BSCI-10. NEUROLOGICAL DYSFUNCTION CAUSED BY BRAIN TUMOR-GENERATED SOLID STRESS IS REVERSED BY LITHIUM

The compression of brain tissue by a tumor mass is believed to be a major cause of the clinical symptoms seen in patients. However, the biological consequences of these physical stresses on the brain tissue are unknown. Using clinical imaging and preclinical studies, we discovered that a subgroup of primary and metastatic brain tumors, classified as nodular based on the growth pattern, exert compressive solid stress on the surrounding brain tissue, leading to a decrease in local vascular perfusion, as well as neuronal death and impaired function. We demonstrated a causal link between solid stress and neurological dysfunction, by applying and removing cerebral compression, mimicking the mechanics of tumor growth and surgical resection respectively. Finally, we showed that treatment with lithium reduced solid stress-induced neuronal death and improved motor coordination in mice. Our results indicate that brain tumor-generated solid stress impairs neurological function in patients and show lithium as a potential therapeutic intervention to counter these effects.

[Influencing factors and antenatal assessment of the vaginal birth after cesarean section]

Objective: To explore the influencing factors of the vaginal birth after cesarean section (VBAC), and establish a model for predicting the risk of trial of the trial of labor after cesarean section (TOLAC). Methods: From January 2016 to December 2018, total 694 pregnant women who underwent TOLAC in Northwest Women's and Children's Hospital were retrospectively analyzed. Those cases were divided into two groups according to the mode of delivery: the VBAC group and the failed TOLAC group. At the same time, 700 cases in the elective repeat cesarean section (ERCS) group were randomly selected as control group. The influencing factors of VBAC were analyzed by univariate and multivariate logistic regression, and the pregnancy outcomes between the three groups were compared. Results: (1) The VBAC rate was 76.1% (528/694) and 166 women underwent the failed TOLAC (23.9%, 166/694). (2) Univariate analysis found that, the pre-pregnancy body mass index (BMI) [(22.0±3.0), (23.3±2.7) kg/m(2)], the previous vaginal delivery history [10.4%(55/528), 3.6%(6/166)], the cervical score (5.2±1.9,4.3±1.6) and the neonatal birth weight [(3 315±468), (3 484±274) g] of the VBAC group were significantly different from the failed TOLAC group (P<0.05). (3) The comparison of pregnancy outcomes: the neonatal birth weight was (3 315±468) g, and the intrapartum hemorrhage volume was (255±121) ml in the VBAC group, which were significantly lower than those in the failed TOLAC group [intrapartum hemorrhage (325±173) ml] and the ERCS group [(3 572±344) g, (281±125) ml], there were statistically significant differences in the comparison among the three groups (all P<0.05). Two cases of bladder injury occurred during cesarean section in the TOLAC failure group (1.2%,2/166). The rates of the blood transfusion, puerperal infection, 5-minute Apgar score and neonatal ICU admission among the three groups were no statistically significantly different (all P>0.05). There was no maternal or perinatal death. (4) Multivariate logistic regression analysis showed that the delivery age of pregnant women (OR=0.92, 95%CI: 0.87-0.98), pre-pregnancy BMI (OR=0.92, 95%CI:0.86-0.98), vaginal delivery history (OR=3.31, 95%CI: 1.35-8.01), cervical score (OR=1.29, 95%CI: 1.13-1.42) and the birth weight of the neonates <3 300 g (OR=3.15, 95%CI: 2.02-4.90) were independent influencing factors for VBAC. The area under curve of the receiver operating characteristic curve was 0.74. Conclusions: The influencing factors of VBAC are delivery age, pre-pregnancy BMI, vaginal delivery history, cervical score and neonatal birth weight <3 300 g. The adequate individualized management and assessment of the TOLAC may be helpful to improve the VBAC rate.

