Improvement of Streptococcus suis glutamate dehydrogenase expression in Escherichia coli through genetic modification of acetate synthesis pathway

Escherichia coli generates acetate as an undesirable by-product that has several negative effects on protein expression, and the reduction of acetate accumulation by modifying genes of acetate synthesis pathway can improve the expression of recombinant proteins. In the present study, the effect of phosphotransacetylase (pta) or/and acetate kinase (ackA) deletion on glutamate dehydrogenase (GDH) expression was investigated. The results indicated that the disruptions of pta or/and ackA decreased the acetate accumulation and synthesis of per gram cell, and increased cell density, and GDH expression and synthesis of per gram cell. The pta gene was more important for acetate formation than the ackA gene. Using the strain with deletions of pta-ackA (SSGPA) for GDH expression, acetate accumulation (2·61 g l^-1 ) and acetate synthesis of per gram cell (0·229 g g^-1 ) were lowest, decreasing by 28·29 and 41·43% compared with those of the parental strain (SSG) respectively. The flux of acetate synthesis (6·6%) was decreased by 72·15% compared with that of SSG, and the highest cell density (11·38 g l^-1 ), GDH expression (2·78 mg ml^-1 ), and GDH formation of per gram cell (0·2442 mg mg^-1 ) were obtained, which were 1·22-, 1·43- and 1·17-times higher than the parental strain respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: Significance and Impact of the Study: Acetate is the key undesirable by-product in Escherichia coli cultivation, and both biomass and production of desired products are increased by the reduction of acetate accumulation. In the present study, the strains with deletions of pta or/and ackA were constructed to reduce the acetate accumulation and improve the GDH expression, and the highest expression level of GDH was obtained using the strain with lesion in pta-ackA that was 1·17-times higher than that of the parental strain. The construction strategy of recombinant E. coli for decreasing the acetate excretion can be used for high expression level of other desired products.

p38-MAPK pathway is activated in retinopathy of microvascular disease of STZ-induced diabetic rat model

OBJECTIVE

To investigate the role of corticotropin releasing hormone (CRH) in diabetic retinopathy of microvascular disease and the potential mechanism.

MATERIALS AND METHODS

The diabetic rat model was constructed by a single intraperitoneal injection of streptozotocin (STZ). The expression of CRH in the retina of diabetic rats and wild-type rats was detected by Real-Time Polymerase Chain Reaction (RT-PCR). CRH shRNA or Scr shRNA adenovirus was injected into the eyes of diabetic rats and wild-type rats, respectively. The effect of down-regulated CRH on visual electrophysiology in rats was evaluated. Protein expressions of vascular endothelial growth factor (VEGF) and inflammatory factors that were related to the microvascular lesion after CRH downregulation were detected by Western blot. Furthermore, p38 expression was detected by Western blot to explore whether mitogen-activated protein kinase (MAPK) signaling pathway was involved in the function of retinal endothelial cells regulated by CRH.

RESULTS

The expression of CRH was significantly up-regulated in the retina of diabetic rats. RT-PCR results showed that the mRNA level of CRH in the retina of diabetic rats injected with CRH shRNA was decreased. However, no significant change in CRH level was observed in rats injected with Scr shRNA adenovirus. The down-regulated CRH could improve the diabetes-induced visual impairment and retinal inflammatory response. Moreover, the down-regulated CRH led to a decreased phosphorylation level of p38.

CONCLUSIONS

CRH improves the diabetic retinopathy of microvascular disease via the p38-MAPK pathway, which is expected to be a new target for the treatment of diabetic microangiopathy.

Bone inflammation and chronic recurrent multifocal osteomyelitis

Chronic recurrent multifocal osteomyelitis (CRMO) is a sporadic condition of inflammatory bone pain that occurs as recurrent flares because of osteomyelitis, which presents in the form of multiple aseptic foci. The estimated prevalence of CRMO is 1-2 per million, affecting mostly children, in the age group of 2 to 17. Main symptoms of CRMO are bone inflammation and pain, which are generally worse at night. Other symptoms seen on radiographs indicate osteolytic lesions surrounded by sclerosis, at later stages of the disease. Markers of inflammation, viz. tumor necrosis factor a and C-reactive protein are elevated in many cases. Because of similar symptoms, differential diagnosis is needed to confirm CRMO from infectious osteomyelitis, bone tumors, and other diseases. The genetic component is likely in some cases such as Majeed syndrome, deficiency of IL-1 antagonist, etc. Imaging is the essential part of diagnosing CRMO, and magnetic resonance imaging of the whole body is the most widely used and recommended method for the evaluation of multiple foci, as compared to radiography for reasons of sensitivity as well as prevention of excessive exposure of affected children to radiation. CRMO is considered an autoimmune and auto-inflammatory disorder, but its precise pathophysiology is not clear. Current treatment options are non-steroid anti-inflammatory drugs like naproxen, as the primary choice, and the bisphosphonates such as pamidronate as the second choice, to counter the symptoms and to reduce bone lesions. The surgical option is the choice for recalcitrant cases, even though recurrence may still be a problem.

