Abstract PS10-51: TAA013 a trastuzumab antibody drug conjugate phase I dose escalation study in recurrent her2 positive breast cancer

Background: A phase 1 dose escalation study of TAA013, an antibody drug conjugate linking trastuzumab to a cytotoxic small molecule, DM1, through an SMCC linker, in previously treated recurrent Her2 positive breast cancer patients. Material and Methods: This phase I study follows the traditional 3+3 design, dosing started at 0.6mg/kg, followed by 1.2, 2.4, 3.6, 4.8mg/kg, one intravenous infusion was given every 3 weeks, the initial infusion had to be over 90 minutes, infusion times were later shortened if treatment was well tolerated. The subsequent recommended dose would be expanded to include at least 10 patients. Patients were observed for dose-limiting toxicity (DLT) during a 21-day DLT observation period. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0. Maximum-tolerated dose (MTD) was defined as the highest dose level that resulted in a DLT in no more than 1 of 6 patients. Study endpoints included safety and tolerability, pharmacokinetic and immunogenicity parameter evaluation, with preliminary evaluation of efficacy. Results: The study enrolled 22 female patients with histologically confirmed Her-2 positive metastatic breast cancer, median age of 50yrs (25-67), median time from initial diagnosis to TAA013 dosing was 39 months (5-99), median prior treatment regimen was 4 (2-10), all had received trastuzumab for a mean of 8.2 months (2-10), alone or in combination with chemotherapy, other prior Her2 targeting drugs given included pertuzumab (2), lapatinib (7), and pyrotinib (8). All patients received at least 2 (median of 6 infusions, range of 1-15) infusions, except for the last 4.8mg/kg patient, but all patients passed the dose limiting toxicity (DLT) observation period of 21 days. There were no dose limiting toxicities, no serious adverse events, nor that resulting in mortality, the maximum tolerated dose was not reached. The most common treatment emergent adverse events (TEAE) included 9 (40.9%) grade 1-2 infusion reactions associated with fever(5) and/or chills(1), the reaction often abated in subsequent cycles. There were no grade 4 TEAE, but there were 3 grade 3 thrombocytopenia, one grade 3 neutropenia, and one grade 3 hyperbilirubinemia which all recovered for the patients to continue treatment, there was also one grade 3 dermatitis in a patient with a history of chronic dermatitis. Antibody drug antibodies were not detected emanating from the TAA013 therapy. Pharmacokinetic studies included evaluation of TAA013, trastuzumab and DM1. Preliminary efficacy evaluation in the 2.4-4.8mg/kg dosing group of heavily pretreated patients resulted in 2 partial responses, including patients who had previously received pyrotinib therapy. Conclusion: TAA013 is a Her2 targeting antibody drug conjugate that is safe and tolerable, with efficacy demonstrated in heavily pretreated Her2 positive breast cancer patients. Keywords: breast cancer, antibody drug conjugates, TAA013.

Citation Format: J M Liu, Y M Yin, Hao Wu, W Li, X Huang, XX Li. TAA013 a trastuzumab antibody drug conjugate phase I dose escalation study in recurrent her2 positive breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-51.

[Effects of hnRNP E1 on expression of early genes E2, E6 of HPV16 and biological function in cervical cancer cells]

Objective: To explore the effects of hnRNP E1 on the expression of early genes E2, E6 of HPV16 and the biological function in cervical cancer SiHa cell lines. Methods: The cell experiments in vitro were carried out in cervical cancer cell lines SiHa. The expression levels of E2, E6 mRNA and protein of HPV16 were detected by Real-time PCR and Western blot, respectively, before and after up-regulating hnRNP E1. Meanwhile, the cell proliferation, cycle and apoptosis were evaluated by CCK-8 and flow cytometry. Data analyses were performed using SPSS 22.0 and Graphpad Prism 7.0 software. Results: Compared with the blank and the blank plasmid group, the cells activity and proliferation decreased at 24, 48 and 72 h after up-regulating hnRNP E1 (P<0.05), while the percentage of cells in G0/G1 phase increased and the percentage in S and G2/M phase and proliferation index decreased (P<0.05). Moreover, the late apoptotic rate and the total apoptotic rate increased (P<0.05). The expression levels of E6 mRNA and protein of HPV16 in hnRNP E1 up-regulated group were significantly lower than that in both blank group and blank plasmid group, the differences were significant (P<0.05), showing the tendency of cells proliferation index decrease and total apoptotic rate increase with decreased HPV16 E6 expression. There were no significant differences in the expression of E2 mRNA of HPV16 among the three groups (P=0.427), and no E2 protein of HPV16 was detected. Conclusions: hnRNP E1 could inhibit the transcription and translation of E6 oncogene of HPV16 and further inhibit the proliferation and promote apoptosis of cervical cancer cells, suggesting that hnRNP E1 might be a potential target marker to prevent cervical lesions. But no association between hnRNP E1 and HPV16 E2 was found in SiHa cells.