Abstract 2744: Blocking CXCR4 alleviates desmoplasia, increases T-lymphocyte infiltration, and improves immunotherapy in metastatic breast cancer

Metastatic breast cancers (mBCs) are largely resistant to immune checkpoint blockade, but the mechanisms remain unclear. Primary breast cancers are characterized by a dense fibrotic stroma, which is considered immunosuppressive in multiple malignancies, but the stromal composition of breast cancer metastases and its role in immunosuppression are largely unknown. Here we show that liver and lung metastases of human breast cancers tend to be highly fibrotic, and unlike primary breast tumors, they exclude cytotoxic T-lymphocytes (CTLs). Unbiased analysis of the TCGA database of human breast tumors revealed a set of genes that are associated with stromal T-lymphocyte exclusion. Among these we focused on CXCL12 as a relevant target based on its known roles in immunosuppression in other cancer types. We found that the CXCL12 receptor CXCR4 is highly expressed in both human primary tumors and metastases. To gain insight into the role of CXCL12/CXCR4 axis, we inhibited CXCR4 and found that CXCR4 blockade decreases fibrosis, alleviates solid stress, decompresses blood vessels, increases CTL infiltration, and decreases immunosuppression in murine mBC models. We confirmed that these immunosuppressive effects are dependent on cancer-associated fibroblast (CAF) signaling through genetic deletion of Cxcr4 in aSMA+ cells. Accordingly, CXCR4 inhibition more than doubles the response to immune checkpoint blockers in mice bearing mBCs. These findings demonstrate that CXCL12/CXCR4-mediated desmoplasia in mBC promotes immunosuppression and is a potential target for overcoming therapeutic resistance to immune checkpoint blockade in mBC patients.

Citation Format: Ivy X. Chen, Vikash P. Chauhan, Jessica Posada, Mei R. Ng, Michelle Wu, Pichet Adstamongkonkul, Peigen Huang, Neal Lindeman, Robert Langer, Rakesh K. Jain. Blocking CXCR4 alleviates desmoplasia, increases T-lymphocyte infiltration, and improves immunotherapy in metastatic breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2744.

ROC study and SUV threshold using quantitative multi-modal SPECT for bone imaging

Background

We investigated the clinical performance of a quantitative multi-modal SPECT/CT reconstruction platform for yielding radioactivity concentrations of bone imaging with ^99mTc-methylene diphosphonate (MDP) or ^99mTc-dicarboxypropane diphosphonate (DPD). The novel reconstruction incorporates CT-derived tissue information while preserving the delineation of tissue boundaries. We assessed image-based reader concordance and confidence, and determined lesion classification and SUV thresholds from ROC analysis.

Methods

Seventy-two cancer patients were scanned at three US and two German clinical sites, each contributing two experienced board-certified nuclear medicine physicians as readers. We compared four variants of the reconstructed data resulting from the Flash3D (F3D) and the xSPECT Bone™ (xB) iterative reconstruction methods and presented images to the readers with and without a fused CT, resulting in four combinations. We used an all-or-none approach for inclusion, compiling results only when a reader completed all reads in a subset. After the final read, we conducted a “surrogate truth” reading, presenting all data to each reader. For any remaining discordant lesions, we conducted a consensus read. We next undertook ROC analysis to determine SUV thresholds for differentiating benign and lesional uptake.

Results

On a five-point rating scale of image quality, xB was deemed better by almost two points in resolution and one point better in overall acceptance compared to F3D. The absolute agreement of the rendered decision between the nine readers was significantly higher with CT information either inside the reconstruction (xB, xBCT) or simply through image fusion (F3DCT): 0.70 (xBCT), 0.67 (F3DCT), 0.64 (xB), and 0.46 (F3D). The confidence level to characterize the lesion was significantly higher (3.03x w/o CT, 1.32x w/CT) for xB than for F3D. There was high correlation between xB and F3D scores for lesion detection and classification, but lesion detection confidence was 41% higher w/o CT, and 21% higher w/CT for xB compared to F3D. Without CT, xB had 6.6% higher sensitivity, 7.1% higher specificity, and 6.9% greater AUC compared to F3D, and similarly with CT-fusion. The overall SUV-criterion (SUV_c) of xB (12) exceeded that for xSPECT Quant™ (xQ; 9), an approach not using the tissue delineation of xB. SUV critical numbers depended on lesion volume and location. For non-joint lesions > 6 ml, the AUC for xQ and xB was 94%, with SUV_c > 9.28 (xQ) or > 9.68 (xB); for non-joint lesions ≤ 6 ml, AUCs were 81% (xQ) and 88% (xB), and SUV_c > 8.2 (xQ) or > 9.1 (xB). For joint lesions, the AUC was 80% (xQ) and 83% (xB), with SUV_c > 8.61 (xQ) or > 13.4 (xB).

