[Predictive value of quantitative electroencephalogram in the poor outcome of children with non-traumatic disturbance of consciousness in pediatric intensive care unit]

Objective: To explore the predictive value of quantitative electroencephalogram (qEEG) in the poor outcome of children with non-traumatic disturbance of consciousness (DoC) in the pediatric intensive care unit (PICU). Methods: A prospective study was conducted. From January 2019 to May 2019, a total of 62 patients aged from 1 month to 11 years with non-traumatic DoC in the PICU of the First Affiliated Hospital of Bengbu Medical College were enrolled. Bedside monitoring with NicoletOne monitor was performed within 24 hours after admission, and qEEG parameters, including amplitude-integrated electroencephalogram (aEEG), relative alpha variability (RAV), relative band power (RBP), and spectral entropy (SE) were recorded. The state of consciousness was assessed with modified pediatric Glasgow coma scale (MPGCS) before monitoring. According to the pediatric cerebral performance category score at 1 year after discharge, the enrolled subjects were divided into good and poor outcome groups. The association between these variables and the poor outcome was analyzed by univariate and multivariate logistic regression analysis, and the predictive performance was analyzed by receiver operator characteristic (ROC) curve. Results: There were 39 males and 23 females, with the age of 12.0 (5.8, 24.0) months. Fifty patients (81%) were in the good outcome group and 12 patients (19%) in the poor outcome group. The univariate Logistic regression analysis showed that age (OR=1.037, 95%CI 1.001-1.074, P=0.041), severe abnormal aEEG (OR=128.000, 95%CI 10.274-1 594.656, P<0.01), RAV (OR=0.877, 95%CI 0.810-0.949, P=0.001), SE (OR=0.892, 95%CI 0.814-0.978, P=0.015), and MPGCS score (OR=0.511, 95%CI 0.349-0.747, P=0.001) were significantly associated with the poor outcome. However, the multivariate Logistic regression analysis showed that only severe abnormal aEEG (OR=315.692, 95%CI 6.091-16 362.298, P=0.004) and RAV (OR=0.808, 95%CI 0.664-0.983, P=0.033) were significantly associated with the poor outcome. The area under the curve (AUC) of the aEEG and RAV in predicting the poor outcome were 0.848 (95%CI 0.735-0.927, P<0.01) and 0.847 (95%CI 0.733-0.926, P<0.01), respectively. The optimal cut-off value was severe abnormal for the aEEG and 38% for the RAV, with sensitivity of 67% and 83%, specificity of 98% and 84%, positive predictive value of 89% and 55%, negative predictive value of 92% and 95%, and Youden index of 0.647 and 0.673, respectively. The AUC of the novel combined index of aEEG and RAV for predicting the poor outcome was 0.974 (95%CI 0.898-0.998, P<0.01). Conclusions: The aEEG and RAV are reliable predictors for the poor outcome of children with non-traumatic DoC, and the novel combined index of aEEG and RAV can improve the predictive performance. The qEEG can be used as a routine method for outcome assessment due to its good objectivity.

Autophagy activators stimulate the removal of advanced glycation end products in human keratinocytes

BACKGROUND

The accumulation of advanced glycation end products (AGEs) can impact cellular homoeostasis and protein structure, thus is implicated in numerous skin conditions including yellow, dull appearance. AGE formation is irreversible; thus, understanding of the recycling process of AGEs in the skin is critical for addressing skin appearance conditions.

OBJECTIVE

To determine whether (i) accumulation of AGEs occurs in dull appearance group among young population (age 20-29) (ii) in vitro autophagy stimulation results in reduction of AGEs in keratinocytes.

METHODS

Facial cheek biopsies were collected from Chinese women (age 20-50) exhibiting either dull or non-dull appearing skin. Histological assessment of glycation was performed for representative subjects among the 20-29 years sub-group by immunofluorescence staining of AGEs. LC-MS methods and keratinocyte cell culture were used to assess impact of autophagy modulators and skin care materials on carboxymethyl lysine (CML) amount, a representative AGE.

RESULTS

Notable amounts of AGEs were observed in the epidermal samples among young females. Interestingly, the amount of AGEs was significantly higher among the dull skin appearance group. Treatment of keratinocytes with glyceraldehyde (GLA) enhanced CML in the cells, and postglycation treatment with autophagy activators reduced CML. Two skin care materials, Nymphaea alba flower extract (a.k.a. white water lily extract) and sucrose dilaurate, were identified based from in vitro autophagy activation and found to reduce CML in keratinocytes.

CONCLUSION

We found AGEs accumulate in the facial epidermis even among young people, correlating to a yellow and dull appearance. We also demonstrated in vitro activation of autophagy can reduce AGEs in keratinocytes, and autophagy activating skin care materials, N. alba flower extract and sucrose dilaurate, also reduce AGEs in the keratinocyte in vitro model. These data suggest epidermal AGEs contribute to the dull skin appearance, and autophagy activators may provide an effective solution to improve dull appearance by removing and recycling the accumulated glycation in the skin.

Effect of lncRNA AK023948 on rats with postmenopausal osteoporosis via PI3K/AKT signaling pathway

OBJECTIVE

To investigate the effect of long non-coding ribonucleic acid (lncRNA) AK023948 (AK0) on rats with postmenopausal osteoporosis via the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) signaling pathway.

MATERIALS AND METHODS

Firstly, postmenopausal osteoporosis rat models were established to obtain osteoblasts. The phosphorylation level of AKT was analyzed by controlling the expression of AK0 gene in osteoblasts. Finally, XTT was used to analyze the proliferation of osteoblasts and the messenger ribonucleic acid (mRNA) expression level of caspase in AK0 gene knockout (KO) rat model.

RESULTS

In the bone tissue of postmenopausal osteoporosis rats, the levels of phospho-PI3K (p-PI3K), p-Akt, and p-phosphoinositide-dependent kinase-1(PDK1) were significantly decreased (p<0.05). In rat model osteoblasts, the overexpression of AK0 gene upregulated the phosphorylation level of AKT, while the interference with small interfering RNA (siRNA) in AK0 gene decreased that of AKT. Knocking out AK0 gene led to the down-regulation of phosphorylation level of AKT in cells. Moreover, if the AK0 gene was re-expressed in the KO rat model cells, the phosphorylation level of AKT was restored to a certain extent, but still lower than that after the overexpression of AK0 gene. Although the proliferation rate of osteoblasts in estrogen deficiency-related osteoporosis rats was low, the growth rate of osteoblasts with AK0 KO was remarkably lower than that in blank control group (p<0.05). It was also found that there was a certain correlation between AK0 gene and osteoblast apoptosis.

CONCLUSIONS

LncRNA AK0 can regulate the phosphorylation level of AKT in osteoblasts of rats with estrogen deficiency-related osteoporosis through the PI3K/AKT signaling pathway, thus regulating the proliferation of osteoblasts. It is speculated that lncRNA AK0 may be an important factor in regulating the PI3K/AKT signaling pathway.

Corrigendum to "Spin structure relation to phase contrast imaging of isolated magnetic Bloch and Néel skyrmions" [Ultramicroscopy 212 (2020) 112973]

Several errors are present in the text and Fig. 3 of the article Ultramicroscopy 212 (2020) 112973. This includes minor confusions concerning the skyrmion helicities and a wrong orientation of a color wheel that represents the electron phase gradient direction. Further, the presented correction factors for finite probe sizes were based on an erratic simulation which is now corrected. This leads to different error values for the measured skyrmion size. These flaws do not affect the main message of the paper which is the relation of the skyrmion structure with the electron phase at all. They only affect the small section of the proof of principle skyrmion size measurement where aberrations were included.

