[The association between serum bilirubin levels and hearing loss in the patients with bilateral sudden deafness]

Objective:The aim of this study was to investigate the association between serum bilirubin levels and the severity of bilateral sudden sensorineural hearing loss （BSSHL）. Method:A total of 113 patients with bilateral axillary sputum were enrolled, and the relationship between serum bilirubin levels and initial hearing levels was explored using a univariate and multivariate linear regression model. Result:Compared with the group with moderate and below hearing loss （≤70 dB HL）, patients with severe profound HL（>70 dB HL） were more likely to have lower levels of total and indirect bilirubin level, magnesium and relative hearing gain, higher levels of final hearing, white blood counts, neutrophil, platelet and alkaline phosphatase. After adjusting for possible confounders, only serum indirect bilirubin levels were significantly negatively correlated with initial hearing loss in patients with bilateral axillary sputum. 1 μmol/L increase of IBIL was associated with 1.1 dB （95%CI: -2.2, 0.0） reduction in initial hearing loss. Conclusion:Within the normal or mildly elevated range, higher levels of IBIL are independently and significantly associated with less severe hearing loss in BSSHL. It suggested a beneficial effect of bilirubin on auditory system.

Alprostadil attenuates LPS-induced cardiomyocyte injury by inhibiting the Wnt5a/JNK/NF-κB pathway

Background

Clinical research has demonstrated that alprostadil has an anti-inflammatory effect; however, to date, its molecular mechanisms remain unclear. This study aimed to examine the anti-inflammatory activity and related mechanisms of alprostadil in lipopolysaccharide (LPS)-treated H9c2 cells.

Methods

Cell morphology was observed under an inverted light microscope, while cell viability was assessed with the 3‑(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide (MTT) assay. Enzyme-linked immunosorbent assays (ELISA) were conducted to study biochemical indicators of cellular damage, such as released lactate dehydrase (LDH) and troponin, and inflammatory cytokine levels including interleukin-1β (IL-1β), IL-6, IL-17, and tumor necrosis factor-α (TNF-α). The mRNA expression levels of Wnt5a, c‑jun N‑terminal kinase (JNK), and nuclear factor kappa B (NF-κB) were further investigated by real-time quantitative polymerase chain reaction (RT-PCR). The effects of alprostadil on the Wnt5a/JNK/NF-κB pathway in H9c2 cells was examined by Western blotting.

Results

Alprostadil increased the cell viability of LPS-stimulated H9c2 cells, reduced LDH and troponin production, and attenuated IL-1β, IL-6, IL-17, and TNF-α secretion. Moreover, alprostadil reduced the mRNA expression of Wnt5a, JNK, and NF-κB and decreased the expression of Wnt5a, NF-κB, and the ratio of p‑JNK/JNK in H9c2 cells treated with LPS. The siWnt5a or JNK inhibitor SP600125 significantly augmented the inhibitory effects of alprostadil on the Wnt5a/JNK/NF-κB pathway.

Conclusion

Our results show that alprostadil has anti-inflammatory effects and could attenuate LPS-induced injury in H9c2 cardiomyocytes via the Wnt5a/JNK/NF-κB pathway.

Abstract GS3-05: Prospective optimization of estrogen receptor degradation yields ER ligands with variable capacities for ER transcriptional suppression

ER+ breast cancers can depend on ER signaling throughout disease progression, including after acquired resistance to existing endocrine agents, providing a rationale for further optimization and development of ER-targeting agents. Fulvestrant is unique amongst currently approved ER ligand therapeutics due to classification as a full ER antagonist, which is thought to be achieved through degradation of ER protein. However, the full clinical potential of fulvestrant is believed to be limited by poor bioavailability, spurring attempts to generate ligands capable of driving ER degradation but with improved drug-like properties.