[Relations of human papillomavirus infection, vaginal micro-environmental disorder with cervical lesion]

Objective: To study the relations of human papillomavirus (HPV) infection, vaginal micro-environmental disorder with cervical lesion. Methods: A total of 1 019 women including 623 with normal cervical (NC), 303 with low-grade cervical lesion (CIN Ⅰ) and 93 with high-grade cervical lesion (CIN Ⅱ/Ⅲ) were enrolled in this study from the communities in Shanxi province, China. Case-control method was adopted, with NC as the control group and CIN as the case group. Related information was collected including demographic characteristics and relevant factors related to cervical lesions. HPV genotypes were detected by flow-through hybridization technology. Vaginal pH was detected by the pH test paper. Vaginal H(2)O(2) was detected by the combined detection kit of aerobic vaginitis and bacterial vaginosis. Vaginal cleanliness was detected by smear method. Results: Data from the unconditional logistic regression analysis showed that HPV infection (CINⅠ: aOR=1.39, 95%CI: 1.01-1.90; CINⅡ/Ⅲ: aOR=11.74, 95%CI: 6.96-19.80), H(2)O(2) (CINⅠ: aOR=2.09, 95%CI: 1.47-2.98; CINⅡ/Ⅲ: aOR=4.12, 95%CI: 2.01-8.43), cleanliness (CIN Ⅱ/Ⅲ: aOR=2.62, 95%CI: 1.65-4.14), and composite indicators (CINⅠ: aOR=1.67, 95%CI: 1.24-2.25; CINⅡ/Ⅲ: aOR=4.24, 95%CI: 2.30-7.81) all had increased the risk of cervical lesion and the trend on the severity (P<0.001) of cervical lesions. Additionally, we observed a synergic effect between HPV infection and vaginal micro-environmental composite indicator in CINⅡ/Ⅲ. With or without HPV infection, the ORs value of CINⅠ caused by vaginal micro-environment disorder remained close. Conclusions: Results from our study revealed that vaginal micro-environmental composite indicator could increase the risk for cervical lesion, in particular with the high-grade ones which all posed stronger risks when combined with HPV infection. However, the role of vaginal micro-environment disorder in the occurrence of CIN Ⅰ should not be ignored.

[Typical case analysis of COVID-19 cluster epidemic in Shaanxi, 2020]

Objective: By analyzed the transmission patterns of 4 out of the 51 COVID-19 cluster cases in Shaanxi province to provide evidences for the COVID-19 control and prevention. Methods: The epidemiological data of RT-PCR test-confirmed COVID-19 cases were collected. Transmission chain was drawn and the transmission process was analyzed. Results: Cluster case 1 contained 13 cases and was caused by a family of 5 who traveled by car to Wuhan and returned to Shaanxi. Cluster case 2 had 5cases and caused by initial patient who participated family get-together right after back from Wuhan while under incubation period. Cluster case 3 contained 10 cases and could be defined as nosocomial infection. Cluster case 4 contained 4 cases and occurred in work place. Conclusion: Higher contact frequency and smaller places were more likely to cause a small-scale COVID-19 cluster outbreak, with potential longer incubation period. COVID-19 control strategies should turn the attention to infection prevention and control in crowded places, management of enterprise resumption and prevention of nosocomial infection.