Properties of Cosmic Helium Isotopes Measured by the Alpha Magnetic Spectrometer

Precision measurements by the Alpha Magnetic Spectrometer (AMS) on the International Space Station of ^{3}He and ^{4}He fluxes are presented. The measurements are based on 100 million ^{4}He nuclei in the rigidity range from 2.1 to 21 GV and 18 million ^{3}He from 1.9 to 15 GV collected from May 2011 to November 2017. We observed that the ^{3}He and ^{4}He fluxes exhibit nearly identical variations with time. The relative magnitude of the variations decreases with increasing rigidity. The rigidity dependence of the ^{3}He/^{4}He flux ratio is measured for the first time. Below 4 GV, the ^{3}He/^{4}He flux ratio was found to have a significant long-term time dependence. Above 4 GV, the ^{3}He/^{4}He flux ratio was found to be time independent, and its rigidity dependence is well described by a single power law ∝R^{Δ} with Δ=-0.294±0.004. Unexpectedly, this value is in agreement with the B/O and B/C spectral indices at high energies.

[Clinical research on sleep quality in patients with tinnitus]

Objective:To understand the sleep quality of patients with tinnitus, and to investigate the correlationship between tinnitus and sleep and analyze the influencing factors. Method:The patients with tinnitus as the main complaint used as the experimental group were 263 cases. One hundred and seventy respondents with no tinnitus complaint were selected as the control group. They were assessed by general information survey, Pittsburgh Sleep Quality Index, the Hamilton Anxiety Scale, the Hamilton Depression Scale, pure tone audiometry and acoustic immittance measurement. Result:There were 122 cases（46.4%） with sleep disorders in the experimental group and 49 cases（28.8%） with sleep disorders in the control group, and the difference was statistically significant（P=0.000）; The anxiety and depression were the influencing factors of sleep quality in patients with tinnitus, it was found that gender had influence on sleep latency and the course of disease and hyperlipidemia had influence on sleep disorders. Conclusion:Tinnitus patients were prone to sleep disorders, and the accompanying anxiety and depression were the important factors affecting sleep quality.

[Preoperative imaging and electrophysiological evaluation of cochlear implantation in children with cochlear nerve dysplasia]

Objective:The aim of this study is to investigate the use of CT, magnetic resonance imaging （MRI）, functional magnetic resonance （fMRI） and electrical evoked auditory brainstem response in children with cochlear nerve deficiency （CND） before cochlear implantation （CI） （electrically evoked auditory brain stem response, EABR） evaluated auditory pathway, auditory cortex function, and cochlear nerve function. Method:Of 6 children with bilateral profound sensorineural hearing loss, bilateral internal auditory meatus stenosis was diagnosed by CT as in 4 cases and unilateral internal auditory meatus stenosis in 1 case. In 3 cases, oblique sagittal MRI reconstruction of the internal auditory meatus showed only facial nerve and vestibular nerve existence. 6 cases were diagnosed as CND by imaging, among which underwent fMRI and EABR in 3 cases, respectively. All the children received unilateral CI and were followed up for at least 1 year after hearing and speech rehabilitation. Result:fMRI was examed in 3 cases with CND. It showed that the right auditory cortex was activated in 1 case after sound given to the left ear but no activation was found in the left cortex when sound given to the right ear. 1 case showed activation in bilateral transverse temporal gyrus while sound was given to the left, right and both ears at 2000Hz. Another case had no activation in both auditory cortex. EABR detection elicited V wave in 2 of 3 cases. 6 children received audiological and speech evaluation 1 month, 6 and 12 months after CI. Among them, the hearing level was improved within 6 months after surgery in 4 cases, and the threshold of sound field was （48.15±6.60） dB HL, MAIS and CAP scores were improved. However, SIR score improvement is limited in 3 cases. The hearing level was improved in 1 case, but speech rehabilitation was poor mainly due to the older age. Conclusion:Preoperative comprehensive application of imaging and electrophysiological evaluation of children with CND can more accurately assess the integrity of the auditory pathway and understand the function of the cochlear nerve. It has important reference significance for whether or not to perform surgery. There was a significant difference in auditory speech rehabilitation after CND in children with CND.

A short follow-up of prosthesis-based breast reconstruction using TiLOOP® Bra surgical mesh

Background

A new approach for prosthesis-based breast reconstruction is the use of a titanium-coated polypropylene mesh TiLOOP^® Bra. However, the safety and outcomes are currently unclear in Chinese breast cancer patients.

Methods

A retrospective study of patients undergoing prosthesis-based breast reconstruction using TiLOOP^® Bra was carried out. Complications were divided into minor complications (require conservative treatment) and major complications (require surgical intervention). The influence of patient- and surgery-related characteristics on complications was analyzed.

Results

Postoperative hematoma and seroma were respectively found in one and two breasts and could be treated conservatively. In three breasts skin infection occurred immediately after surgery resulting in skin necrosis of two breasts and wound dehiscence of one breast. These three breasts were treated with mesh removal, and revisionary surgery. Increased risk of mesh removal and implant explantation were observed in case of skin infection (P = 0.011) and skin necrosis (P = 0.033). Neither patient-related characteristics including age >50 years, BMI >25 kg/m², and postoperative radiotherapy/chemotherapy, nor surgery-related characteristics including sentinel lymph node biopsy or axillary dissection alone, and curative/prophylactic surgery were significantly correlated with minor and major complications. Ultrasound evaluation showed a well-incorporated mesh into surrounding tissue.

Conclusion

This titanium-coated polypropylene mesh showed acceptable complications and could be used safely in prosthesis-based breast reconstruction by stabilizing the implant pocket. Longer follow-up data and more randomized trials are necessary to determine the clinical use of this mesh.