Conclusion

The incorporation of high-resolution CT-based tissue delineation in SPECT reconstruction (xSPECT Bone) provides better resolution and detects smaller lesions (6 ml), and the CT component facilitates lesion characterization. Our approach increases confidence, concordance, and accuracy for readers with a wide range of experience. The xB method retained high reading accuracy, despite the unfamiliar image presentation, having greatest impact for smaller lesions, and better localization of foci relative to bone anatomy. The quantitative assessment yielded an SUV-threshold for sensitively distinguishing benign and malignant lesions. Ongoing efforts shall establish clinically usable protocols and SUV thresholds for decision-making based on quantitative SPECT.

Methicillin-resistant Staphylococcus aureus causes sustained collecting lymphatic vessel dysfunction

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity and mortality worldwide and is a frequent cause of skin and soft tissue infections (SSTIs). Lymphedema-fluid accumulation in tissue caused by impaired lymphatic vessel function-is a strong risk factor for SSTIs. SSTIs also frequently recur in patients and sometimes lead to acquired lymphedema. However, the mechanism of how SSTIs can be both the consequence and the cause of lymphatic vessel dysfunction is not known. Intravital imaging in mice revealed an acute reduction in both lymphatic vessel contractility and lymph flow after localized MRSA infection. Moreover, chronic lymphatic impairment is observed long after MRSA is cleared and inflammation is resolved. Associated with decreased collecting lymphatic vessel function was the loss and disorganization of lymphatic muscle cells (LMCs), which are critical for lymphatic contraction. In vitro, incubation with MRSA-conditioned supernatant led to LMC death. Proteomic analysis identified several accessory gene regulator (agr)-controlled MRSA exotoxins that contribute to LMC death. Infection with agr mutant MRSA resulted in sustained lymphatic function compared to animals infected with wild-type MRSA. Our findings suggest that agr is a promising target to preserve lymphatic vessel function and promote immunity during SSTIs.

Factors Influencing Families' Decision-Making for Organ Donation in Hunan Province, China

BACKGROUND

In 2010, the Chinese government started a pilot project of donation after Chinese citizens' death. Seeking the consent of the families of potential donors is an important task in the organ donation process.

OBJECTIVE

We aimed to explore the factors that influence the families' decision-making for organ donation.

METHODS

We performed a content analysis of 30 semistructured in-depth interviews with immediate family members who made the decision for an organ donation. The interviewees were asked questions such as how the decision to donate was made, what factors influenced the decision, and whether the decision was rejected by relatives and friends.

RESULTS

The interviewees were the donors' parent (15; 50%), spouse (9; 30%), brother (3; 10%) or son (3; 10%), including 18 men and 12 women, with a mean age of 41.6 (standard deviation, 10.7) years; rural households accounted for 83.3%. Through analyzing the interview notes, 17 factors ware mentioned by interviewees, and 3 types of decision-making in organ donors' families were obtained. Then, the factors affecting the decisions of the donor families were classified into 3 categories and 11 subcategories.

CONCLUSIONS

Factors influencing the families' decision-making for organ donation were analyzed preliminarily in this study.