Novel DNA methylation signatures of tobacco smoking with trans-ethnic effects

BACKGROUND

Smoking remains one of the leading preventable causes of death. Smoking leaves a strong signature on the blood methylome as shown in multiple studies using the Infinium HumanMethylation450 BeadChip. Here, we explore novel blood methylation smoking signals on the Illumina MethylationEPIC BeadChip (EPIC) array, which also targets novel CpG-sites in enhancers.

METHOD

A smoking-methylation meta-analysis was carried out using EPIC DNA methylation profiles in 1407 blood samples from four UK population-based cohorts, including the MRC National Survey for Health and Development (NSHD) or 1946 British birth cohort, the National Child Development Study (NCDS) or 1958 birth cohort, the 1970 British Cohort Study (BCS70), and the TwinsUK cohort (TwinsUK). The overall discovery sample included 269 current, 497 former, and 643 never smokers. Replication was pursued in 3425 trans-ethnic samples, including 2325 American Indian individuals participating in the Strong Heart Study (SHS) in 1989-1991 and 1100 African-American participants in the Genetic Epidemiology Network of Arteriopathy Study (GENOA).

RESULTS

Altogether 952 CpG-sites in 500 genes were differentially methylated between smokers and never smokers after Bonferroni correction. There were 526 novel smoking-associated CpG-sites only profiled by the EPIC array, of which 486 (92%) replicated in a meta-analysis of the American Indian and African-American samples. Novel CpG sites mapped both to genes containing previously identified smoking-methylation signals and to 80 novel genes not previously linked to smoking, with the strongest novel signal in SLAMF7. Comparison of former versus never smokers identified that 37 of these sites were persistently differentially methylated after cessation, where 16 represented novel signals only profiled by the EPIC array. We observed a depletion of smoking-associated signals in CpG islands and an enrichment in enhancer regions, consistent with previous results.

CONCLUSION

This study identified novel smoking-associated signals as possible biomarkers of exposure to smoking and may help improve our understanding of smoking-related disease risk.

Tunable interfacial Dzyaloshinskii-Moriya interaction in symmetrical Au/[Fe/Au]n multilayers

The interfacial Dzyaloshinskii-Moriya interaction (i-DMI) has been exploited in as-made symmetrical Au/[Fe/Au]n structures. By tailoring the chirality of the i-DMI at the Au/Fe interface, an overall enhancement of the i-DMI can be obtained in such a symmetrical structure. Furthermore, the tunability of the i-DMI was realized by changing the stacking number n. Compared to the top of Fe, a large tensile stress at the bottom of Fe due to lattice mismatch was responsible for the chirality change in the sub/Au/Fe system. Layer-resolved DMI calculations revealed that the sign of the spin-orbit coupling (SOC) energy was changed for Au near the interface of Au/Fe under tensile stress, subsequently reversing the chirality of the i-DMI from left-handed to right-handed. Our findings provide a simplest way to tune the i-DMI in a multilayer system, further benefiting the application of skyrmion-based devices.

[Determination of mifepristone in workplace air by ultra-performance liquid chromatography]

Objective: To establish an ultra-high performance liquid chromatography method for the determination of mifepristone in the air of workplaces. Methods: From January to July 2018, glass fiber filter membrane was used to collect mifepristone in the workplace air, eluted with acetonitrile/water solution, and determined by ultra-high performance liquid chromatography-UV method. Results: The detection limit of mifepristone determination method was 0.005 μg/ml, the lower limit of quantification was 0.015 μg/ml, and the lowest detection concentration was 0.14 μg/m(3) (calculated by collecting 75 L air samples) . The concentration of mifepristone has a good linear relationship between 0.015-40.24 μg/ml, r=0.9999. The accuracy and elution efficiency of the method were calculated based on the recovery rate, ranging from 92.7% to 100.0%. The average sampling efficiency was 99.6%-100.0%. The intra-assay precision of the method was 0.92% to 5.41%, and the inter-assay precision was 0.89% to 6.25%. The sample could be stored stably for 3 days at 4°C. Conclusion: The ultra-high performance liquid chromatography method for determination of mifepristone is easy to operate, and its indicators meet the requirements of GBZ/T 201.4-2008 "Guidelines for the Establishment of Occupational Hygiene Standards Part 4: Methods for Determination of Chemical Substances in Workplace Air", which is suitable for the detection of mifepristone in the air of the workplace.

Cohort Profile: West China Health and Aging Trend (WCHAT)

OBJECTIVES

The West China Health and Aging Trends study (WCHAT) is intended to focus on the research that will guide efforts to reduce disability, maximize health and independent functioning, and enhance quality of life at older ages in different ethnicities. And provide the basis for understanding trends and dynamics in late-life functioning, how these differ in various ethnic subgroups, and the economic or social consequences of aging and disability in western China.

PARTICIPANTS

The cohort enrolled 7536 participants and 7439 participants aged 50 years and older in the baseline in 2018 and every year would be followed up. Finding to date: The data in WCHAT were prospectively collected from Yunnan, Guizhou, Sichuan and Xinjiang by 7 medical institutions. A number of age-related outcome measures were collected though corresponding geriatric assessments. Blood testing, saliva, urine and feces testing are available for all cohort participants. Future plans: The data in WCHAT can be used for various types of epidemiological research, particularly for examining how the culture specific life styles and diet influences geriatrics related outcomes. We are initially planning cohort studies and established a sample biobank in relation to the risk and prognosis of frailty, sarcopenia and other geriatric syndromes. Strengths and limitations of this study: It is a first multi-ethnic cohort study in West China that aimed to investigate the influence of culture specific life styles, diet and living environment on the prevalence of geriatric syndromes like frailty, sarcopenia and so on. This is a prospective multi-center observational study, which will be conducted in various ethnic groups gathering places. This study collected information that related to fatigue, falls, and cognition were obtained through self-reports, which might have recall bias and grouping errors. This study has problems such as the interviewees' refusal to visit, death, going out, and large population mobility may lead to high loss of visit rates. This study collected information from a comparatively healthier elderly population in which external validity was limited.

The Combined Effect of Hearing Impairment and Cognitive Impairment with Health-Related Outcomes in Chinese Older People

OBJECTIVES

To determine the risk of poor health-related outcomes in older adults with cooccurring hearing impairment and cognitive impairment, and to compare the risk of hearing impairment only, cognitive impairment only, and multiple morbidities.

DESIGN

Cross-sectional study.

SETTING

Community-dwelling older adults aged 60 years and older were included.

PARTICIPANTS

The data of missing hearing and cognitive status were excluded, and 3770 older people participated in the study.

MEASUREMENTS

The hearing function evaluation was conducted by questionnaire survey. Assessment of cognitive function was completed using the SPMSQ scale. The subjects were divided into hearing impairment and cognitive impairment group, hearing impairment only group, cognitive impairment only group and neither group. Multiple logistic regression was used to analyze the risks of hearing and cognitive impairment and health-related condition.