Association between rs12742784 polymorphism and hip fracture, bone mineral density, and EPHB2 mRNA expression levels in elderly Chinese women

Objective: This study aimed to determine the association between rs12742784 polymorphism in the non-coding area and hip fracture, bone mineral density (BMD), and EPHB2 mRNA expression levels in elderly Chinese women.Methods: We investigated 250 Chinese women (mean age: 63.5 ± 8.3 years) including 123 hip fracture patients and 127 non-fracture controls. All participants underwent clinical examination to meet the inclusion criteria. Lumbar and hip BMD were detected by dual-energy X-ray absorptiometry. rs12742784 polymorphism was determined by restriction fragment length polymorphism and EPHB2 mRNA expression levels were measured by real-time polymerase chain reaction.Results: Distribution of rs12742784 genotypes agreed with Hardy-Weinberg equilibrium. The frequency of the CT + TT genotype was significantly associated with decreased risk of hip fracture (adjusted odds ratio = 0.57, p < 0.01) after adjusting for age and body mass index, and with increased BMD and EPHB2 mRNA expression levels. The T allele of the rs12742784 single nucleotide polymorphism (SNP) was a protective factor for hip fracture (adjusted odds ratio = 0.56, p < 0.01).Conclusion: rs12742784 polymorphism was associated with EPHB2 mRNA expression levels, BMD, and hip fracture in Chinese women. The T allele of the rs12742784 SNP was a protective factor for osteoporosis and hip fracture.

[Risk factors analyses for lateral neck lymph node metastasis in papillary thyroid carcinoma]

Objective:To study the risk factors for the lateral neck lymph node metastasis(LNM) in patients with papillary thyroid carcinoma(PTC).Method:Total 145 cases of papillary thyroid carcinoma patients were reviewed. These patients were divided into the following 2 groups: a lateral LNM-positive group and a lateral LNM-negative group.Clinical factors and tumor ultrasound characteristics were recorded, and the final pathology results were recorded as well. Result: Univariate and multivariate analyses indicated that primary tumor size(pathological diameter) >1.0 cm, upper portion location and lymph node metastasis in central neck were the three risk factors for lateral LNM of PTC(OR=6.250,4.881,5.222,P<0.05). The lymph node metastasis in the lateral neck was not correlated obviously with gender, age, capsuleinvasion, multifocality and tumor ultrasonic characteristics(including illdefined and irregular in shape, calcification, hypervascularized). The probability of lateral LNM was then calculated according to the number of risk factors present in each of the 145 patients, using the three factors. When two or more factors were present, the probability increased up to 38.1 %(95%CI23-53).Conclusion: The present study provides that lateral LNM occurs mainly in patients, with a tumor size(pathological diameter) diameter>1.0 cm, with the primary tumor located in the upper part of the lobe and positive central compartment lymph node metastasis. The risk increased up when at least two of the three factors were present. So it needs to pay attention to the high risk factors seriously which effect lateral neck lymph node metastasis in patients with PTC, combined with ultrasonic characteristics of lateral cervical lymph node or more meticulous evaluations, to establish the lymph node dissection individually.

Non-invasive screening of a microRNA-based dysregulation signature in oral cancer and oral potentially malignant disorders

INTRODUCTION

We have previously shown that oral swirls are a robust source of microRNA protected by extracellular vesicles, potentially useful to detect oral squamous cell carcinoma (OSCC)-associated molecular aberration.

OBJECTIVES

To study a developed dysregulation score and risk classification algorithm based upon a panel of OSCC-associated microRNA in oral swirls from individuals with OSCC and oral potentially malignant disorders (OPMDs).

MATERIALS AND METHODS

An OSCC-associated panel of 5 microRNAs (miR-24; miR-21; miR-99a; let-7c; miR-100;) was quantified by qPCR in 190 individuals with and without mucosal abnormalities, including OSCC (n = 53) and OPMDs (n = 74). Each sample was analyzed using a developed dysregulation score (dSCORE) and risk classification algorithm, allocating a LOW- or HIGH-RISK score. The influence of demographic, systemic, oral health and mucosal disease factors on the developed test was analyzed.

RESULTS

MicroRNA for analysis can be predictably isolated from oral swirls sourced from individuals with a range of demographic, systemic and oral health findings. Utilizing the presence of HIGH-RISK identified OSCC patients with 86.8% sensitivity and 81.5% specificity. Older age and female gender were associated with higher dSCOREs and higher proportions of HIGH-RISK classification amongst individuals with no mucosal abnormalities. The dSCOREs for all subgroups of OPMDs were significantly different from the OSCC group.

CONCLUSION

This is the first comparison of microRNA sourced from oral swirls from individuals with OPMDs with individuals with and without OSCC. A HIGH-RISK dysregulation signature was found to be accurate in indicating the presence of OSCC and exampled to parallel malignant transformation.

Study on diagnostic value of P1NP and β-CTX in bone metastasis of patients with breast cancer and the correlation between them

OBJECTIVE

This study aimed to investigate the diagnostic value of the total amino-terminal propeptide of type 1 procollagen (P1NP) and C-terminal telopeptide of β-I collagen (β-CTX) in bone metastasis of patients with breast cancer and the correlation between them.

PATIENTS AND METHODS

The medical records of 73 patients were retrospectively analyzed. These patients with breast cancer were treated in Oncology, General Surgery, and Orthopedic Departments in The Third People's Hospital of Qingdao from March 2014 to April 2017, including 40 patients with bone metastasis (bone metastasis group) and 33 patients with no bone metastasis (non-bone metastasis group). Other 40 healthy people who received physical examination in the same period were selected as the control group. The expression of P1NP and β-CTX in plasma were detected by the Enzyme-linked immunosorbent assay, and the correlation between them was analyzed.