A puzzling pregnancy epulis with aggressive bone loss mimicking malignant neoplasm: A case report

Epulis is a benign tumor, rarely involves aggressive alveolar bone resorption. This study reported a rare case of rapid growth of pregnancy epulis with extensive alveolar bone destruction and the management of this case. A 24-year old pregnant woman at 35 weeks and 1 day of gestation presented a large asymptomatic nodular mass with severe teeth loosening at the anterior mandibular region for 4 weeks. Radiographic examination showed extensive alveolar bone resorption around the affected teeth to the apical area. After delivery, the patient received an extended resection under general anesthesia. The final histopathological analysis revealed the diagnosis of epulis. In conclusion, the rapid growth of epulis during pregnancy mimicking malignant neoplasm with aggressive alveolar bone destruction was rare and puzzling. In such cases, the histopathological and immunohistochemical examinations are the only effective method to reach the correct diagnosis and clinician should proceed with high precaution.

Analysis of Forensic Sciences Literature in SCIE from 2008 to 2017

OBJECTIVES

To analyze the literature on forensic sciences indexed in Science Citation Index Expanded （SCIE） in recent 10 years, and to understand the research status, characteristics and trends in the field of forensic sciences.

METHODS

Literature on forensic sciences from 2008 to 2017 in Web of Science （WoS） was retrieved. The documents number and geographical distribution, document types, source titles, organizations, research areas, authors, funding agencies, and the high cited articles were detected. The impact factors （IF） of journals were retrieved in Journal Citation Reports （JCR）. The data were analyzed with descriptive statistics.

RESULTS

From 2008 to 2017, there were 21 001 documents on forensic sciences in SCIE. The main document type was articles, with English as the major language. With regards to research areas, pathology has the largest number of papers worldwide, and genetics and heredity has the largest number of publications in mainland China. Among the 18 journals where the documents was published, Forensic Science International ranks the first on publication count, and Forensic Science International Genetics has the highest IF （5.637） in the JCR 2017. In 2017, the number of papers from mainland China increased by 48.50% compared with 2016, which was higher than the global increase （32.63%） and the top-5 countries in terms of number of publications （the US, Germany, the UK, Australia, Italy）. The average document count per organization is 1.98 worldwide and 1.17 in mainland China, respectively. The publication number per author is 0.53 worldwide and 0.36 in mainland China, respectively. Around 28.17% of the publications were funded, with National Natural Science Foundation of China （NSFC） as the Top 1 funding agency （192 papers）. Among the documents with citations, the most cited publication has been cited for 366 times.

CONCLUSIONS

The yearly numbers of publications on forensic sciences are increasing during recent 10 years. Focusing on the mainland China, there would be more high-quality papers with the steady funding of NSFC.

Classification of water contamination developed by 2-D Gabor wavelet analysis and support vector machine based on fluorescence spectroscopy

The identification of the specific categories of pollutants in the urban water supply system is necessary. Traditional detection methods are based mainly on common water quality indicators. However, inspecting these water quality indicators is made difficult by issues such as long analysis time, insufficient sensitivity, need for reagents, and generation of waste liquid. These problems hinder high-frequency water detection and monitoring. In this study, three-dimensional (3D) fluorescence spectroscopy is adopted as a monitoring method for water quality. An identification method based on two-dimensional (2D) Gabor wavelets and support vector machine (SVM) multi-classification is also proposed. The Delaunay triangulation method for interpolation is used to pre-process 3D fluorescence spectra and thereby eliminate Rayleigh scattering and Raman scattering. A 2D Gabor wavelet function generated by filters of different scales and rotation angles is proposed to extract the features of the spectra. The block statistics method, based on Gabor feature description, is employed to enhance the efficiency in describing spectra features. Then, multiple SVM classifiers are used in pollutant classification and recognition. By comparing the proposed method with principal component analysis, which is a commonly used feature extraction method, this study finds that the application of 2D Gabor wavelets and block statistics can effectively describe the characteristics of 3D fluorescence spectra. Moreover, 2D Gabor wavelets achieve high classification accuracy, especially for substances with closely positioned or overlapping characteristic peaks.

Infrared Spectral Characteristics of Electrical Injuries on Swine Skin Caused by Different Voltages Based on Machine Learning Algorithms

OBJECTIVES

To explore infrared spectrum characteristics of different voltages induced electrical injuries on swine skin by using Fourier transform infrared-microspectroscopy （FTIR-MSP） combined with machine learning algorithms, thus to provide a reference to the identification of electrical skin injuries caused by different voltages.