[Observation of cosmetic effect of corneal interlamellar staining in patients with corneal leucoma]

Objective: To observe the clinical effect of corneal staining in patients with corneal leucoma. Methods: Restrospective case series study.Thirty eyes of 30 patients (17 males, 13 females) with corneal leucoma who underwent corneal interlamellar staining at Beijing Aier-Intech Eye Hospital from October 2014 to July 2018 were included. The mean age was 31.50±15.66 years. Postoperative follow-up was more than 1 year. All the patients underwent appearance examination, anterior segment examination with a slit lamp, B-scan examination and anterior segment OCT examination preoperatively and postoperatively. The effect of corneal staining, patient satisfaction and the incidence of complications were investigated. Results: The corneal epithelium of all the patients healed completely within 1-3 days after operation. The mean follow-up period was 30.68±18.02 months (range, 12.37-58.10 months). During the postoperative follow-up period, no staining permeation or inflammatory reaction in the anterior chamber occurred. The corneal color and appearance were well maintained in 18 patients (72.0%). Seven patients (28.0%) showed mild corneal color-fading. One patient was treated with enucleation and orbital hydroxyapatite implantation because of eye atrophy and corneal banding degeneration caused by the primary disease at 4 years after operation. The surgeon was satisfied with the improvement of the appearance of all cases; 22 patients (88.0%) were satisfied with the postoperative appearance. No significant complications were observed in all the cases. Conclusions: Corneal interlamellar staining is one of best choices for the treatment of corneal leucoma. It has advantages of quick postoperative recovery, long-standing color staining and good cosmetic effect. The operation is simple and easy to carry out and there is no obvious damage to eye tissues. (Chin J Ophthalmol, 2020, 56:465-472).

[Analysis of transmission characteristics of COVID-19 in Shaanxi Province]

A total of 245 cases of COVID-19 in Shaanxi Province reported in the China information system for disease control and prevention as of February 24, 2020 were selected as the research objects, the cases are divided into imported cases (116 cases, 47.3%) and local cases (129 cases, 52.7%), their basic characteristics, time distribution, transmission mode, intergenerational interval and latent period transmission are analyzed. The age of local cases [(51.74±15.67) years old], female patients (69 cases, 53.5%), housework and retired staff (40 cases, 31.0%), and patients isolated at the time of onset (50 cases, 38.8%) were higher than imported cases, respectively[(40.66±15.41) years old, (45 cases, 38.8%), (21 cases, 18.1%), (17 cases, 14.6%)] (P values were < 0.05); The infection rate was 0.8% (31/3 666) in close contacts with local cases, which was lower than imported cases 2.0% (69/3 435) (P<0.001); The main source of infection in local cases was relatives (70 cases, 54.3%), and the main way of infection was living together and party (90 cases, 69.8%); the proportion of latent period transmission in our province was 15.5% (20 cases), and the interval between the second-generation case and the source of infection was about 4 days, and the interval between generations was about 6 days. In summary, the main way of infection of local cases in Shaanxi Province was living together and party, there were a certain proportion of latent period transmission cases at present, it's suggested that the investigation of close contacts should be started 4 days or earlier before the onset of the case.

[A summary of ocular fundus diseases in China over the past 70 years]

After 70 years of development, China has become a global leader in the academic research and clinical practice of fundus diseases. The dramatic progress is mainly attributable to the relentless efforts of generations of fundus ophthalmologists. We are moving forward to incorporate new technologies such as AI and big data into the treatment of fundus diseases. The summary is intended to commemorate the past masters and to inspire the young ophthalmologists. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. (Chin J Ophthalmol, 2020, 56:241-245).

[Epidemiological characteristics of COVID-19 in Shaanxi province]

Objective: To understand the incidence trend and epidemiological characteristics of COVID-19 in Shaanxi province. Methods: The incidence data of COVID-19 reported in Shaanxi as of 22 February, 2020 were collected for an epidemiological descriptive analysis. Results: A total of 245 confirmed cases of COVID-19 were reported in Shaanxi. Most cases were mild (87.76%). As time passed, the areas where confirmed cases were reported continued to increase. The case number in Xi'an was highest, accounting for nearly half of the total reported cases in the province. The epidemic pattern in Shaanxi had gradually shifted from imported case pattern to local case pattern, and the transmission of local cases was mainly based on family cluster transmission. The confirmed cases from different sources had caused the secondary transmission in Shaanxi. After February 7, the number of reported cases began to fluctuate and decrease stably, indicating a decrease-to-zero period. Conclusions: At present, the overall epidemic of COVID-19 in Shaanxi has gradually been mitigated. However, considering the approaching of return to work and study and the increasing of imported cases from other countries, the prevention and control of COVIS-19 in Shaanxi will face new challenges.