RESULTS

The prevalence of hearing impairment and cognitive impairment, hearing impairment only, cognitive impairment only, and neither were 9.4%, 8.3%, 29.9% and 52.4%, respectively. Compared with the control group, the individuals with hearing impairment and cognitive impairment were associated with depression (OR=3.48, 95% CI=2.66, 4.56), anxiety (OR=2.35, 95% CI=1.92, 3.33), frailty (OR=4.30, 95% CI=2.89, 6.40), and ADL impairment (OR=2.77, 95% CI=2.03, 3.77).

CONCLUSION

The studies shows that hearing impairment combined with cognitive impairment is significantly associated with anxiety, depression, frailty, and ADL impairment. Comprehensive management and intervention should be provided for older people to reduce the occurrence of adverse health consequences.

[The correlation between tissue oxygen saturation and postoperative cognitive dysfunction in elderly patients with one lung ventilation]

Objective: To investigate the correlation between tissue oxygen saturation during one lung ventilation and postoperative neuro cognitive dysfunction (PND) in elderly patients in thoracic surgery. Methods: One hundred and twenty-eight elderly patients who underwent selective lobectomy from August 2017 to September 2018 in the Forth Hospital of Hebei Medical University were enrolled. The patients were divided into PND group (n=34) and non-PND group (n=94) according to whether PND occurred 3 days after surgery. Tissue oxygenation was monitored at bilateral forebrain, brachioradialis muscle and quadriceps. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) at baseline and the third day after the operation. Postoperative cognitive dysfunction was diagnosed if postoperative MoCA decreased at least 2 scores compared with preoperative baseline value. Outcomes included the incidence of PND, the incidence of tissue oxygen desaturation during one lung ventilation, postoperative complications within 30 days and length of postoperative in-hospital stay. Logistic regression was used to screen independent risk factors of PND. Results: The incidence of postoperative cognitive dysfunction was 26.6% (34/128). The two groups had no significant difference in the incidence of non-neurogenic complications (new occurred arrhythmia, pulmonary infection, pulmonary embolism, acute renal insufficiency, sepsis, deep vein thrombosis, all P>0.05). However, the length of postoperative in-hospital stay of PND group was 7.0 (6.0, 8.5) d, which was longer than that of non-PND group [6.0 (5.0, 8.0) d]. There was significant difference (U=2.394, P=0.017) . There was no correlation between the two groups within the minimum of SmtO(2) in upper limbs (OR=0.988, 95%CI: 0.954-1.024, P=0.519) and the range of desaturation (OR=1.010, 95%CI: 0.979-1.042, P=0.514) , as well as the minimum of SmtO(2) in legs (OR=0.996, 95%CI: 0.961-1.032, P=0.832) and the range of desaturation (OR=0.997, 95%CI: 0.971-1.025, P=0.851) . Multivariate logistic regression analysis showed that the high ASA grade (OR=2.617, 95%CI: 1.112-6.157, P=0.029) and the minimum of cerebral oxygen saturation during one lung ventilation (OR=0.931, 95%CI: 0.880-0.986, P=0.014) were independent risk factors of PND. There was no statistical correlation between muscle oxygen saturation and PND. Conclusion: Cerebral desaturation during one lung ventilation increased the risk of PND in elderly patients, while the muscle desaturation has no statistical correlation with PND.

[Analysis of the clinical value of ultrasound attenuation parameters in evaluating liver steatosis degree in patients with chronic liver disease]

Objective: To evaluate the clinical value of ultrasound attenuation parameters (UAP) in diagnosing the liver steatosis degree in patients with chronic liver disease, and to explore the relevant factors that affect UAP detection values. Methods: 130 cases with chronic liver disease diagnosed as liver steatosis by liver biopsy during January 2014 to May 2019 were selected from the Hepatology Department of Integrated Traditional Chinese and Western Medicine of the Third Hospital of Hebei Medical University. UAP and liver stiffness (LSM) were detected by iLivTouch, and the body mass index (BMI) was calculated. Simultaneously, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total bilirubin (TBil), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels and peripheral platelet (PLT) counts were measured. The correlation between UAP and liver steatosis was analyzed based on the liver histopathological results. SPSS 21.0 statistical software was used for statistical analysis. Receiver operating characteristic curve (ROC) was used to analyze the accuracy and specificity of UAP in the diagnosis of liver steatosis in patients with chronic liver disease. Spearman's rank correlation analysis was used to study the relevant factors affecting UAP value. Results: The histopathological changes of liver biopsy showed that there were 43 cases of grade F1, 47 cases of F2, 32 cases of F3 and 8 cases of F4. UAP and BMI (r = 0.363, P < 0.001), and UAP and liver steatosis degree (r = 0.380, P < 0.001) were positively correlated. BMI and the liver steatosis degree were independent predictors of UAP value. The cut-off points for UAP to diagnose liver steatosis degree were 276 dB/m for F≥2, 288 dB/m for F≥2, 293 dB/m for F≥3, and F = 4, respectively. The sensitivity and specificity was 0.379, 0.500, 0.750, and 0.930, 0.922, 0.836, respectively. Conclusion: Ultrasonic attenuation parameters cannot only determine the presence or absence of liver steatosis in patients with chronic liver disease, but also can better assess the liver steatosis degree.

A direct aspiration first-pass technique (ADAPT) versus stent retriever for acute ischemic stroke (AIS): a systematic review and meta-analysis

BACKGROUND AND PURPOSE

There is an ongoing debate about whether a direct aspiration first-pass technique (ADAPT) or stent retriever should be used as the first-pass mechanical thrombectomy device for patients with acute ischemic stroke (AIS). This meta-analysis aimed to compare the safety and efficacy of ADAPT versus stent retriever in patients with AIS.

METHODS

Structured searches on the PubMed, Embase, and Cochrane Library databases were conducted through July 2020. The primary outcomes of this study were: successful and complete recanalization; excellent and favorable outcomes; all-cause mortality at 90 days; and symptomatic intracerebral hemorrhage (sICH). The secondary outcomes of this study were: successful recanalization by primary chosen device; additional therapy; occurrence of emboli in a new territory; hemorrhagic complication; hemorrhagic infarction; parenchymatous hematoma; and subarachnoid hemorrhage. The odds ratios (ORs) with 95% confidence intervals (CIs) of the primary and secondary outcomes were calculated using a random-effects model. I² statistics were used to assess the heterogeneity for each outcome among the included studies.

RESULTS

Finally, 20 studies with a total of 6311 patients were included in our meta-analysis. There were no significant differences between the ADAPT group and the stent retriever group of the primary and secondary outcomes except additional therapy. Our pooled results indicated that patients in the ADAPT group needed more additional therapy than those in the stent retriever group (OR 2.24, 95% CI 1.41-3.57).

CONCLUSION

In conclusion, our meta-analysis showed similar clinical outcomes of ADAPT and stent retriever. However, patients in the ADAPT group had higher additional therapy rates than those in the stent retriever group. Due to several inevitable limitations of this meta-analysis, more large-scale randomized controlled trials are required to further investigate this topic.

IGF-1R/β-catenin signaling axis is implicated in streptozotocin exacerbating bone impairment in ovariectomized rats

OBJECTIVE

The aim of this study was to investigate the role of the insulin-like growth factor-1 receptor (IGF-1R)/β-catenin signaling axis in bone impairment induced by hyperglycemia in ovariectomized rats.