Here, we evaluate three ER ligand clinical candidates that recently emerged from prospective optimization of ER degradation – GDC-0810, AZD9496 and GDC-0927 - and show that they display distinct mechanistic features. GDC-0810 and AZD9496 are more limited in their ER degradation capacity relative to GDC-0927 and fulvestrant, display evidence of weak transcriptional activation of ER in breast cancer cells (i.e. partial agonist activity), and do not achieve the same degree of in vitro anti-proliferative activity as GDC-0927 and fulvestrant. In the HCI-013 (ER.Y537S) and HCI-011 (ER.WT) ER+ patient-derived xenograft models, GDC-0927 drives greater transcriptional suppression of ER, and greater anti-tumor activity relative to GDC-0810.

We found that despite their full antagonist phenotype, GDC-0927 and fulvestrant promote association of ER with DNA, including at canonical ERE motifs, prior to ER degradation. Interestingly however, integration of ER ChIP-Seq and ATAC-Seq data revealed that ER complexed with fulvestrant or GDC-0927 fails to increase chromatin accessibility at DNA binding sites, in contrast to partial agonists which result in increased chromatin accessibility at ER binding sites. Thus, although ER contacts DNA when engaged with fulvestrant and GDC-0927, it is functionally inert. To further explore mechanistic features that might account for the differential activity of full antagonists and partial agonists that occurs prior to ER degradation, we used cell-based florescence recovery after photobleaching (FRAP) to measure the kinetics of ER diffusion within the nucleus. We demonstrate that while ER is generally highly mobile, including after engagement with GDC-0810 and AZD9496, GDC-0927 and fulvestrant immobilize intra-nuclear ER. A site saturating mutagenesis screen revealed a series of novel ER mutations that prevent ER immobilization by fulvestrant and GDC-0927. This class of “always mobile” ER variants promotes an antagonist-to-agonist transcriptional switch for fulvestrant and GDC-0927, and simultaneously prevents ER degradation by these molecules, implying that ER immobilization is a key functional determinant of robust transcriptional suppression.

We thus propose that ER degradation is not a driver of full ER antagonism, but rather a downstream consequence of ER immobilization, occurring after a suppressive phenotype has been established at chromatin. We additionally argue that evaluating the transcriptional output of candidate ER therapeutics, both pre-clinically and clinically, will be critical for the identification of ER ligands with best-in-class potential.

Citation Format: Metcalfe C, Zhou W, Guan J, Daemen A, Hafner M, Blake RA, Ingalla E, Young A, Oeh J, De Bruyn T, Ubhayakar S, Chen I, Giltnane JM, Li J, Wang X, Sampath D, Hager JH, Friedman LS. Prospective optimization of estrogen receptor degradation yields ER ligands with variable capacities for ER transcriptional suppression [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS3-05.

[Characteristic and function of peripheral blood mononuclear cells-induced macrophages in patients with myelodysplastic syndrome]

目的

观察骨髓增生异常综合征（MDS）患者单个核细胞诱导的巨噬细胞的功能，分析其与MDS疾病发展的关系。

方法

以2014年9月至2015年12月天津医科大学总医院血液科24例MDS患者为病例组，以15名健康志愿者为正常对照组。收集外周血标本并分离单个核细胞，体外以GM-CSF诱导分化形成巨噬细胞。在光学显微镜下观察巨噬细胞的形态；使用流式细胞术检测巨噬细胞的数量及其表面受体CD206、SIRPα的表达水平；分别采用流式细胞术和免疫荧光显微镜检测巨噬细胞的吞噬功能。

结果

①MDS来源的巨噬细胞形态较正常对照差（形态不规则、细胞体积小、异形明显、无足突、数量减少），MDS外周血单个核细胞转化为巨噬细胞的转化率为（5.17±3.47）%，显著低于正常对照组的（66.18±13.43）%（t=3.529，P=0.001）；②MDS来源的巨噬细胞表面识别受体CD206的表达水平[（9.73±2.59）%]显著低于正常对照组[（51.15±10.82）%]（t=4.551，P<0.001），SIRPα的表达水平[（0.51±0.09）%]显著低于正常对照组[（0.77±0.06）%]（t=2.102，P=0.043）；③MDS来源的巨噬细胞吞噬免疫微球的吞噬指数、吞噬百分率分别为0.45±0.08、（23.69±3.22）%，显著低于正常对照组的0.92±0.07、（42.75±2.13）%（P值均<0.05），MDS来源的巨噬细胞吞噬单个核细胞的吞噬指数（0.24±0.04）显著低于正常对照组（0.48±0.96，t=3.464，P=0.001）。

