet failed to reach statistic significance (P=0.115 and 0.052). Relative abundance of gut microbiota differed in each taxonomic category. The relative abundance of Firmicutes in PD group was 53.6%(41.7%-64.8%), while that of Bacteroidetes in NC group was 51.7%(31.7%-65.3%). The ratios of Firmicutes to Bacteroidetes were significantly different between the two groups (1.6(0.9-3.4) vs 0.7(0.5-1.4), P=0.001). In Clostridia, Bacilli and Erysipelotrichia of Firmicutes, the relative abundances of Clostridiales, Christensenellaceae, Peptoclostridium, Lactobacillus and Erysipelatoclostridium were higher in PD group (P=0.024, 0.046, 0.036, 0.022 and 0.037). The relative abundance of Prevotella of Bacteroidales, was lower in PD group, yet failed to reach statistic significance (P=0.121). The relative abundances of Alistipes of Rikenellaceae and Butyricimonas of Marinilabiliales in PD group were significantly higher than those in NC group (P=0.047 and 0.033). The relative abundance of Bifidobacterium of Actinobacteria was significanly higher in PD group when compared with NC group (P=0.009). Despite the relatively low abundance, Akkermansia of Verrucomicrobia was significantly higher in PD group than in NC group (P=0.025). Conclusion: The structures of the fecal microbiota differ significantly between PD patients and healthy controls.

[Effects of simultaneous nasometer and nasopharyngeal fibroscopic examination on the value of nasalization rate in cleft palate patients]

Objective: To evaluate the changes of nasalance when cleft palate patients examined using nasometer and nasopharyngeal fiberscopy simultaneously. Methods: A total of 33 cleft palate patients from August 2004 to August 2010 were examined by nasopharyngeal fiber endoscopy and nasometer simultaneously. The nasalance of 33 voice samples was compared under two situations only nasometer and nasometer with nasopharyngeal fiberscopy. Results: The statistics showed that the nasalance value of 33 voice samples of 33 participants under different situations were no significant difference through paired t-test (P>0.05). Conclusions: Nasopharyn fiber endoscopy had no influence to the results of the nasalance value under simultaneous condition. The nasometer and nasopharyn fiber endoscopy can be applied to evaluate the velopharyngeal function of cleft palate patients simultaneously.

[The diagnostic utility of thin-slice CT navigation combined with radial endobronchial ultrasound for peripheral pulmonary lesions]

Objective: To evaluate the diagnostic value of thin-slice CT navigation combined with radial endobronchial ultrasound in peripheral lung lesions. Methods: The clinical data of patients with peripheral lung lesions diagnosed by thin-slice CT navigation combined with radial endobronchial ultrasound in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from November 2015 to August 2018 were retrospectively analyzed. The success rate of thin-slice CT for guiding radial endobronchial ultrasound was statistically analyzed, and the diagnostic rate, sensitivity and specificity of thin-slice CT combined with radial endobronchial ultrasound were analyzed. Results: 140 consecutive patients with 145 lesions were included, 139 lesions in 136 patients were found by thin-layer CT guidance, the success rate was 95.9%; 137 lesions in 135 patients were examined by histology and/or cytology, and 106 lesions were finally diagnosed, the diagnostic rate was 77.37%; and the diagnosis sensitivity and specificity was 88.45% and 99.96%. Histological and cytological diagnostic rate, sensitivity and specificity was 72.18% versus 63.50%, 70.58% versus 66.85%, 100% versus 88.23%, respectively. Factors influencing the diagnostic rate of thin-slice CT navigation combined with radial endobronchial ultrasound include the relationship between the lesion and the target bronchus, the location of the probe and the lesion, and the size of the lesion, and the difference between the farthest generation of bronchoscopy insertion and the bronchial generation of lesions. Five patients had mild bleeding and one ultrasonic probe was damaged. Conclusion: Thin-slice CT has a higher positive rate in guiding peripheral lung lesions with radial ultrasound, and this method has a higher diagnostic value for peripheral lung lesions.