METHODS

Rats were divided into four groups. The sham group received sham operation and a single intraperitoneal administration of vehicle. The ovariectomy (OVX) group was subjected to bilateral OVX and vehicle injection. The streptozotocin (STZ) group received sham operation and a single STZ injection to induce hyperglycemia. The OVX + STZ group received bilateral OVX and a single STZ injection. Dual-energy X-ray absorptiometry measurement, bone biomechanics test, micro-computed tomography scan, and hematoxylin-eosin staining were performed to evaluate bone alteration in this model. The expression of relevant signals including IGF-1R, glycogen synthase kinase-3β (GSK-3β), and β-catenin were examined by quantitative real-time polymerase chain reaction and western blot.

RESULTS

The OVX, STZ, and OVX + STZ groups induced bone loss, attenuated bone strength, and impaired microarchitecture compared with the sham group, respectively. Compared with OVX, more serious bone damage was found in the OVX + STZ group, which showed enhanced phosphorylation of IGF-1R, GSK-3β, and β-catenin.

CONCLUSION

OVX plus STZ induced more serious bone impairment than OVX alone, which involves the IGF-1R/β-catenin signaling axis in the pathogenesis. This may provide a potential target for treatment of postmenopausal diabetic osteoporosis.

PLCE1 inhibits apoptosis of non-small cell lung cancer via promoting PTEN methylation

OBJECTIVE

To explore the role of phospholipase C epsilon 1 (PLCE1) in regulating cell apoptosis of non-small cell lung cancer (NSCLC) and its underlying mechanism.

PATIENTS AND METHODS

The mRNA and protein levels of PLCE1 in NSCLC tissues, adjacent normal tissues and NSCLC cell lines (A549 and H1299) were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. Methylation status in the promoter region of PTEN in NSCLC cells was accessed using the relative commercial kit. Cell apoptosis after transfection of PLCE1 siRNA in NSCLC cells was detected by flow cytometry. Protein expressions of apoptosis-related genes in NSCLC cells after altering PLCE1 expression were detected by Western blot.

RESULTS

PLCE1 was highly expressed in NSCLC tissues and cell lines than that of controls. PLCE1 knockdown promoted PTEN expression and inhibited methylation in H1299 cells. Transfection of PLCE1 siRNA in NSCLC cells remarkably induced cell apoptosis.

CONCLUSIONS

PLCE1 inhibits cell apoptosis of NSCLC by promoting PTEN methylation.

The regulatory roles of long noncoding RNAs in osteoporosis

Osteoporosis is a common metabolic bone disease characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue, which leads to decreased bone strength and increased fracture risk. Osteoporosis mainly results from a disruption of the balance between bone formation mediated by osteoblasts and bone resorption mediated by osteoclasts. At present, the molecular mechanisms underlying osteoporosis are still not fully understood. Long noncoding RNAs (lncRNAs) are RNA molecules that exceed 200 nucleotides (nt) in length and have limited or no protein-coding capacity. Over the past decade, numerous lncRNAs have been demonstrated to participate in multiple biological processes and to play essential roles in the pathogenesis of various diseases. In this review, we summarize recent progress in research on lncRNAs in osteoporosis and mainly focus on their regulatory roles in osteogenesis and osteoclastogenesis. Moreover, we briefly discuss the potential clinical applications of lncRNAs in osteoporosis.

Modulatory effect of 17β-estradiol on myeloid cell infiltration into the male rat brain after ischemic stroke

Ischemic stroke is the leading cause of human disability and mortality in the world. Neuroinflammation is the main pathological event following ischemia which contributes to secondary brain tissue damage and is driven by infiltration of circulating immune cells such as macrophages. Because of neuroprotective properties against ischemic brain damage, estrogens have the potential to become of therapeutic interest. However, the exact mechanisms of neuroprotection and signaling pathways is not completely understood. In the current study, 12-week-old male Wistar rats underwent an experimental ischemia by occluding the middle cerebral artery transiently (tMCAO) for 1 h. Male rats subjected to tMCAO were randomly assigned to receive 17β-estradiol or vehicle treatment. The animals were sacrificed 72 h post tMCAO, transcardially perfused and the brains were proceeded either for TTC staining and gene analysis or for flow cytometry (CD45, CD11b, CD11c, CD40). We found that 17β-estradiol substitution significantly reduced the cortical infarct which was paralleled by an improved Garcia test scoring. Flow cytometry revealed that CD45+ cells as well as CD45+CD11b+CD11c+ cells were massively increased in tMCAO animals and numbers were nearly restored to sham levels after 17β-estradiol treatment. Gene expression analysis showed a reperfusion time-dependent upregulation of the markers CD45, CD11b and the activation marker CD40. The reduction in gene expression after 72 h of reperfusion and simultaneous 17β-estradiol substitution did not reach statistical significance. These data indicate that 17β-estradiol alleviated the cerebral ischemia-reperfusion injury and selectively suppressed the activation of the neuroinflammatory cascade via reduction of the number of activated microglia or infiltrated monocyte-derived macrophages in brain.

[Analysis of risk factors and prognosis of cirrhosis combined with bacterial pneumonia]

Objective: To study the bacterial pathogen, the optimal plan of antibacterial drugs and the prognostic factors in patients with liver cirrhosis combined with bacterial pneumonia. Methods: Data of 324 cases with liver cirrhosis from the Department of Traditional and Western Medical Hepatology, the Third Hospital of Hebei Medical University were collected, including 217 cases of bacterial pneumonia. Baseline characteristics of the patients, factors affecting the efficacy of antibacterial treatment and prognosis were compared and analyzed. Logistic regression analysis was used to screen and predict the antibacterial efficacy indicators and a prediction model was established. Receiver operating characteristic curve was used to evaluate the value of the established model and Child-Turcortte-Pugh, model for end-stage liver disease, and model for end-stage liver disease combined with serum sodium concentration predict the therapeutic efficacy. Results: Chronic HBV and HCV infections were the main causes of cirrhosis, followed by cryptogenic cirrhosis and alcoholic cirrhosis. Diabetes, cardio-cerebrovascular and chronic obstructive pulmonary disease were susceptible factors for bacterial pneumonia. As infection occurred, the ratio of neutrophils to lymphocytes, serum C-reactive protein, procalcitonin, alanine aminotransferase, and total bilirubin levels had increased significantly. The results of pathogenic analysis showed that the top three pathogenic bacteria were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus. The resistance rate of Klebsiella pneumoniae to ceftriaxone was 50.0%, and that of ceftazidime, cefepime, and cefoperazone sulbactam were 27.8%. Imipenem and piperacillin tazobactam containing β-lactamase inhibitors were the most effective antibacterial therapies. Regression analysis showed that age, procalcitonin, and albumin was significantly correlated with antibacterial effects. The PAA model was established and had predicted the efficacy of Child-Turcortte-Pugh, model for end-stage liver disease, and model for end-stage liver disease combined with serum sodium. The specificity and sensitivity of the PAA was confirmed to be 94.12% and 93.62%, which was significantly higher than other models. Conclusion: The main common pathogenic bacterium of cirrhosis combined with bacterial pneumonia is Klebsiella pneumonia (G-bacilli). In addition, gram positive cocci (Staphylococcus aureus) and other are also visible. The elderly, diabetics and patients using hormones are prone to secondary fungal infections. Age, procalcitonin and serum albumin can accurately predict the antibacterial effect, guide clinical treatment and judge the prognosis of the established PAA model.