结论

MDS患者外周血单个核细胞诱导形成巨噬细胞能力下降，吞噬识别受体减少，吞噬能力减弱。

[Classification of sudden deafness prognosis based on deep learning method]

Objective:This study aimed to develop predictive models for sudden sensorineural hearing loss through deep belief network (DBN) and explore whether the model performances differ when adopting different outcome criteria. Method: 228 potential predictors involving the clinical characteristics, audio logical data, and serological parameters out of 1 220 hospitalized SSHL patients who were admitted from June 2008 to December 2015 were analyzed retrospectively. The hearing data of sudden deafness were classified into two or four categories based on Chinese criteria and Siegel criteria, which were used to develop the DBN models. The area under the receiver operating characteristic curve (ROC-AUC) and accuracy were used to compare the predictive performance of different models. Result: The DBN model developed for predicting the dichotomized outcomes had better performance than that of the fourcategory outcomes. When the iteration number reached 500 times, DBN model constructed for prediction of dichotomized outcomes based on Siegel's criteria had demonstrated the best performance with an accuracy of 76.25% and an AUC of 0.81. According to indices from first layer weights, DBN gave a rank of top 10 sensitive features for hearing outcome prediction focusing on indicators regarding coagulation, demographics and pre-treatment hearing levels independent of the outcome assessment criteria. Conclusion: DBN provides a robust outcome prediction ability in SSHL datasets with rich and complex variables, especially when utilized to predict dichotomized outcomes based on the Siegel criteria. In addition, this advanced deep learning technique can automatically extract valuable predictors, which is consistent with those that had been verified in previous studies by traditional statistical methods. This study provides further evidence for extending the use of DBN algorithm to the field of developing prediction or classification models for other otological diseases in the future..

[Technical specification for clinical application of critical ultrasonography]

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound, the examiner and interpreter of the image are critical care medicine physicians. The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes. With the idea of critical care medicine as the soul, it can integrate the above information and clinical information, bedside real-time diagnosis and titration treatment, and evaluate the therapeutic effect so as to improve the outcome. CUS is a traditional technique which is applied as a new application method. The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept, implementation and application of CUS. It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure. At the same time, the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications, and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS. Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group, based on the rich experience of clinical practice in critical care and research, combined with the essence of CUS, to learn the traditional ultrasonic essence, established the clinical application technical specifications of CUS, including in five parts: basic view and relevant indicators to obtain in CUS; basic norms for viscera organ assessment and special assessment; standardized processes and systematic inspection programs; examples of CUS applications; CUS training and the application of qualification certification. The establishment of applied technology standard is helpful for standardized training and clinical correct implementation. It is helpful for clinical evaluation and correct guidance treatment, and is also helpful for quality control and continuous improvement of CUS application.

Efficacy of 3D VIBE Dixon fat quantification for differentiating clear-cell from non-clear-cell renal cell carcinoma

AIM

To assess the efficacy of three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) with Dixon quantification for differentiating clear-cell from non-clear-cell types of renal cell carcinoma (RCC).

MATERIALS AND METHODS

The 3D VIBE Dixon renal MRI examinations of 44 patients with 45 histologically confirmed RCCs was analysed. The fat fractions and signal intensity indexes (SI_index) of the solid portions of clear-cell and non-clear-cell RCCs were measured and compared using Student's t-test and receiver operating characteristic (ROC) curves. The agreement of measurements among observers was evaluated by the intraclass correlation coefficient (ICC), and Bland-Altman plots.