Effect of Application Rate and Timing on Residual Efficacy of Pyraclostrobin in the Control of Pepper Anthracnose

Anthracnose is a devastating disease that seriously affects pepper production worldwide. Anthracnose management is currently a major problem because of the widespread and long period of infection of this disease. Therefore, determination of the optimal fungicide application timing is important for controlling anthracnose in a timely manner . In vitro sensitivity tests showed no significant difference in the pyraclostrobin sensitivity of Colletotrichum scovillei collected from 2016 and 2017, with mean half maximal effective concentration values of 0.349 to 0.542 and 0.0475 to 0.0639 mg/liter for the inhibition of mycelial growth and spore germination, respectively. Fungicide application initiated at the full-bloom stage could significantly delay anthracnose disease onset, decrease anthracnose incidence and development (23.67 to 89.80%), and increase pepper yield by 10.7 to 29.2%. In addition, the application dosage was decreased by >50%. BF-500-3, the main metabolite of pyraclostrobin, was detected in pepper fruit and exhibited high inhibitory activity against C. scovillei. The final residues of all fungicides at different application timing were below maximum residue limits. Moreover, structural equation modeling indicated that application timing plays the most important role in anthracnose disease inhibition. The tank mixtures of pyraclostrobin with tebuconazole and fludioxonil showed more satisfactory efficacy (69.87 to 78.36%) against anthracnose than did pyraclostrobin alone under field conditions. This study is the first to determine the best fungicide application timing for anthracnose management. These results establish the basis for sustainable development of the pepper industry.

Effect of Pyrisoxazole on Colletotrichum scovillei Infection and Anthracnose on Chili

Anthracnose caused by Colletotrichum scovillei is one of the most destructive diseases affecting chili production. Disease control mainly relies on conventional fungicides, and repeated exposure to single-site mode-of-action fungicides may pose a risk for the development of resistant isolates within the population. Our previous study suggested that pyrisoxazole has strong inhibitory activity against C. scovillei in vitro. However, the effects of pyrisoxazole on the C. scovillei infection process and the performance of pyrisoxazole in the field remain unclear. In this study, pyrisoxazole exhibited strong inhibitory activity against the mycelial growth, appressorium formation, and appressorium diameter of C. scovillei, with half maximal effective concentration values of 0.1986, 0.0147, and 0.0269 μg/ml, respectively, but had no effect on sporulation, even at the highest concentration of 1.6 μg/ml. The baseline sensitivity curves were unimodal with a long right-hand tail. The in vivo data showed that pyrisoxazole provided both preventive and curative activity against anthracnose on chili. Pyrisoxazole decreased the incidence of anthracnose and reduced disease progress. The results of electron microscopy showed that pyrisoxazole can affect the C. scovillei infection process by altering mycelial morphology, degrading conidia and germ tubes, suppressing conidial germination and appressorium formation, and enhancing conidiophore production. Pyrisoxazole can be used to effectively control anthracnose under field conditions and increase chili yield; moreover, no phytotoxicity symptoms were observed after treatment. These results provide new insight into the mechanisms by which pyrisoxazole controls disease and suggest that pyrisoxazole is a feasible alternative for the management of anthracnose in chili.

[The role of human papillomavirus 16 early genes E2 and E6 and heterogeneous nuclear ribonucleoprotein E2 in cervical carcinogenesis and their interaction effect]