Using a phenotype microarray and transcriptome analysis to elucidate multi-drug resistance regulated by the PhoR/PhoP two-component system in Bacillus subtilis strain NCD-2

The PhoRP two-component system (TCS), one of the most important signaling pathways in Bacillus subtilis, regulates cell physiological reactions mainly under phosphate starvation conditions. The mechanism by which PhoRP TCS regulates resistance towards antibiotics in B. subtilis strain NCD-2 was investigated in this study. Using phenotype microarray (PM) technology, the susceptibility of B. subtilis to 240 antimicrobial compounds was compared among the wild-type strain NCD-2, the phoR-null mutant (MR), and the phoP-null mutant (MP). Compared with the wild type, the MR mutant was more resistant to 13 antibiotics with different functions, and the MP mutant was more resistant to 14 antibiotics, of which 8 were 30S/50S ribosome-targeted. To investigate the molecular mechanisms involved in changing the level of antibiotic resistance, transcriptional analysis was performed to compare the differentially expressed genes among the wild-type strain and the MR and MP mutants. Compared with the wild-type strain, 294 genes were differentially expressed in the MR mutant, including 97 up-regulated genes and 197 down-regulated genes. Most of the differently expressed genes were associated with carbohydrate mechanism, amino acid mechanism, ABC-transporters and phosphotransferase systems. A total of 212 genes were differentially expressed in the MP mutant, including 10 up-regulated genes and 202 down-regulated genes, and most were associated with ribosome synthesis, amino acid metabolism, carbohydrate metabolism and ABC-transporters. The khtSTU operon (encoding the K⁺ efflux pump) that was up-regulated in the MP mutant was deleted by in-frame deletion in the MP mutant. The phoP and khtSTU operon double mutant MPK showed decreased antibiotic resistance to doxycycline, chlortetracycline, spiramycin, puromycin, and paromomycin when compared with the MP mutant. Thus, the results indicated that the khtSTU operon was responsible for the PhoP-mediated multiple antibiotic resistance.

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

BACKGROUND

Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long-term consequences.

OBJECTIVES

To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis.

METHODS

We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients.

RESULTS

A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow-up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome.

CONCLUSIONS

Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.

[The expression and significance of IGF1R-Ras/RAGE-HMGB1 pathway in colorectal cancer patients with type 2 diabetes mellitus]

Objective: To investigate the expression of IGF1R-Ras and RAGE-HMGB1 signaling pathways in colorectal cancer patients with type 2 diabetes mellitus and their significance. Methods: The resected cancer tissues were obtained from 59 patients with colorectal cancer (CRC), including 29 patients with type 2 diabetes mellitus (CRC/DM group) and 30 with CRC alone (CRC group). The expressions of IGF1R, Ras, RAGE and HMGB1 in cancer tissues were detected by immunohistochemistry. The differences between the two groups were compared and the relationship between the expression and clinicopathological characteristics was analyzed. Results: In CRC/DM group, the positive rates of IGF1R and Ras were both 65.5% (19/29), and 51.7% (15/29) patients had IGF1R+ Ras+ immunophenotype, which were significantly higher than those in CRC group [33.3% (10/30), 36.7% (11/30) and 20.0% (6/30); P=0.013, 0.027 and 0.011, respectively]. The expression of IGF1R and Ras in CRC / DM group was positively correlated (r=0.479, P=0.017). The positive rate of RAGE expression in CRC group and CRC/DM group was 70.0% (21/30) and 72.4% (21/29) respectively, and the positive rate of HMGB1 expression was 46.7% (14/30) and 58.6% (17/29) respectively, neither was observed with significant difference (P=0.358 and 0.838). However, the proportion of patients with RAGE+ HMGB1+ immunophenotype in CRC/DM group [55.2% (16/29)] was higher than that in CRC Group [26.7% (8/30)] which was statistically significant (P=0.026), and the expression of both proteins was positively correlated in CRC/DM group (r=0.578, P=0.003). The clinicopathological analysis showed that in both groups the expression of IGF1R, Ras, RAGE and HMGB1 had no correlation with the sex, age, differentiation degree, tumor length, T stage and lymph node metastasis (P>0.05). Conclusion: Both IGF1R-Ras and RAGE-HMGB1 pathways may be involved in the oncogenesis of colorectal cancer in patients with type 2 diabetes.

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

Background and Purpose: The lifetime prevalence of benign paroxysmal positional vertigo (BPPV) is high, especially in the elderly. Patients with BPPV are more susceptible to ischemic stroke, dementia, and fractures, severely reducing quality of life of patients. Many studies have analyzed risk factors for the occurrence of BPPV. However, the results of these studies are not identical. We performed this meta-analysis to determine potential risk factors associated with the occurrence of BPPV.

Methods: PubMed, EMBASE, and the Cochrane Library (January 2000 through March 2020) were systematically searched for eligible studies analyzing risk factors for the occurrence of BPPV. Reference lists of eligible studies were also reviewed. We selected observational studies in English with a control group and sufficient data. Pooled odds ratios (ORs) or the mean differences (MDs) and 95% confidence intervals (CIs) were calculated to measure the impacts of all potential risk factors. Heterogeneity among studies was evaluated using the Q-test and I² statistics. We used the random-effect model or the fixed-effect model according to the heterogeneity among the included studies.

Results: We eventually included 19 studies published between 2006 and 2019, including 2,618 patients with BPPV and 11,668 participants without BPPV in total. In this meta-analysis, the occurrence of BPPV was significantly associated with female gender (OR = 1.18; 95% CI, 1.05–1.32; P = 0.004), serum vitamin D level (MD = −2.12; 95% CI, −3.85 to −0.38; P = 0.02), osteoporosis (OR = 2.49; 95% CI, 1.39–4.46; P = 0.002), migraine (OR = 4.40; 95% CI, 2.67–7.25; P < 0.00001), head trauma (OR = 3.42; 95% CI, 1.21–9.70; P = 0.02), and total cholesterol level (MD = 0.32; 95% CI, 0.02–0.62; P = 0.03).

Conclusion: Female gender, vitamin D deficiency, osteoporosis, migraine, head trauma, and high TC level were risk factors for the occurrence of BPPV. However, the effects of other risk factors on BPPV occurrence need further investigations.

Direct admission versus secondary transfer for acute ischemic stroke patients treated with thrombectomy: a systematic review and meta-analysis

BACKGROUND AND PURPOSE

Randomized controlled trials have demonstrated that mechanical thrombectomy (MT) could provide more benefit than standard medical care for acute ischemic stroke (AIS) patients due to emergent large vessel occlusion. However, most primary stroke centers (PSCs) are unable to perform MT, and MT can only be performed in comprehensive stroke centers (CSCs) with on-site interventional neuroradiologic services. Therefore, there is an ongoing debate regarding whether patients with suspected AIS should be directly admitted to CSCs or secondarily transferred to CSCs from PSCs. This meta-analysis was aimed to investigate the two transportation paradigms of direct admission and secondary transfer, which one could provide more benefit for AIS patients treated with MT.

METHODS

We conducted a systematic review and meta-analysis through searching PubMed, Embase and the Cochrane Library database up to March 2020. Primary outcomes are as follows: symptomatic intracerebral hemorrhage (sICH) within 7 days; favorable functional outcome at 3 months; mortality in hospital; mortality at 3 months; and successful recanalization rate.