RESULTS

The mean values of fat fraction (13.16±7.16%) and SI_index (22.64±15.7%) in clear-cell RCCs were significantly higher than that in non-clear-cell RCCs (7.7±2% and 7.9±4.8%; p<0.001, respectively). With the area under the ROC curve (AUC) of the fat fraction at 0.811, 75% (95% CI: 55.1-89.43%) sensitivity and 76.5% (95% CI: 50.1-93.2%) specificity for diagnosing clear-cell RCC were obtained at a cut-off fat fraction value of 8.9%. With a cut-off value of 8.89%, the diagnostic sensitivity and specificity were 85.7% (95% CI: 67.3-96%) and 70.6% (95% CI: 44-89.7%), respectively. The AUC of the SI_index was 0.870 (0.766-0.973). ICC and Bland-Altman plots show excellent agreement of the tumour fat fraction and SI_index measurement between the two observers.

CONCLUSION

Intracellular lipid content analysis using the 3D Dixon technique can help to differentiate clear-cell from non-clear-cell RCCs.

The role for cyclic Glycine-Proline, a biological regulator of insulin-like growth factor-1 in pregnancy-related obesity and weight changes

Cyclic Glycine-Proline (cGP) regulates the homeostasis of insulin-like growth factor (IGF)-1 function and cGP/IGF-1 ratio determines IGF-1 bioactivity in vitro and in vivo. Plasma IGF-1 represents largely inactive IGF-1 and weakly associated with human obesity and hypertension. We evaluated the regulatory role for cGP in pregnancy-related obesity and hypertension, and in obesity status between pregnancy and postpartum. Women were recruited in their first pregnancy. A cross-sectional study compared plasma concentration of cGP, IGF-1 and IGF binding protein (IGFBP)-3 in women with obesity and/or hypertension to normal controls 6-year postpartum using UPLC-MS and ELISA. A longitudinal study compared the changes of these peptides from 15-week gestation to 6-year post-partum in the women who remained normal weight, remained obese or changed to obese or to normal respectively. Study 1 is a cross-sectional study. The obese group had lower IGF-1(p = 0.001), higher cGP/IGF-1 ratio (p = 0.0055) and the hypertensive group had lower IGFBP-3 (p = 0.046) and cGP (p = 0.043) than the controls. Study 2 is a longitudinal study. Women with weight loss had increased cGP/IGF-1 ratio (p = 0.0026) and decreased IGFBP-3 (p = 0.0001) compared with women whose weight remained normal. Women with weight gain had lower IGFBP-3 (p less than 0.0001) only. Women who remained obese had increased cGP/IGF-1 ratio (p = 0.006) only. Increase in cGP/IGF-1 ratio is associated with obesity, but not hypertension. Changes of IGFBP-3 and/or cGP/IGF-1 ratio are associated with weight changes. The data suggest the role for cGP in obesity through autocrine regulation of IGF-1.

Predicting the hearing outcome in sudden sensorineural hearing loss via machine learning models

OBJECTIVE

Sudden sensorineural hearing loss (SSHL) is a multifactorial disorder with high heterogeneity, thus the outcomes vary widely. This study aimed to develop predictive models based on four machine learning methods for SSHL, identifying the best performer for clinical application.

DESIGN

Single-centre retrospective study.

SETTING

Chinese People's liberation army (PLA) hospital, Beijing, China.

PARTICIPANTS

A total of 1220 in-patient SSHL patients were enrolled between June 2008 and December 2015.

MAIN OUTCOME MEASURES

An advanced deep learning technique, deep belief network (DBN), together with the conventional logistic regression (LR), support vector machine (SVM) and multilayer perceptron (MLP) were developed to predict the dichotomised hearing outcome of SSHL by inputting six feature collections derived from 149 potential predictors. Accuracy, precision, recall, F-score and the area under the receiver operator characteristic curves (ROC-AUC) were exploited to compare the prediction performance of different models.

RESULTS

Overall the best predictive ability was provided by the DBN model when tested in the raw data set with 149 variables, achieving an accuracy of 77.58% and AUC of 0.84. Nevertheless, DBN yielded inferior performance after feature pruning. In contrast, the LR, SVM and MLP models demonstrated opposite trend as the greatest individual prediction powers were obtained when included merely three variables, with the ROC-AUC ranging from 0.79 to 0.81, and then decreased with the increasing size of input features combinations.