RESULTS

There were significant differences in P1NP and β-CTX concentrations among the three groups (p<0.05). The concentrations of P1NP in the control group and the non-bone metastasis group were significantly lower than that in the bone metastasis group (p<0.05); the concentrations of β-CTX in the control group and the non-bone metastasis group were significantly lower than that in the bone metastasis group (p<0.05). P1NP: AUC=0.852, sensitivity: 72.5%, specificity: 93.9%, CUT OFF=66.44. β-CTX: AUC=0.883, sensitivity: 85.0%, specificity: 84.8%, CUT OFF=69.8. Joint detection: AUC=0.952, sensitivity: 84.8%, specificity: 99.5%, CUT OFF=99.5. The results of the concentrations of P1NP and β-CTX in the bone metastasis group detected by the Pearson correlation analysis showed that their concentrations were positively correlated in the bone metastasis group (r=0.764, p<0.05).

CONCLUSIONS

P1NP and β-CTX in plasma have a high diagnostic value for bone metastasis of breast cancer and have important significance in the diagnosis of bone metastasis and disease monitoring.

Dibutyl phthalate-induced activation of ROS and ERK1/2 causes hepatic and renal damage in Kunming mice

Dibutyl phthalate (DBP), a ubiquitous environmental contaminant, has been reported to be involved in hepatic and renal tissue damage. However, the role of DBP in oxidative stress and in extracellular signal-regulated kinase (ERK1/2) pathways remains unclear. To investigate the underlying mechanism, Kunming (KM) mice received daily doses of combinations of 50 mg/kg DBP, 50 mg/kg vitamin E (VitE), and 1 mg/kg PD98059 for 28 consecutive days. Any changes in reactive oxygen species (ROS) and malondialdehyde (MDA) levels, as well as any histopathological alterations in tissues, were observed to assess oxidative stress. In addition, the levels of alanine aminotransferase, aspartate aminotransferase, and albumin in serum were used to evaluate liver function. The levels of creatinine and urea nitrogen in serum were measured to evaluate kidney function. We found that DBP significantly increased oxidative damage and the expression of phosphorylated ERK1/2. Furthermore, pretreatment with the ERK inhibitor PD98059 followed by the antioxidant VitE attenuated the levels of ROS, MDA, ERK1/2 phosphorylation, and DBP-mediated disorders, indicating that the oxidative stress and the ERK1/2 pathways are associated with DBP-induced hepatic and renal dysfunction in KM mice.

[Outcome of neck dissection for 154 cN0/cN1 patients with squamous cell carcinoma of hypopharynx and prognostic analysis]

Objective: To determine the relationship between nodal disease distribution patterns and oncological outcome and optimum management of cN0/cN1 patients with hypopharyngeal squamous cell carcinoma (HPSCC). Methods: The collected clinical data and the follow-up disease-free survival (DFS) information from 154 patients with HPSCC treated between 2001 and 2014 in Eye Ear Nose and Throat Hospital of Fudan University were retrospectively analyzed. Kaplan-Meier method was used to calculate DFS rate. Log-rank test and Cox regression model were performed to evaluate the survival prognostic factors for univariate and multivariate analyses. Results: Among 154 patients (63 cN0 patients, 91 cN1 patients) with HPSCC,in whom 148 were male, 6 were female, with an arerage age of (58.6±9.9), 63 cN0 patients received lateral neck dissection, of whom 9 were histologically positive nodes. Particularly, occult metastasis rate was 15.6%(7/45) for HPSCC in pyriform sinus and 18.2%(2/11) for HPSCC in posterior pharyngeal wall. Among 91 cN1 HPSCC, 34 underwent radical neck dissection and 54 underwent selective neck dissection. DFS for patients(T3-4N1) with radical neck dissection was lower than that for patient with selective neck dissection(15.2% vs.39.5%, χ(2)=5.153, P<0.05). The DFS of cN0 HPSCC was overestimated by the false-negative patients (cN0→pN+) for cN0 HPSCC and the DFS of cN1 HPSCC was underestimated by the false-positive(cN1→pN0) for cN1 HPSCC. Conclusions: For cN1 HPSCC, compared with radical neck dissection, selective neck dissection may be considered as a more adequate method for removal of metastatic lymph nodes. Postoperative combined therapy and follow-up strategy should be established according to pathological N staging.

Multidisciplinary clinic approach improves overall survival outcomes of patients with metastatic germ-cell tumors

Background

To report our experience utilizing a multidisciplinary clinic (MDC) at Indiana University (IU) since the publication of the International Germ Cell Cancer Collaborative Group (IGCCCG), and to compare our overall survival (OS) to that of the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program.

Patients and methods

We conducted a retrospective analysis of all patients with metastatic germ-cell tumor (GCT) seen at IU from 1998 to 2014. A total of 1611 consecutive patients were identified, of whom 704 patients received an initial evaluation by our MDC (including medical oncology, pathology, urology and thoracic surgery) and started first-line chemotherapy at IU. These 704 patients were eligible for analysis. All patients in this cohort were treated with cisplatin-etoposide-based combination chemotherapy. We compared the progression-free survival (PFS) and OS of patients treated at IU with that of the published IGCCCG cohort. OS of the IU testis cancer primary cohort (n = 622) was further compared with the SEER data of 1283 patients labeled with 'distant' disease. The Kaplan-Meier method was used to estimate PFS and OS.