Objective: To investigate the role of human papillomavirus (HPV) 16 early genes E2 and E6 and heterogeneous nuclear ribonucleoprotein (hnRNP) E2 and their interaction effects in the progression of the cervical cancer. Methods: Women with normal cervix (NC), low cervical intraepithelial neoplasia (CIN Ⅰ) and high cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ) from the cervical lesions cohort in Jiexiu County of Shanxi Province from June 2014 to September 2014, and patients with cervical squamous cell carcinoma (SCC) treated at the Second Hospital of Shanxi Medical University in the same period were enrolled in this study. There were 257 participants, about 67 NC cases (26.07%), 69 CIN Ⅰ cases (26.85%), 68 CIN Ⅱ/Ⅲ cases (26.46%), and 53 SCC cases (20.62%), respectively. The information of demographic characteristics, life health habits and cervical lesions were collected by using the structured questionnaire. Cervical exfoliated cells and cervical biopsy tissues were collected to detect the infection of HPV16 and the protein expression levels of hnRNP E2, HPV16 E2 and E6. According to the median-value of the protein expression levels of hnRNP E2, HPV16 E2 and E6 and E2/E6 ratio in the NC group, the study participants were divided into the high and low expression groups/ratio groups. The multivariate logistic regression model was used to analyze the correlation between HPV16 early gene E2 and E6, hnRNP E2 and cervical cancer. The interaction effect was analyzed by using the generalized multifactor dimensionality reduction (GMDR) model. Results: The ages of NC, CIN Ⅰ, CIN Ⅱ/Ⅲ and SCC groups were (47.00±9.07), (47.64±7.35), (46.37±8.67) and (51.26±8.03) years old, respectively. The multivariate logistic regression model analysis showed that the HPV16 E2 low expression, E6 high expression and E2/E6 low ratio could increase the risk of CIN Ⅱ/Ⅲ, about OR (95%CI) values 11.11 (1.63-75.56), 8.00 (1.28-50.04), and 9.75 (1.22-77.72), respectively and SCC, about OR (95%CI) values 14.22 (2.11-95.88), 10.33 (1.67-64.00), and 12.38 (1.56-97.91), respectively. The hnRNP E2 low expression could increase the risk of CIN Ⅱ/Ⅲ and SCC, about OR (95%CI) values 3.35 (1.39-8.10) and 5.53 (1.54-19.88). The result of GMDR showed that there were interaction effects of the hnRNP E2 low expression, HPV16 E2 low expression and HPV16 E6 high expression in both CIN Ⅱ/Ⅲ and SCC groups. Conclusion: The HPV16 E2 low expression, HPV16 E6 high expression and hnRNP E2 low expression could increase the risk of high-grade cervical intraepithelial neoplasia and cervical cancer, and they might have an important interaction effect in the progression of the cervical cancer.

miR-147b-modulated expression of vestigial regulates wing development in the bird cherry-oat aphid Rhopalosiphum padi.. [DOI: 10.21203/rs.2.9668/v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Most aphids exhibit wing polyphenism in which wingless and winged morphs produce depending on the population density and host plant quality. Although the influence of environmental factors on wing polyphenism of aphids have been extensively investigated, molecular mechanisms underlining morph differentiation (i.e. wing development /degeneration), one downstream aspect of the wing polyphenism, has been poorly understood. Results: We examined the expression levels of the twenty genes involved in wing development network, and only vestigial (vg) showed significantly different expression levels in both whole-body and wall-body of third instar nymphs, with 5.4- and 16.14- fold higher expression in winged lines compared to wingless lines, respectively in Rhopalosiphum padi. vg expression was higher in winged lines compared to wingless lines in third, fourth instar nymphs and adults. Larger difference expression was observed in third (21.38-fold) and fourth (20.91-fold) instar nymphs relative to adults (3.12-fold). Suppression of vg using RNAi repressed the wing development of third winged morphs. Furthermore, dual luciferase reporter assay revealed that the miR-147 can target the vg mRNA. Modulation of miR-147b levels by microinjection of its agomir (mimic) decreased vg expression levels and repressed wing development. Conclusions: Our findings suggest that vg is essential for wing development in R. padi and that miR-147b modulates its expression.

[Angioimmunoblastic T-cell lymphoma: histopathological grading and prognosis]

Objective: To investigate the histological features and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL). Methods: The pathological data of 62 patients with AITL with complete follow-up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed. Results: The cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki-67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki-67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival. Conclusions: AITL could be divided into two different prognostic groups, low-grade and high-grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low-grade malignant group progresses slowly, and high-grade malignant group is highly invasive.