RESULTS

Our pooled results showed that patients directly admitted to CSCs had higher chances of achieving a favorable functional outcome at 3 months than those secondarily transferred to CSCs (OR = 1.26; 95% CI, 1.12-1.42; P < 0.001). In addition, no significant difference was found between the two transportation paradigms in the rate of sICH (OR = 0.86; 95% CI, 0.62-1.18; P = 0.35), mortality in hospital (OR = 0.84; 95% CI, 0.51-1.39; P = 0.51), mortality at 3 months (OR = 1.01; 95% CI, 0.85-1.21; P = 0.91), and successful recanalization (OR = 1.03; 95% CI, 0.88-1.20; P = 0.74). However, in the 100% bridging thrombolysis usage rate subgroup, our subgroup analysis indicated that no difference was found in any outcome between the two transportation paradigms.

CONCLUSION

Patients with AIS directly admitted to CSCs for MT may be a feasible transportation paradigm for AIS patients. However, more large-scale randomized prospective trials are required to further investigate this issue.

THU0427 SHOULD FEBUXOSTAT-RESISTANCE BE ADDED TO CRITERIA FOR REFRACTORY GOUT? A PRELIMINARY STUDY

Background:

Refractory gout manifests as recurrent flares, chronic arthritis and progressive tophaceous deposits. Febuxostat is a widely-used potent serum urate-lowering reagent, but some gout patients cannot achieve target serum uric acid (sUA) after they used this reagent.

Objectives:

To determine whether febuxostat-resistance should be a criterion for refractory gout, characteristics of gout patients who were resistance to febuxostat or allopurinol were compared.

Methods:

This study was performed from December 2015 to December 2019. Medical records of gout patients who met the 2015 gout classification criteria [1] and undertook febuxostat (febuxostat group) or allopurinol (allopurinol group) urate-lowing therapy (ULT) were assessed. Dose of ULT was adjusted till sUA was below 6 mg/dL and 5 mg/dL for patients with urate deposition. We screened gout patients who had contraindication or history of failure to normalize sUA for≥ 3 months of treatment with the maximum medically appropriate febuxostat (febuxostat-resistance) or allopurinol (allopurinol-resistance) dose as defined by physicians. Furthermore, these screened patients met the traditional criteria of refractory gout except therapeutic reaction [2].Demography and clinical characteristics were recorded. Features between febuxostat-resistance and allopurinol-resistance patients were compared.

Results:

(1) Of 683 gout patients who were included, 516 and 167 of them used febuxostat or allopurinol. (2) Age (41.92±11.58 vs. 42.26±9.41 years), Male gender (97.50% vs. 97.01%), duration of gout (5.78±4.74 vs. 5.05±4.72 years) and sUA (6.30±2.50 vs. 6.67±2.14 mg/dL) were similar between febuxostat group and allopurinol group (P>0.05). (3) Dose of febuxostat or allopurinol were 47.28mg/day and 178.24mg/day. (4) Sixteen patients were febuxostat-resistance, while 6 patients were allopurinol-resistance. Prevalence rates of treatment resistance were comparable between groups (3.10% vs. 3.59%,P>0.05). (5) Some parameters were different between resistance patients and non-resistance patients in both groups (Table 1,P<0.05). However, characteristics of febuxostat-resistance and allopurinol-resistance patients were similar (P>0.05).

Table 1

Characteristics of gout patients in febuxostat group and allopurinol group

ParametersFebuxostat GroupAllopurinol GroupNon-resistance(n=500)Resistance(n=16)Non-resistance(n=161)Resistance(n=6)Age (year)41.93±11.6541.67±9.5842.22±13.3344.50±16.98Male Gender (%)97.40100.0096.89100.00BMI (kg/m2)25.44±3.4626.22±3.4725.86±3.9725.60±6.42Duration of gout (years)5.75±4.767.00±3.97*4.96±4.737.75±2.62*Flares in previous 18 months (times)1.31±0.443.67±0.70*1.13±0.243.25±0.50*Presence of Tophi (%)23.80100.00*14.90100.00*Presence of Complication (%)35.8100.00*31.06100.00*sUA (mg/dL)6.21±2.479.13±1.24*6.42±2.3210.15±3.55*SCr (μmol/L)100.67±15.03163.96±29.41*96.93±22.91133.75±31.60*ESR (mm/L)24.59±19.2842.83±21.13*27.49±24.1056.50±28.12*CRP (mg/L)18.92±18.5928.81±23.85*23.12±22.6332.28±23.64*

*P<0.05 compared with non-resistance patients in the same group.

BMIbody mass index,sUAserum uric acid,SCrserum creatinine,ESRerythrocyte sedimentation rate,CRPC-reactive protein

Conclusion:

Febuxostat-resistance is a potential criterion for refractory gout, because febuxostat-resistance patients shares similar characteristics of patients with refractory gout.

References:

[1]Neogi T, Jansen TL, Dalbeth N, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2015;74(10):1789-1798.

[2]Lawrence Edwards N, Singh JA, Troum O, et al. Characterization of patients with chronic refractory gout who do and do not have clinically apparent tophi and their response to pegloticase. Rheumatology (Oxford) 2019; pii: kez017.

Acknowledgments:

None.

Disclosure of Interests: :

None declared

AB0931 THE QUALITY OF LIFE IN GOUT PATIENTS WITH ULCERATION OVER TOPHI

Background:

The prevalence of gouty patients with ulcerations over tophi are increasing over time and it has been reported that gouty patients have significantly poor quality of life (QoL) compared to those healthy controls. [1, 2] there is no study on comparison of the QoL in patients with or without ulceration over tophi.

Objectives:

To compare the QoL in gout patients with or without ulcerations over tophi.

Methods:

A total of 79 inpatients with gout who were admitted to Guangdong Second Provincial General Hospital from January 2019 to January 2020 were included. Among them, ulcerations were identified in 28 patients. Short Form-36 Scales (SF-36) were chosen to assess patients. Differences between the groups were tested with Student’s t test or Mann-Whitney U test for continuous variables, and Chi-square tests for categorical variables.

Results:

Of 79 subjects, 74 were male, mean age was 54.23±14.3 years, disease duration was 10.94±7.06 years. Gouty patients had moderate- to high-quality levels in general health, vitality, social functioning, role emotional, and mental health (median: 65, 75, 75, 88, and88, respectively), while had low levels of quality in role physical, and bodily pain (median: 0, and 22, respectively). Patients presenting with ulcerations over tophi had worse scores on five SF-36 domains, the mental component summary (MCS) and the physical component summary (PCS) than gout patients without ulcerations [mean (SD); P < 0.05 for all]: Bodily pain, 30.86(31.59) vs 35.17(33.40); General health, 49.46(27.01) vs 64.17(23.69); Vitality, 57.14(32.53) vs 72.84(26.38); Mental health, 75.4(22.43) vs 83.05(20.96); Reported health transition, 3.58(0.89) vs 3.78(1.42); MCS, 52.62(21.82) vs 66.65(21.44); PCS, 35.85(21.17) vs 46.67(23.86).

Conclusion:

Patients with ulcerations over tophi present much worse QoL compared those without ulcerations. Our study suggests that the presence of ulceration over tophi further deteriorates the QoL in gout patients.

References:

[1]Z. Huang, X. Liu, Y. Liu, et al., Clinical characteristics and risk factors of ulceration over tophi in patients with gout, Int J Rheum Dis, 22 (2019) 1052-1057.