Results

With a median follow-up of 4.4 years, patients with good, intermediate, and poor risk disease by IGCCCG criteria treated at IU had 5-year PFS of 90%, 84%, and 54% and 5-year OS of 97%, 92%, and 73%, respectively. The 5-year PFS for all patients in the IU cohort was 79% [95% confidence interval (CI) 76% to 82%]. The 5-year OS for the IU cohort was 90% (95% CI 87% to 92%). IU testis cohort had 5-year OS 94% (95% CI 91% to 96%) versus 75% (95% CI 73% to 78%) for the SEER 'distant' cohort between 2000 and 2014, P-value <0.0001.

Conclusion

The MDC approach to GCT at high-volume cancer center associated with improved OS outcomes in this contemporary dataset. OS is significantly higher in the IU cohort compared with the IGCCCG and SEER 'distant' cohort.

Towards Understanding the Origin of Cosmic-Ray Electrons

Precision results on cosmic-ray electrons are presented in the energy range from 0.5 GeV to 1.4 TeV based on 28.1×10^{6} electrons collected by the Alpha Magnetic Spectrometer on the International Space Station. In the entire energy range the electron and positron spectra have distinctly different magnitudes and energy dependences. The electron flux exhibits a significant excess starting from 42.1_{-5.2}^{+5.4}  GeV compared to the lower energy trends, but the nature of this excess is different from the positron flux excess above 25.2±1.8  GeV. Contrary to the positron flux, which has an exponential energy cutoff of 810_{-180}^{+310}  GeV, at the 5σ level the electron flux does not have an energy cutoff below 1.9 TeV. In the entire energy range the electron flux is well described by the sum of two power law components. The different behavior of the cosmic-ray electrons and positrons measured by the Alpha Magnetic Spectrometer is clear evidence that most high energy electrons originate from different sources than high energy positrons.

Abstract P2-14-18: Achiveing rapid intrao-operative diagnosis during breast cancer surgery using high-reloution full-field optical coherence imaging and dynamic cell imaging

Background: Intraoperative pathological diagnosis such as frozen section and imprint cytology is not routinely recommended in clinical practice because of time and accuracy concerns. Full-field optical coherence tomography (FF-OCT) is a new optical imaging technique that could generate sectioning tomogram from fresh tissue and provide depiction of the morphological structure and pathological changes in minutes without conventional tissue preparation, slicing, and staining, and dynamic cell imaging (DCI) added the viability information of cells/tissue, which could be more important in cancer diagnosis. This study was to evaluate the feasibility and diagnostic value of FF-OCT and DCI in breast lesions and lymph node specimens during breast cancer surgery.

Methods: We evaluated normal breast tissue, benign breast lesions, breast cancer and axillary lymph node specimens from 107 patients using FF-OCT and DCI. After the optical assessment, the tissue was paraffin embedded and sent to conventional H&E diagnosis. The similar layer of OCT and H&E images were compared and diagnostic criteria were generated. The diagnostic sensitivity and specificity by two trained surgeons without pathology diagnosis experience were evaluated.

Results: A total of 194 specimens were examined, including 143 breast tissue(101 malignant and 42 benign/normal) and 51 lymph nodes(26 metastatic and 25 non-metastatic). On FF-OCT and DCI, normal morphological structures such as adipose, collagen, mammary ducts, and lobules in breast tissue and lymphoid follicle and hilum in lymph nodes were easily recognized. Breast cancer characteristics on H&E imaging correspond to collagen distortion, focal hypointensity, micro-calcification, clustered or linear lively cells et etc on FF-OCT or DCI, which could also be easily distinguished. We included the previously mentioned features to build diagnosis criteria for cancer on FF-OCT and DCI. The average acquisition time is 14±11 minutes. The sensitivity and specificity for breast cancer diagnosis were 92.1% and 94.3% respectively. The sensitivity and specificity for lymph node involvement were 92.3% and 84% respectively.

Conclusion: The time- and tissue-saving optical imaging technique yielded high accuracy that was comparable to that of traditional intraoperative and postoperative pathological diagnosis in breast cancer and lymph node metastasis. These results implied the promising application in the intraoperative evaluation and possible decrease of the re-excision rate for breast cancer surgery.

Citation Format: Yang H, Zhang S, Guo J, Xie F, Tong F, Cao Y, Liu P, Zhou B, Cheng L, Liu M, Wang S, Peng Y, Wang C, Yang Y, Ma Y, Chen D, Shen D, Wang S. Achiveing rapid intrao-operative diagnosis during breast cancer surgery using high-reloution full-field optical coherence imaging and dynamic cell imaging [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 P2-14-18.

Abstract P6-02-13: Withdrawn

This abstract was withdrawn by the authors.

Citation Format: Huang C-S, Fann JC-Y, Chen H-H, Hsu G-C, Ho M-F, Chen S-C, Chen Y-J, Chen S-T, Chen C-Y, Sheen-Chen S-M, Chang H-T, Yeh D-C, Chao M, Yeh H-T, Cheng L, Chen D-R, Chang Y-C, Chang K-J. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-02-13.