Vestigial mediated by miR-147b regulates wing development in the bird cherry-oat Rhopalosiphum padi.. [DOI: 10.21203/rs.2.9668/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The wing polyphenism occurs under crowding and nutrition-deficiency conditions in most aphid species. Although the influence of environmental factors on wing polyphenism of aphids have been extensively investigated, molecular mechanisms underlining morph differentiation (i.e. wing development /degeneration) has been poorly understood. Results: We examined the expression levels of the twenty genes involved in wing patterning network, and only vestigial (vg ) showed significantly different expression levels in both whole-body and wall-body of third instar nymphs, with 5.4- and 16.14- fold higher in winged lines compared to wingless lines, respectively in Rhopalosiphum padi . Moreover, vg expressions were higher in winged aphids compared to wingless aphids at third, fourth instar nymphs and adults, and larger difference ratio were observed in third (21.38-fold) and fourth (20.91-fold) instar nymphs relative to adult (3.12-fold) between wing morphs. Suppression of vg using RNAi repressed the wing development of third winged morphs. Furthermore, dual luciferase reporter assay revealed that the miR-147 can target the vg mRNA, and modulation of miR-147b levels by microinjection of its mimics decreased vg expression levels and repressed wing development. Conclusions: Our findings suggest that vg is essential for wing development and that miR-147b modulates its expression. To our knowledge, our results provide an evidence that miRNA is involved in the regulation of wing morphs in aphids.

[Endemic situation of schistosomiasis in Jiangshan City from 2008 to 2018]

OBJECTIVE

To analyze the endemic situation of schistosomiasis in Jiangshan City from 2008 to 2018, so as to provide evidence for formulating the future control strategy.

METHODS

The data regarding Oncomelania snail survey and control, schistosomiasis examinations and environmental improvements were collected in Jiangshan City from 2008 to 2018. The changes in snail status and morbidity due to Schistosoma japonicum infections were analyzed to assess the effectiveness of comprehensive schistosomiasis control.

RESULTS

From 2008 to 2018, a total of 61 220 person-times were examined for S. japonicum infections in Jiangshan City, and the overall seroprevalence of S. japonicum infections was 0.56% (343/61 220); however, no egg-positives were detected. Among 4 231 cattle screened for S. japonicum infections using blood tests in Jiangshan City during the period from 2008 to 2018, 12 were sero-positive, with sero-prevalence of 0.28% (12/4 231), and no egg-positives were identified. There were 422 snail habitats identified in Jiangshan City during the study period, covering an area of 46.915 hm², and among the 31 686 snails dissected, no S. japonicum infections were detected. An area of 3 625.492 hm² snail habitats were subjected to repeated snail control and 11 settings were given environmental improvements, covering snail habitats of 17.880 hm² and historical snail habitats of 204.380 hm².

CONCLUSIONS

Following the implementation of environmental improvements-based comprehensive schistosomiasis control, the endemic situation of schistosomiasis is stable in Jiangshan City; however, there is still a risk of snail importation and re-emerging schistosomiasis. Therefore, the monitoring of snails and morbidity due to S. japonicum infections should be intensified in the city.

[The development of malnutrition assessment criteria and the analysis of current problems]

It is well known that parenteral and enteral nutrition support is helpful to improve clinical outcomes in patients with malnutrition or nutritional risk, and surgical nutrition has been used in China for 40 years. However, there is still insufficient awareness of malnutrition among clinical workers. There were different opinions from many experts after the publications of the European Society for Parenteral and Enteral Nutrition (ESPEN) consensus of malnutrition assessment 2015 and ESPEN guidelines on definitions and terminology of clinical nutrition 2017. Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition has also been published in 2018. Though it is lack of clinical validation, it is a big step forward. In order to achieve better prevention and treatment of malnutrition in clinical work, this present paper analyzes and compares the core contents of malnutrition assessment (diagnosis) in recent years, proposes current practical strategy for Chinese clinical workers, emphasizes that GLIM criteria cannot replace the three steps named "screening-assessment-intervention" .