CONCLUSIONS

With the input of enough features, DBN can be a robust prediction tool for SSHL. But LR is more practical for early prediction in routine clinical application using three readily available variables, that is time elapse between symptom onset and study entry, initial hearing level and audiogram.

FMNL2 destabilises COMMD10 to activate NF-κB pathway in invasion and metastasis of colorectal cancer

BACKGROUND

Diaphanous-related formins (DRFs), actin necleator, have been known to participate in the progression of cancer cells. We previously reported that FMNL2 (Formin-like2), a member of DRFs, was a positive regulator in colorectal cancer (CRC) metastasis, yet proteins and pathways required for the function of this pro-invasive DRFs remain to be identified.

METHODS

The relationship between FMNL2 and COMMD10 was examined using Co-IP, GST pull-down, immunofluorescence and in vitro ubiquitination assay. The in vitro and in vivo function of COMMD10 in CRC was evaluated using CCK-8 proliferation assay, plate colony formation, cell cycle, apoptosis and animal models. The inhibition of NF-κB signalling by COMMD10 was detected using dual-luciferase reporter assay and western blotting. Co-IP, GST pull-down and nuclear protein extraction assay were performed to evaluate the effect on p65 by COMMD10. Real-time PCR and western blotting were performed to detect expressions of FMNL2, COMMD10 and p65 in paired tissues.

RESULTS

FMNL2 targets COMMD10 for ubiquitin-mediated proteasome degradation in CRC cells. COMMD10 targets p65 NF-κB (nuclear factor-κB) subunit and reduces its nuclear translocation, thereby leading to the inactivation of NF-κB pathway and suppression of CRC invasion and metastasis. Inhibition of NF-κB signalling by COMMD10 is necessary for FMNL2-mediated CRC cell behaviours. Downregulation of COMMD10 predicts poor prognosis of CRC patients. The expressions of FMNL2, COMMD10 and p65 are highly linked in CRC tissues.

CONCLUSIONS

These data demonstrate that the FMNL2/COMMD10/p65 axis acts as a critical regulator in the maintenance of metastatic phenotypes and is strongly associated with negative clinical outcomes.

[The value of lung ultrasound score for therapeutic effect assessment of ventilator-associated pneumonia]

To study the value of lung ultrasound score (LUS) in assessing the clinical outcome of patients with ventilator-associated pneumonia(VAP). A total of 99 VAP patients were enrolled in a prospective study. All patients met the diagnostic criterion of VAP based on the 2013 guidelines and admitted into our ICU from Jun 2013 to Jun 2015. All parameters were recorded on the diagnostic day (day 1) and day 5, including LUS, clinical pulmonary infection score (CPIS), chest X ray (CXR), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment(SOFA) score, etc. According to the CPIS, patients were divided into 2 groups(CPIS less than 6 and more or equal to 6). CPIS and LUS were similar on day 1 between two groups (P>0.05). However, on day 5, significant differences of CPIS and LUS were found between groups with CPIS<6 and CPIS≥6 (P=0.019 and P<0.001 respectively). LUS decreased on day 5 in CPIS<6 group and increased in CPIS≥6 group. In CPIS<6 group, there was a positive correlation between LUS and CPIS on day 1(r=0.375, P=0.003) and day 5 (r=0.590, P<0.001). CPIS≥6 groupshowed the same trend on day 1 (r=0.484, P=0.002) and day 5 (r=0.407, P=0.011). LUS can be used to dynamically evaluate the clinical outcome of VAP.

Abstract P5-02-05: Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014)

Background: Milestone studies showed that ultrasound (US) was an effective primary screening test for breast cancer both in the western world and in China [PMID: 26712110, 26715161, and 25668012]. Ultrasound has been officially designated to be the initial imaging test for breast cancer screening in Beijing and several other cities in China, due to its improved sensitivity in Chinese women who usually have denser breasts and develop breast cancer earlier than Caucasian counterparts. Study showed that it would take 40 years to screen each woman in the target age group once [PMID: 26808342].The mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. However, there is little data about the tumor biology and long-term survival of the US-detected non-palpable breast cancer (NPBC) in hospital-based Chinese population.