[Therapeutic effect of low-temperature radiofrequency coblation on early-stage laryngeal cancer]

Objective: To evaluate the safety,efficacy and prognosis of low-temperature plasma radiofrequency coblation for early-stage laryngeal cancer(Tis, T1 and T2). Method: A retrospective analysis of 202 patients with early-stage laryngeal cancer who underwent the low-temperature radiofrequency coblation surgery, including 34 cases of Tis(16.83%), 49 cases of stage T1aN0M0(24.26%), 50 cases of stage T1bN0M0(24.75%) and 69 cases of stage T2N0M0(34.16%). Surgical patients were followed up closely for 6 to 60 months, with a median follow-up of 29 months. Result: Of the 202 patients,165(81.68%) had no recurrence and achieved good surgical results. None of them suffered severe complications such as post-operative hemorrhage and asphyxia. 37 cases(18.32%) had recurrence, including 1 case(0.50%) in stage Tis, 7 cases(3.47%) in stage T1a,7 cases(3.47%) in stage T1b, and 22 cases(10.89%) in stage T2. Thirteen patients who had recurrence underwent total laryngectomy(5 of which had a recurrence of T3 and 8 of which progressed to T4), including 1 in the stage T1a,2 in the stage T1b, and 10 in the stage T2. Vertical hemilaryngectomy were performed in 4 cases, 3 cases of stage T1a and 1 case of stage T2; 5 cases underwent plasma radiofrequency coblation again, including 3 cases of stage T1b and 2 cases of stage T2,no recurrence was found in all the patients; 1 patient had no obvious recurrence in the larynx but had cervical lymph node metastasis, radical neck dissection was performed; 1 patient with stage T2 recurrence was treated with a tracheotomy to relieve laryngeal obstruction without further treatment;3 cases showed improvement by radiotherapy and chemotherapy treatment after recurrence; 9 death cases,5 patients died after radiotherapy and chemotherapy, and 4 patients stopped getting treatment after recurrence.Conclusion: Low-temperature radiofrequency coblation surgery for patients with early-stage laryngeal cancer has great advantages in the preservation of laryngeal function and reduction of surgical trauma after surgery compared with traditional surgical method, and can obtain satisfactory results, but the selection of surgical indications for some patients with clinical stage T2 is still need to be carefully considered..

Towards Understanding the Origin of Cosmic-Ray Positrons

Precision measurements of cosmic ray positrons are presented up to 1 TeV based on 1.9 million positrons collected by the Alpha Magnetic Spectrometer on the International Space Station. The positron flux exhibits complex energy dependence. Its distinctive properties are (a) a significant excess starting from 25.2±1.8  GeV compared to the lower-energy, power-law trend, (b) a sharp dropoff above 284_{-64}^{+91}  GeV, (c) in the entire energy range the positron flux is well described by the sum of a term associated with the positrons produced in the collision of cosmic rays, which dominates at low energies, and a new source term of positrons, which dominates at high energies, and (d) a finite energy cutoff of the source term of E_{s}=810_{-180}^{+310}  GeV is established with a significance of more than 4σ. These experimental data on cosmic ray positrons show that, at high energies, they predominantly originate either from dark matter annihilation or from other astrophysical sources.

[Correlation analysis of eosinophils in peripheral blood and polyp tissues of patients with chronicrhinosinusitis with nasal polyps]

Objective:To explore the correlation between peripheral blood eosinophils and tissue eosinophils in patients with chronic rhinosinusitis with nasal polyps(CRSwNP) in different periods.Method:This trial was a prospective study involved 342 patients with CRSwNP who were treated by endoscopic sinus surgery in the Huai'an First People's Hospital, Nanjing Medical University in 2008, 2012 and 2016. Nasal polyp resection specimens were stained by HE.Tissue eosinophils were counted per high-power field, and peripheral blood eosinophils were collected from blood routine examination before operation.The relationship between peripheral blood eosinophils and tissue eosinophils were evaluated.Result:The correlation between peripheral blood eosinophils and tissue eosinophils was positive in nasal polyps in 2008,2012 and 2016(r= 0.275,0.435,0.505, respectively). AUC values were all greater than 0.7. Conclusion:There is a positive correlation between peripheral blood eosinophils and tissue eosinophils infiltration in patients with CRSwNP. Although the cutoff value is changing, peripheral blood eosinophils can be used as an indicator for predicting eosinophilic CRSwNP.

[Mechanism of innate immunity and adaptive immunity in the development of allergic rhinitis]

The pathogenesis of allergic rhinitis (AR) has not well been clarified, and the imbalance of immune system is its important feature. Interaction between innate and adaptive immune cells and inflammatory mediators secreted by them triggers, maintains and aggravates AR. In this review, Toll-like receptor signaling pathways are used as a bridge to systematically analyze the mechanisms of innate and adaptive immunity in the development of AR.

Effect of a mixed silage of king grass (Cenchrus purpureus) and forage legumes (Leucaena leucocephala or Gliricidia sepium) on sheep intake, digestibility and nitrogen balance

Ensiled king grass (Cenchrus purpureus (Schumach.) Morrone) is commonly used as feed in tropical ruminant production. However, ruminant performance can be limited by low nitrogen (N) content in tropical grass silage. A mixed feed of legume–king grass silage may be an option to improve ruminant production. We investigated the effects of feeding an ensiled mixture of king grass forage and foliage of a browse tree legume, either leucaena (Leucaena leucocephala (Lam.) de Wit) or gliricidia (Gliricidia sepium (Jacq.) Walp), on dry matter (DM) intake, DM digestibility, organic matter (OM) digestibility and N balance of Pelibuey sheep. Twelve male lambs 9–11 months old were blocked by initial bodyweight (33 ± 3 kg, mean ± s.d.) into three groups of four lambs and randomly assigned to one of three feed treatments: king grass silage (KS); mixed king grass and leucaena silage (KLS); and mixed king grass and gliricidia silage (KGS). Results showed that DM and OM were similar among silages. The N content was higher (P &lt; 0.001) in KLS and KGS than in KS. DM intake and DM digestibility were higher (P &lt; 0.001) in KLS and KGS than in KS. OM digestibility was higher (P &lt; 0.001) in KLS than in KS. Nitrogen intake, faecal N, urine volume, urinary N, digested N, N digestibility, N retention and retained N:N intake ratio from KLS and KGS treatments were higher (P &lt; 0.05) than from KS. A lower (P &lt; 0.01) urinary N:N intake ratio was detected from KGS and KLS than from KS. This study demonstrated that, compared with silage made from king grass alone, legume–king grass silage mixtures can improve intake and nutrient digestibility in Pelibuey lambs. Further, N retention can be enhanced when legume–king grass silages are used as feed compared with king grass silage alone.