[Principle of surgical management for rectal cancer patients with complete clinical response after neoadjuvant therapy]

A proportion of patients with locally advanced rectal cancer will achieve clinical complete response (cCR) or pathologic complete response (pCR) after neoadjuvant chemoradiotherapy. With the proposal of the concept of total neoadjuvant therapy (TNT), higher complete response rates will be observed. The management of patients with cCR has long been an issue of controversy and is attractive for clinical trials. A "watch and wait" strategy for patients with cCR has been put forward by some scholars. A non-operative approach can preserve the organfunction and avoid complications after radical surgery. The safety and feasibility of a "watch and wait" strategy have been established in several non-randomized controlled studies. There is no consensus on how to make an optimal decision for patients with cCR. For example, it is only observed in partial patients that cCR is consistent with pCR and the molecular biomarkers for predicting pCR are suboptimal. Besides, cCR is inconsistently defined and surveillance recommendations varies. Furthermore, there are insufficient high-level evidence for the "watch and wait" strategy. For patients with good response after chemoradiotherapy, local excision is an attractive alternative to total mesorectal excision, however with uncertain indications and challenged oncological safety. For patients with cCR, we implement the therapeutic principles of goal-orientation, layered treatment and the whole process management.

[Controversies and progress in adjuvant chemotherapy for patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy]

Colorectal cancer is one of the most common malignant tumors worldwide. Surgical resection is the most important and decisive method in the treatment of rectal cancer. Total mesorectal excision (TME) has greatly reduced the local recurrence rate of middle and low rectal cancer. However, local recurrence and distant metastasis remain the leading cause of death in patients with rectal cancer. 5-fluorouracil (5-FU)-based neoadjuvant chemoradiotherapy has been widely accepted in locally advanced rectal cancer and was recommended by various clinical practice guidelines as the standard treatment option. Tumors often achieve satisfactory reduced stage after neoadjuvant radiotherapy, and some patients even achieve pathological complete regression, which brings much controversies to the choice of adjuvant chemotherapy. This article intends to introduce evidence-based evidences for adjuvant chemotherapy for rectal cancer, impact of current neoadjuvant models on choice of adjuvant chemotherapy strategies, controversies and considerations for adjuvant chemotherapy in the context of neoadjuvant radiotherapy.

[The influence factors of quality-of-life in patients with thyroid-associated ophthalmopathy]

Objective: To assess the risk factors associated with decreased quality-of-life in patients with thyroid-associated ophthalmopathy (TAO). Methods: Cross-sectional study. One hundred and twelve patients with TAO and 68 controls were recruited to answer the Graves' ophthalmopathy quality-of-life questionnaire (GO-QOL) from January 2014 to April 2016. The GO-QOL included two subscales: the visual functioning and the psychosocial consequences. The differences in the GO-QOL scores between TAO patients and controls were analyzed. The influences of multiple factors on the GO-QOL scores among TAO patients were explored. Results: Among 112 TAO patients, 63 were male and 49 were female, with an average age of (45.4±13.1) years. Among 68 controls, 36 were male and 32 were female, with an average age of (39.5±10.8) years. Independent sample t test showed that TAO patients had significantly lower scores than controls in the visual functioning subscale and the psychosocial consequences subscale (55.63±29.02 vs 97.48±6.96, t=-14.58, P<0.01; 57.61±29.97 vs100±0.00, t=-14.97, P<0.01). Among TAO patients, smokers were associated with significantly lower psychological subscale scores than non-smokers (t=-2.284, P=0.024). Patients with abnormal primary position of eye scored significantly lower than those with normal alignment in functional (t=-3.979, P<0.001) and psychological subscales (t=-2.154, P=0.034) Patients with abnormal eye movement had significantly lower functional scores than those without (t=-2.975, P=0.004). One-way analysis of variance showed that higher CAS scores were significantly related to lower psychological subscale scores (F=3.178, P=0.018). Patients with upper eyelid retraction had significantly lower psychological subscale scores than those without (F=3.562, P=0.032). Pearson correlation analysis showed that age was negatively correlated with functional subscale scores (r=-0.366; P<0.01). TAO course was negatively correlated with functional (r=-0.235, P<0.05) and psychological subscale scores (r=-0.320, P<0.01). The degree of exophthalmos was negatively correlated with psychological subscale scores (r=-0.209, P<0.01). Multivariable linear regression analysis showed that only primary position of eye (P=0.013) and TAO course (P=0.007) were negatively correlated with functional subscale scores and only CAS scores (P=0.022) and TAO course (P=0.024) were negatively correlated with psychological subscale scores. Conclusion: Risk factors associated with lower quality-of-life among TAO patients included abnormal primary position of eye, higher CAS scores, and longer TAO course.(Chin J Ophthalmol,2017,53: 575-582).