Methods: From January 2001 to December 2014, 3,786 asymptomatic women with positive (BI-RADS 4 and 5) initial screening US underwent biopsies in Peking Union Medical College Hospital, and 572 NPBC in 556 women were diagnosed. Women without dense breasts (defined as BI-RADS category C and D) also received screening mammography (MG) after physical examination and ultrasound. 788 patients with positive (BI-RADS 4 and 5) mammogram (MG) and normal US (BI-RADS 1, 2 and 3) underwent MG-guided biopsies and another 127 NPBC were diagnosed in 126 women. The clinicopathological features, treatment choice, 10-year disease-free survival (DFS) and overall survival (OS) were reviewed and compared between the US-detected and MG-detected NPBC. Prognostic factors of NPBC were identified.

Results: Overall, US could detect more invasive NPBC (83.4% vs 54.3%, p&lt;0.001), lymph node positive cancer (19.1% vs 10.2%, p&lt;0.001)and multifocal cancer (19.2% vs 6.3%, p&lt;0.001). In invasive NPBC, US detected more low grade cancer (21.4% vs 10.2%, p=0.001), multifocal cancer (20.7% vs 2.9%, p&lt;0.001), Her2 negative cancer (77.6% vs 62.3%, p=0.001) and larger tumor (pT1c+pT2, 53.3% vs 37.6%, p&lt;0.001). There was no significant difference in immunophenotype/subtype, treatment methods, DFS or OS between US- and MG-NPBC among ductal carcinoma in situ (DCIS), invasive and all NPBC. For all NPBC and the US-NPBC, the common DFS-factors included pT, pN and p53 whereas OS-predictors were pN and immunophenotype/subtype.

Table 1. Kaplan-Meier estimates of DFS and OS between US-NPBC and MG-NPBC§.Patients (No.)10-year DFS (%)P value10-year OS (%)P valueAllUS-NPBC (572)90.60.73896.10.142 MG-NPBC (127)92.7 100.0 DCISUS-NPBC (94)100.00.060100.0- MG-NPBC (58)93.8 100.0 InvasiveUS-NPBC (478)88.60.68095.20.239 MG-NPBC (69)92.0 100.0 § Kaplan-Meier survival curves between each two subgroups would be displayed in the poster.

Conclusion: Compared to MG, US detected more invasive NPBC with positive lymph node in hospital-based asymptomatic self-referred Chinese women, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US could serve as the feasible initial imaging modality in hospital-based opportunistic screening Chinese women.

Citation Format: Yao R, Pan B, Zhu Q, Xu Q, Zhou Y, Zhang J, Mao F, You S, Lin Y, Shi J, Guan J, Wang X, Zhang Y, Zhang X, Shen S, Zhong Y, Xu Y, Liang Z, Jiang Y, Sun Q. Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-02-05.

[Experimental study of autologous fibroblast cell transplantation in the treatment of vocal fold scar]

Objective:To study the change characteristics of vocal cords scar after the implantation of autologous fibroblast cells into the vocal cords. Method:Forty New Zealand rabbits were used for the production of vocal fold scar model by creating a unilateral vocal fold wounds, we take the skin tissues of each rabbits and cultured them via enzyme digestion method to obtain autologous fibroblast cells. The models were separated into the experimental group and the control group, the third generation fibroblast cells with CM DIL labeled were then injected into the surrounding area of the vocal fold scar in the experimental group, the survival situation of the injected cells were observed by fluorescence microscopy after 1 week, histological examination was performed after 1 months to observe the morphological changes of vocal fold scar tissues, RT-PCR method was used to measure the expression variation of typeⅠcollagen and type Ⅲ collagen in the vocal cords and the normal vocal cords, respectively. Result:After 1 week of autologous fibroblast transplantation into the vocal folds, the fluorescence labeled cells were observed.1 month after transplantation, the collagen protein in the vocal fold scar tissues was similar to that in the normal vocal folds，the expression of typeⅠcollagen and type Ⅲ collagen in vocal fold scars is similar to those in the normal vocal folds. Conclusion:Autologous fibroblast migration into the vocal cords can survive well inside the vocal cords, and the vocal scar can be recovered to normal vocal cord structure after transplantation of autologous fibroblast cells.