Sublingual immunotherapy of house dust mite respiratory allergy in China

Sublingual immunotherapy (SLIT) has been widely used for the treatment of allergic respiratory diseases, but many problems remain unsolved. Currently available data suggest that SLIT is very effective in children and adults with IgE-mediated respiratory diseases. Most allergists in China generally believe that SLIT is suitable for allergic rhinitis and asthma due to its safety and tolerability. SLIT for three years is suitable for patients to acquire stable therapeutic effects, and the efficacy of single-allergen SLIT for polysensitized patients has also been confirmed. Nevertheless, there are still several factors restricting its application in China, such as the uncertainty of its long-term effects and the prevention of new sensitizations onset, the risk of asthma attacks, the low public awareness of SLIT and poor compliance by patients. This is a narrative review of current evidence on SLIT coming from China.

[Clinical application of modified global osteitis score in chronic rhinosinusitis]

Objective:To compare GOSS and a newly proposed modified scoring system for assessment of CRS with osteitis.Method:Seventy-one CRS patients were enrolled prospectively.Their preoperative computed tomography (CT) were assessed for severity and extent of osteitis by two otolaryngologists using OsiriX DICOM Viewer software. The method of measurement was similar with GOSS, which retained scoring maxillary and sphenoid, producing a modified global osteitis score(rang: 0-20). Collected the history and completed VAS, SNOT-22, Lund-Kennedy, Lund-Mackay in preoperative. Postoperative follow-up mounted up to 12 months and evaluating CRS patients' outcome. Compared for test-retest and inter-rater reliability between the modified system and GOSS.Result:There is a significant linear positive correlation between Modified GOSS score and GOSS(r=0.913,P<0.001).And Modified GOSS had more association with pre and postoperative L-M and L-K scores than GOSS (r=0.316, 0.357). The modified GOSS showed the highest inter-rater and test-retest, interclass correlation coefficient (pre-ICC=0.947; post-ICC=0.943).Conclusion:Modified GOSS may be a more suitable and convenient scoring system for clinical practice to grading osteitis.

[Screening of microRNAs targeting Notch signaling pathway implicated in inner ear development and the role of microRNA-384-5p]

Objective: To screen the key microRNAs targeting Notch signaling pathway in inner ear and investigate its potential regulating function. Methods: The interaction network and the Core-Notch network, involved with key genes in Notch signal pathway and differential-expressed microRNAs in inner ear, were constructed by bioinformatics methods. The important microRNAs in regulating Notch signaling pathway were screened via topological and GO analysis, followed by in vivo and in vitro investigation. Results: MiRNA-384-5p was identified as a key regulator specifically expressed in mouse brain and inner ear, which could down-regulate Notch1. The Notch1 expression was found significantly down-regulated in miRNA-384-5p-mimic-transfected HeLa cells. The dual-luciferase reporter gene assay further confirmed the effect of miRNA-384-5p on the down-regulation of Notch1 and Dll4 in Notch signaling pathway. Conclusions: The Core-Notch network is constructed to screen microRNAs implicated in inner ear development, and miRNA-384-5p is screened and verified to be target-regulating the Notch signaling pathway, which could be the potential target in the regeneration of impaired hair cells.

[Retrospective analysis of 760 laryngeal squamous cell carcinoma patients treated with open laryngeal function-preserving operations]

Objective:To explore the fundamental clinical characteristics and survival prognostic factors of laryngeal squamous cell carcinoma (LSCC) patients treated with open laryngeal function-preserving operations. Method: The collected clinical data and the follow-up survival information from 760 patients with LSCC undergoing open laryngeal function-preserving operations between January 2005 and December 2010 in Eye & ENT Hospital of Fudan University were retrospectively analyzed. Kaplan-Meier was applied to calculate survival rates. Log-rank test and Cox regression model were performed to evaluate the survival prognostic factors for univariate and multivariate analysis. Result: Among the enrolled 760 cases, 697 patients were glottic cancer, followed by 59 cases in supraglottis and 4 cases in subglottis. The number of laryngeal cancer patients staged in T1 to T4 was 222, 420, 112 and 6, respectively. 27 patients had positive cervical lymph nodes. There were 220, 408, 111 and 21 patients with clinical stage Ⅰ to Ⅳ, respectively. The 5-year overall survival (OS), disease free survival (DFS) and disease specific survival (DSS) rates were 89.3%, 83.9% and 89.8%, respectively. Multivariate Cox analysis indicated that clinical stage and second primary tumor were independent influencing factors for the OS rate, while, age, primary site, pathological differentiation, T stage, clinical stage and surgical margin were independent risk factors for tumor recurrence and progression (P<0.05). Conclusion: Open laryngeal function-preserving operation is a crucial therapeutic strategy applicable to LSCC patients in early and selected advanced stage in China. Early diagnosis and therapy, and sufficient safety surgical margin are keys for improving the survival rate and reducing the risk of relapse for laryngeal cancer patients.

[Inflammatory priming adipose derived stem cells significantly inhibit the proliferation of peripheral blood mononuclear cells]

OBJECTIVE

To explored whether adipose derived stem cells (ASCs) could inhibit the pro-liferation of peripheral blood mononuclear cells (PBMCs) and whether inflammatory priming could enhance this property of ASCs.