[Clonal evolution and clinical significance of trisomy 8 in acquired bone marrow failure]

Objective: To analyze clonal evolution and clinical significance of trisomy 8 in patients with acquired bone marrow failure. Methods: The clinical data of 63 patients with acquired bone marrow failure accompanied with isolated trisomy 8 (+8) from June 2011 to September 2018 were analyzed retrospectively, the clonal evolution patterns and relationship with immmunosuppressive therapy were summarized. Results: Totally 24 male and 39 female patients were enrolled, including 39 patients with aplastic anemia (AA) and 24 patients with relatively low-risk myelodysplastic syndrome (MDS) . Mean size of+8 clone in MDS patients[65% (15%-100%) ]was higher than that of AA patients[25% (4.8%-100%) , z=3.48, P=0.001]. The patients were was divided into three groups (<30%, 30%-<50%,and ≥50%) according to the proportion of+8 clone. There was significant difference among the three groups between AA[<30%:55.6% (20/36) ; 30-50%: 22.2% (8/36) ; ≥50%22.2% (8/36) ]and MDS patients[<30%:19.0% (4/21) ; 30%-<50%:19.0% (4/21) ; ≥50%61.9% (13/21) ] (P=0.007) . The proportion of AA patients with+8 clone <30% was significantly higher than that of MDS patients (P=0.002) ; and the proportion of AA patients with+8 clone ≥50%was significantly lower than that of MDS patients (P=0.002) . The median age of AA and MDS patients was respectively 28 (7-61) years old and 48.5 (16-72) years old. Moreover, there was no correlation between age and+8 clone size in AA or MDS (r(s)=0.109, P=0.125; r(s)=-0.022, P=0.924, respectively) . There was statistical difference in total iron binding capacity, transferrin and erythropoietin between high and low clone group of AA patients (P=0.016, P=0.046, P=0.012, respectively) , but no significant difference in MDS patients. The immunosuppressive therapy (IST) efficacy of AA and MDS patients was respectively 66.7% and 43.8% (P=0.125) . Comparing with initial clone size (27.3%) , the +8 clone size (45%) of AA patients was increased 1-2 year after IST, but no statistical difference (z=0.83, P=0.272) . Consistently, there was no significant change between initial clone size (72.5%) and 1-2 year clone size (70.5%) after IST in MDS patients. There was no significant difference in IST efficient rate between +8 clone size expansion and decline group of in AA patients at 0.5-<1, 1-2 and>2 years after IST. We found four dynamic evolution patterns of +8 clone, which were clone persistence (45%) , clone disappearance (30%) , clone emergence (10%) and clone recurrence (15%) . Conclusions: AA patients had a low clone burden, while MDS patients had a high burden of +8 clone. The +8 clone of AA patients didn't significantly expanded after IST, and the changes of +8 clone also had no effect on IST response.

miR-147b-modulated expression of vestigial regulates wing-morph differentiation in the bird cherry-oat aphid Rhopalosiphum padi.. [DOI: 10.21203/rs.2.9668/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background The wing polyphenism occurs under crowding and nutrition-deficiency conditions in most aphid species. Although the influence of environmental factors on wing polyphenism of aphids have been extensively investigated, molecular mechanisms underlining wing-morph differentiation has not been fully understood. Results The expression levels of the twenty genes involved in wing patterning network were examined, and only vestigial (vg) showed significantly different expression levels in both whole-body and wall-body of third nymphal instars, with 5.4- and 16.14- fold higher in winged lines compared to wingless lines, respectively in Rhopalosiphum padi. Moreover, vg expressions were higher in winged aphids compared to that in wingless aphids of third, fourth instar nymphs and adults, and larger difference ratio were observed in third (21.38-fold) and fourth (20.91-fold) instar nymphs relative to adult (3.12-fold) between wing morphs. Suppression of vg using RNAi repressed the wing development of third winged morphs. Furthermore, modulation of miR-147b levels by microinjection of its mimics decreased vg expression levels and repressed wing development. Conclusions Our findings suggest that vg is essential for wing development and that miR-147b modulates its expression. To our knowledge, our results provide an empirical evidence that miRNA is involved in the regulation of wing morphs in aphids.