[2]T. Fu, H. Cao, R. Yin, et al., Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study, BMC Musculoskelet Disord, 18 (2017) 429.

Table 1.

Clinical characteristics

VariableTotal (n=79)Non-ulcerations (n=51)Ulcerations (n=28)PvalueMale, n (%)74(93.7)47(92.1)27(96.4)0.462Agea, mean, y54.23±14.3053.96±12.2454.71±17.690.842Body mass indexa, kg/m224.87±3.9725.13±4.0224.40±3.910.444Gout durationa,y10.96±7.0610.04±6.7512.63±7.410.119Maximum Serum uric acid, mg/dL625.5±133.86630.9±124.23614.3±166.430.639Smoking, n (%)38(48.1)23(45.1)15(53.5)0.477Alcohol, n (%)26(32.9)13(25.5)13(46.4)0.072Hypertension, n (%)34(43.0)18(35.3)16(57.1)0.062Diabetes mellitus, n (%)13(16.5)10(19.6)3(10.7)0.281Regular treatment, n(%)3(3.8)3(5.9)0(0)0.971Glucocorticoid abuse, n (%)18(22.8)11(21.5)7(25.0)0.173

aMean (SD).

Table 2.

QoL scores

Median (IQR)Non-ulcerations (n=51), mean (SD)Ulcerations (n=28), mean (SD)PvaluePhysical functionb50(20-80)58.62(32.17)40.89(35.97)0.095Role physicalb0 (0-100)33.03(46.91)17.85(37.17)0.119Bodily painb22(0-62)35.17(33.40)30.86(31.59)0.007General healthb65 (40-80)64.17(23.69)49.46(27.01)0.014Vitalityb75 (50-95)72.84(26.38)57.14(32.53)0.023Social functionb75(38-100)72.55(3.02)60.27(33.85)0.107Role emotionalb88 (68-96)33.98(47.37)15.43(34.45)0.135Mental healthb88 (68-96)83.05(20.96)75.4(22.43)0.007Reported health transition3.78(1.42)3.58(0.89)0.007PCS46.67(23.86)35.85(21.17)0.048MCS66.65(21.44)52.62(21.82)0.007

b(range = 0-100)

Disclosure of Interests:

None declared

THU0450 OPTIMISTIC STATUS ASSOCIATES WITH COMPLIANCE TO URATE-LOWERING THERAPY IN GOUT PATIENTS

Background:

Compliance to urate-lowering therapy (ULT) is poor in gout patients, which contributes to increased frequency of acute gout attacks, deposition of tophi and urate nephropathy [1]. Optimistic status is probably a potential and considerable factor affecting compliance to ULT in gout patients.

Objectives:

To compare optimistic status between gout patients and healthy controls, and also between gout patients with good and poor compliance. Relationship between optimistic status and compliance to ULT, sUA target achievement of gout patients were assessed as well.

Methods:

This was a monocentric and observational study which was performed from August 2018 to December 2019. Adult patients who met the 2015 gout classification criteria were included in this study. The healthy controls were individuals who were free of gout, hyperuricemia and other rheumatic diseases from the physical examination center of our hospital. Demographic data, including age, gender and education were collected from all individuals. Serum uric acid (sUA) were collected from gout patients at enrollment and again after 3 months. Disease duration of gout, visual analogue scale (VAS) of pain were also assessed for gout patients at enrollment. Compliance to ULT was measured using the medication possession ratio (MPR) in the following 3 months. Poor compliance was defined as MPR<0.8 and good compliance was defined as MPR≥0.8. All subjects completed the life orientation test-revised (LOT-R) for optimistic status assessment.

Results:

Five hundred and thirty gout patients and 307 healthy controls matched by age (41.4±12.3 vs. 42.1±9.3 years), gender (male 97.1% vs. 95.1%) and education (college graduated 54.2% vs. 58.0%) were included in this study. Of the 530 gout patients, the mean disease duration was 5.7±4.9 years, and 292 (55.1%) patients’ MPR were lower than 0.8. There was no statistic difference in LOT-R between gout patients and healthy controls (19.0±2.4 vs. 19.2±2.5, P>0.05) (Table 1). Gout patients with poor compliance (MPR<0.8) had higher level of sUA (525.5±138.0 vs. 471.2±152.5 μmol/L, P<0.05), followup sUA (450.1±154.5 vs. 361.6±120.0 μmol/L, P<0.05) and higher LOT-R (19.6±2.6 vs. 17.8±1.7, P<0.05) than those with good compliance (MPR≥0.8). Of the 292 gout patients with poor compliance, there were only 83 (28.4%) patients achieved sUA target after 3 months, and their LOT-R were significantly lower than those did not achieve sUA target (18.8±2.1 vs. 19.6±2.4, P<0.05). Finally, LOT-R correlated positively with sUA (r=0.131, P<0.05) and followup sUA (r=0.09, P<0.05), but negatively with MPR (r=-0.473, P<0.05) of gout patients (Table 2).

Table 1

Demographic and optimistic status of gout patients and healthy controls

VariablesGout patients(n=530)Controls(n=307)PAge (years)41.4±12.342.1±9.30.116Male gender, n (%)511 (96.4)292 (95.1)0.368College graduated, n (%)287 (54.2)178 (58.0)0.312LOT-R19.0±2.419.2±2.50.189

LOT-R:life orientation test-revised

Table 2

Correlation analysis between LOT-R and clinical variables in gout patients

VariablesLOT-RrPAge00.994Disease duration-0.0580.182VAS0.0340.432sUA0.1310.003*Followup sUA0.1260.016*MPR-0.393<0.001*

LOT-R: life orientation test-revised,VAS:visual analogue scale,sUA:serum uric acid,MPR:medication possession ratio

*P<0.05

Conclusion:

Gout patients share similar optimistic status to healthy controls. However, optimistic status relates to compliance to ULT and sUA target achievement of gout patients.

References:

[1]Harrold L R, Andrade S E, Briesacher B A, et al. Adherence with urate-lowering therapies for the treatment of gout. Arthritis research & therapy 2009, 11(2):R46.

Disclosure of Interests: :

None declared

0005 Cataplexy Triggered by Social Cues: A Role for Oxytocin in the Amygdala

Introduction

People with narcolepsy type 1 report that cataplexy is triggered most often by positive social experiences such as laughing with friends, yet the mechanisms through which social interaction promotes cataplexy are unknown. We hypothesize a subpopulation of central amygdala neurons that are sensitive to the prosocial neuropeptide, oxytocin (CeAOTR), respond to positive valence and trigger cataplexy.

Methods

We have used in vivo calcium imaging, chemogenetic and optogenetic approaches to characterize the activity pattern of these neurons and to manipulate their activity state.

Results

Cre-dependent anterograde tracing of the CeAOTR neurons of the central amygdala indicate a moderate to dense projection to the REM sleep-regulatory region of the ventral lateral periaqueductal gray (vlPAG). Additionally, Channel Rhodopsin Assisted Circuit Mapping (CRACM) experiments show that CeAOTR neurons inhibit vlPAG neurons that innervate the REM atonia-promoting region, the sublaterodorsal nucleus. Targeted photostimulation (15Hz (10ms) for 20sec every hour) of the CeAOTR fibers in the vlPAG doubled the amount of cataplexy. Preliminary in vivo calcium imaging indicates that the CeAOTR are active just prior to the onset of cataplexy. Chemogenetic and optogenetic activation of CeAOTR neurons increased cataplexy.