METHODS

We isolated ASCs using collagenase from adipose tissue and expanded them in vitro. Cells were induced to differentiate into adipogenic and osteogenic lineages. The cells at passage 3 to passage 5 were used for the experiments. After carboxy fluoresce in succinimidyl ester (CFSE) staining, PBMCs were co-cultured with inflammatory priming ASCs. The PBMCs cultured without ASCs or with non-treated ASCs defined as control groups. Then we used flow cytometry to detect the proliferation of PBMCs.

RESULTS

ASCs had fibroblast-like phenotype and were spindle shaped. They were able to differentiate into cells of adipogenic and osteogenic lineages in specific induction media. ASCs had the CD expression profile consistant with the International Federation for Adipose Therapeutics statement. The percentage of parent cells in PBMC after co-cultured with ASCs increased, though there was no statistical significance. However, when co-cultured with inflammatory priming ASCs, the percentage of parent cells significantly increased (with inflammatory priming ASCs group vs. without ASCs group, 38.7%±10.0% vs. 28.4%±8.9%, P<0.05). This indicated that inflammatory priming ASCs could significantly inhibit the proliferation of PBMCs.

CONCLUSION

Inflammatory cytokines can enhance the immunosuppressive ability of ASCs. Our findings may help the application of ASCs in tissue repairment with better results.

[The expression characteristics and clinical significance of candidate molecular markers in vocal cord leukoplakia]

Objective: To investigate the expression of marker proteins in vocal cord leukoplakia, and to find markers for the early stage of diagnosis and prognosis of precancerous lesions. Methods: The study included 119 cases, 68 cases of vocal cord leukoplakia (22 cases with epithelial simple hyperplasia, 46 cases with epithelial dysplasia), and 51 cases of vocal cords benign lesions(31 cases of vocal cord polyps, 20 cases of Reinke's edema). The expression of p53, Ki-67, p21, Survivin, p16, p27, PTEN, c-Myc and vascular endothelial growth factor (VEGF) in vocal cords leukoplakia were detected, vocal cord benign lesions (vocal cord polyps and Reinke's edema) acted as controls, comparing the expression differences of different pathological tissue. Data was analyzed by SPSS 22.0 software. Results: The expression of p53, p16, Ki-67, VEGF in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia did not show significant differences. There was a grading increase in the positive expression of p53, Ki-67 in the vocal cord leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia (p53: χ(2)=13.340, P=0.002, Ki-67: χ(2)=53.386, P=0.000). The expression of p27, PTEN, c-Myc in vocal cord benign lesions and vocal cords leukoplakia with epithelial dysplasia did not show significant differences. There was a grading increase in the positive expression of p21 Survivin in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions (P<0.05). Expression of Survivin in vocal cords leukoplakia with mild-moderate epithelial dysplasia showed a significant increase than those in vocal cord benign lesions (P<0.05). The positive expression grade of p21 showed a rising trend (P=0.073) between the different grades of dysplasia. Conclusion: The positive expression grade of p53, Ki-67, p21 Survivin showed an increase in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions, which might be an implication for evaluating the diagnosis and prognosis of precancerous lesions. Expression of p21 was correlated to the degrees of dysplasia and expression of Survivin showed a significant difference in early stage of epithelial dysplasia contrasting to benign lesions.

Observation of Complex Time Structures in the Cosmic-Ray Electron and Positron Fluxes with the Alpha Magnetic Spectrometer on the International Space Station

We present high-statistics, precision measurements of the detailed time and energy dependence of the primary cosmic-ray electron flux and positron flux over 79 Bartels rotations from May 2011 to May 2017 in the energy range from 1 to 50 GeV. For the first time, the charge-sign dependent modulation during solar maximum has been investigated in detail by leptons alone. Based on 23.5×10^{6} events, we report the observation of short-term structures on the timescale of months coincident in both the electron flux and the positron flux. These structures are not visible in the e^{+}/e^{-} flux ratio. The precision measurements across the solar polarity reversal show that the ratio exhibits a smooth transition over 830±30 days from one value to another. The midpoint of the transition shows an energy dependent delay relative to the reversal and changes by 260±30 days from 1 to 6 GeV.

Precision Measurement of Cosmic-Ray Nitrogen and its Primary and Secondary Components with the Alpha Magnetic Spectrometer on the International Space Station

A precision measurement of the nitrogen flux with rigidity (momentum per unit charge) from 2.2 GV to 3.3 TV based on 2.2×10^{6} events is presented. The detailed rigidity dependence of the nitrogen flux spectral index is presented for the first time. The spectral index rapidly hardens at high rigidities and becomes identical to the spectral indices of primary He, C, and O cosmic rays above ∼700  GV. We observed that the nitrogen flux Φ_{N} can be presented as the sum of its primary component Φ_{N}^{P} and secondary component Φ_{N}^{S}, Φ_{N}=Φ_{N}^{P}+Φ_{N}^{S}, and we found Φ_{N} is well described by the weighted sum of the oxygen flux Φ_{O} (primary cosmic rays) and the boron flux Φ_{B} (secondary cosmic rays), with Φ_{N}^{P}=(0.090±0.002)×Φ_{O} and Φ_{N}^{S}=(0.62±0.02)×Φ_{B} over the entire rigidity range. This corresponds to a change of the contribution of the secondary cosmic ray component in the nitrogen flux from 70% at a few GV to <30% above 1 TV.