The ALK inhibitor PF-06463922 is effective as a single agent in neuroblastoma driven by expression of ALK and MYCN

The first-in-class inhibitor of ALK, c-MET and ROS1, crizotinib (Xalkori), has shown remarkable clinical efficacy in treatment of ALK-positive non-small cell lung cancer. However, in neuroblastoma, activating mutations in the ALK kinase domain are typically refractory to crizotinib treatment, highlighting the need for more potent inhibitors. The next-generation ALK inhibitor PF-06463922 is predicted to exhibit increased affinity for ALK mutants prevalent in neuroblastoma. We examined PF-06463922 activity in ALK-driven neuroblastoma models in vitro and in vivo In vitro kinase assays and cell-based experiments examining ALK mutations of increasing potency show that PF-06463922 is an effective inhibitor of ALK with greater activity towards ALK neuroblastoma mutants. In contrast to crizotinib, single agent administration of PF-06463922 caused dramatic tumor inhibition in both subcutaneous and orthotopic xenografts as well as a mouse model of high-risk neuroblastoma driven by Th-ALK(F1174L)/MYCN Taken together, our results suggest PF-06463922 is a potent inhibitor of crizotinib-resistant ALK mutations, and highlights an important new treatment option for neuroblastoma patients.

Risk of hip fracture following stroke, a meta-analysis of 13 cohort studies

This study systematically reviews prospective and retrospective cohort studies evaluating the risk of hip fracture following stroke. Stroke survivors are at high risk of hip fracture and had a 1.5-fold increased risk compared to stroke-free men and women of the same age. Hip fracture often occurs in ageing and female stroke patients. We performed a meta-analysis to summarize evidence from prospective and retrospective cohort studies about the risk of hip fracture following stroke. We identified English and non-English publications in MEDLINE and EMBASE using stroke and fracture as keywords to 31 December 2015. The data of the incidence of hip fracture were extracted to calculate raw incident rate in stroke survivors as well as risk of hip fractures in strokes comparing populations using a random-effects model. Subgroup analyses were performed to identify the potential influence of some factors. Six prospective and seven retrospective cohort studies were included, involving 512,214 stroke patients with 22,559 hip fractures. The pooled prevalence of hip fractures was 4.87 % (95 % CI, 4.05 to 5.68 %) in stoke patients. We conducted subgroup analysis according to sex, age, duration of follow-up, study design, and region, which showed that female (vs. male) stroke patients older than 70 years (vs. those less than 70 years) and duration of follow-up more than 2 years (vs. those less than 2 years) have higher proportions of hip fractures. Four studies showed that stroke patients had a significantly higher risk of hip fracture compared with the general population, while the other study had a non-significant higher risk. The overall prevalence of hip fracture was 3.28 % (3431 of 104,646) in stroke patients and 2.83 % (36,493 of 1,287,726) in general population, respectively, and the unadjusted combined relative risk of hip fracture was 1.54 (95 % CI, 1.06-2.25). Hip fractures often occur in ageing and female stroke patients.

[Characteristics of tinnitus related to idiopathic suddensensorineural hearing loss in 272 patients]

Objective:To investigate the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus.Method:Two-hundred and seventy two SSHL patients with tinnitus underwent evalution through Tinnitus Handicap Inventory(THI) and Tinnitus Questionnaire(TQ).Demographic data and tinnitus characteristics were analyzed.Result:In 272 patients,41.6% of patients suffered from low frequency tinnitus,2.0% with medium frequency tinnitus,56.4% with high frequency tinnitus.There were 79% patients whose tinnitus were continous,while 21% were intermittent;From the view point of daily life compromising,37.4% were minor,44.8% were moderate,17.8% were serious.The most important factors that deteriorate tinnitus were bad sleep,noise,life pressure and tiredness.Conclusion:There were individual differences among patients with sudden deafness and tinnitus.Enough evaluation should be made to decrease the infection of tinnitus.