Conclusion

We conclude that the CeAOTR subpopulation is sufficient to promote cataplexy. Our future directions include determining the necessity of these oxytocin sensitive neurons in cataplexy under different conditions of positive valence.

Support

R01 NS106032 and WakeUp Narcolepsy.

Cathodoluminescent screen imaging system for seeded blob detection in toroidal plasma experiment

We designed and built a diagnostic based on a cathodoluminescent screen for the detection of turbulent plasma structures with high spatial resolution. The screen is coated with a low threshold energy cathodoluminescent powder that emits light when exposed to a plasma. The emitted light is imaged with a fast frame camera combined with an image intensifier and an optical bandpass filter. The diagnostic is used to study turbulent structures and seeded blobs. The results are analyzed with pattern recognition algorithms to track the turbulent structures and study their evolution in time.

Qualitative and Quantitative Analyses of the Colonization Characteristics of Bacillus subtilis Strain NCD-2 on Cotton Root

Bacillus subtilis strain NCD-2 is an excellent biocontrol agent against plant soil-borne diseases. With the purpose of understanding the colonization characteristics of strain NCD-2, firstly, a constitutive expression promoter was cloned from strain NCD-2 and was used to construct GFP-labeled strain NCD-2. The GFP-labeled strain NCD-2 showed strong green fluorescence under planktonic cells and biofilm formation. The colonization characteristics of strain NCD-2 on different parts of cotton root were qualitatively observed by confocal laser scanning microscopy (CLSM). Results showed that strain NCD-2 mainly colonized on the zone of differentiation and elongation. Rhizosphere populations of B. subtilis strain NCD-2 on different cotton root were quantitatively evaluated by traditional plating count and quantitative PCR (qPCR) analysis in both autoclaved soil and non-autoclaved soil, respectively. Results showed that both traditional plating count and qPCR analysis showed similar trend for colonization characteristics of strain NCD-2. The greatest strain NCD-2 populations were in the root tip, at 9.19 × 10⁷ CFU g^-1 root and 6.75 × 10⁷ CFU g^-1 root as estimated by qPCR in non-autoclaved and autoclaved soil, respectively. This study provides a clearer understanding of the interactions between biocontrol agent and plant, as well as with the indigenous microorganisms in the soil.

Spin structure relation to phase contrast imaging of isolated magnetic Bloch and Néel skyrmions

Magnetic skyrmions are promising candidates for future storage devices with a large data density. A great variety of materials have been found that host skyrmions up to the room-temperature regime. Lorentz microscopy, usually performed in a transmission electron microscope (TEM), is one of the most important tools for characterizing skyrmion samples in real space. Using numerical calculations, this work relates the phase contrast in a TEM to the actual magnetization profile of an isolated Néel or Bloch skyrmion, the two most common skyrmion types. Within the framework of the used skyrmion model, the results are independent of skyrmion size and wall width and scale with sample thickness for purely magnetic specimens. Simple rules are provided to extract the actual skyrmion configuration of pure Bloch or Néel skyrmions without the need of simulations. Furthermore, first differential phase contrast (DPC) measurements on Néel skyrmions that meet experimental expectations are presented and showcase the described principles. The work is relevant for material sciences where it enables the engineering of skyrmion profiles via convenient characterization.

[Effects of ticagrelor on cardiorespiratory fitness in patients after percutaneous coronary intervention]

Objective: To investigate the effects of ticagrelor on cardiorespiratory fitness in patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: A total of 1 073 patients, who were diagnosed as coronary heart disease and underwent cardiopulmonary exercise testing (CPET) within 1 year after PCI, were enrolled from September 2017 to September 2019 in Peking University Third Hospital, including 309 patients in ticagrelor group and 764 patients in clopidogrel group. Clinical information, blood test results, echocardiographic parameters, cardiorespiratory fitness related parameters (including peak oxygen uptake (VO(2)), anaerobic threshold VO(2), peak oxygen pulse (VO(2)/HR) and carbon dioxide ventilation equivalent (VE/VCO(2)) slope), coronary lesions and intervention information were obtained. Cardiopulmonary fitness related indexes were compared between the two groups, and the correlation between ticagrelor use and cardiopulmonary fitness related indexes was analyzed by multivariate logistic regression. Patients who underwent CPET within 1 month after PCI were included in the subgroup analysis. Results: In ticagrelor group, the age was (60.3±10.3) years, and 253(81.9%) cases were male. The age of clopidogrel group was (60.6±10.0) years, and there were 608(79.6%) males. No significant differences were observed in peak VO(2), anaerobic threshold VO(2), and peak VO(2)/HR between the two groups (all P>0.05), but the VE/VCO(2) slope was significantly higher in the ticagrelor group than in the clopidogrel group (30.075 (27.207, 33.603) vs. 28.853 (25.970, 32.336), P<0.001). Logistic regression analysis suggested that the peak VO(2), anaerobic threshold VO(2) and peak VO(2)/HR were not significantly correlated with the ticagrelor use (all P>0.05), while the VE/VCO(2) slope was independently correlated with ticagrelor use (OR=1.098, 95%CI 1.032-1.168, P=0.003). Subgroup analysis of patients who underwent CPET within 1 month after PCI also indicated that no significant difference were observed in peak VO(2), anaerobic threshold VO(2), peak VO(2)/HR and VE/VCO(2) slope between the two groups (all P>0.05). Logistic regression analysis suggested that the peak VO(2), anaerobic threshold VO(2) and peak VO(2)/HR were not significantly correlated with ticagrelor use (all P>0.05), while the VE/VCO(2) slope was significantly correlated with ticagrelor use (OR=1.132, 95%CI 1.030-1.244, P=0.010). Conclusion: Among coronary heart disease patients after PCI, treatment with clopidogrel does not result in significant decrease in exercise endurance as compared with patients treated with ticagrelor.

[Progress of antiviral therapy for hepatitis C virus-related decompensated cirrhosis]

Direct-acting antiviral agents (DAAs) are the main antiviral therapeutics for hepatitis C virus-related decompensated stage cirrhosis. DAAs of NS3/4A protease inhibitors use is not recommended for patients with decompensated cirrhosis due to characteristics of DAAs metabolism in liver. The recent guidelines have recommended sofosbuvir (SOF)-based plan including pan-genotype plan of sofosbuvir(SOF)/velpatasvir (VEL), sofosbuvir combined with daclatasvir (DCV), genotype 1,4,5,6 specific plan of sofosbuvir (SOF) / ledipasvir (LDV) for 24 weeks or above in combination with ribavirin for 12 weeks because NS5B and NS5A inhibitors has no obvious effect on CYP450 enzyme system and achievement of sustained virological response (SVR) rates at 12/24 weeks is achievable in 88% ~ 100%, and liver reserve function improves in 42% ~ 53% of patients. Furthermore, approximately 15.5% ~ 49% of patients waiting for liver transplantation after treatment with DAAs do not require liver transplantation for short-term and 10.3% ~19.2% of patients receiving SOF/LDV, and SOF combined with DCV not needed liver transplantation. Thus, the clinical application of DAAs provides a safe and reliable antiviral treatment plan for hepatitis C virus-related decompensated stage cirrhosis.