METHODS

Electrical skin injury model was established on swines. The skin was exposed to 110 V, 220 V and 380 V electric shock for 30 s and then samples were took, with normal skin tissues around the injuries as the control. Combined with the results of continuous section HE staining, the FTIR-MSP spectral data of the corresponding skin tissues were acquired. With the combination of machine learning algorithms such as principal component analysis （PCA） and partial least squares-discriminant analysis （PLS-DA）, different spectral bands were selected （full band 4 000-1 000 cm^-1 and sub-bands 4 000-3 600 cm^-1, 3 600-2 800 cm^-1, 2 800-1 800 cm^-1, and 1 800-1 000 cm^-1）, and various pretreatment methods were used such as orthogonal signal correction （OSC）, standard normal variables （SNV）, multivariate scatter correction （MSC）, normalization, and smoothing. Thus, the model was optimized, and the classification effects were compared.

RESULTS

Compared with simple spectrum analysis, PCA seemed to be better at distinguishing electrical shock groups from the control, but was not able to distinguish different voltages induced groups. PLS-DA based on the 3 600-2 800 cm^-1 band was used to identify the different voltages induced skin injuries. The OSC could further optimize the robustness of the 3 600-2 800 cm^-1 band model.

CONCLUSIONS

It is feasible to identify electrical skin injuries caused by different voltages by using FTIR-MSP technique along with machine learning algorithms.

[Prevalence and risk factors of diabetic retinopathy in hospital patients]

Objective: To analyze the prevalence and risk factors of diabetic retinopathy (DR) in ophthalmic patients. Methods: A cross-sectional study was performed. Diabetic patients who were admitted to Department of Ophthalmology, Traditional Chinese Medicine Hospital of Muping between October 2012 and June 2013 were included. General information and medical history were obtained from each subject by questionaires. Laboratory and detailed ophthalmic examinations were performed during the study. DR was diagnosed and graded by mydriatic fundus photography. Prevalence of DR was calculated and logistic regression was used to analyze the relationship between DR and various factors. Results: A total of 676 diabetic patients were included, and 455 of them presented with DR at a morbidity rate of 67.31%. Among DR patients, the number of mild, moderate, severe non-proliferative diabetic retinopathy (NPDR) patients and proliferative diabetic retinopathy (PDR) patients were 211 (46.37%), 167 (36.70%), 57 (12.53%) and 20 (4.40%), respectively. There was no significant difference in the prevalence of DR among different age groups (χ(2)=6.527, P=0.089). However, there was a significant difference between different disease duration groups (χ(2)=39.401, P<0.001), as well as between insulin therapy group and non-insulin therapy group (χ(2)=7.378, P=0.007). The multivariate logistic regression analysis demonstrated the independent risk factors for DR occurrence were hemoglobin A1c (HbA1c) (OR=1.131, 95%CI: 1.022-1.252, P=0.011) and duration of diabetes (OR=1.077, 95%CI: 1.046-1.108, P<0.001). Conclusions: The prevalence of DR in ophthalmic patients was associated with duration of diabetes, HbA1c, obesity, smoke, nephropaty and insulin therapy. Increased HbA1c level and longer duration of diabetes were independent risk factors for DR in diabetic patients.

Convective-Dispersion Modeling in 3D Contrast-Ultrasound Imaging for the Localization of Prostate Cancer

Despite being the solid tumor with the highest incidence in western men, prostate cancer (PCa) still lacks reliable imaging solutions that can overcome the need for systematic biopsies. Dynamic contrast-enhanced ultrasound imaging (DCE-US) allows us to quantitatively characterize the vascular bed in the prostate, due to its ability to visualize an intravenously administered bolus of contrast agents. Previous research has demonstrated that DCE-US parameters related to the vascular architecture are useful markers for the localization of PCa lesions. In this paper, we propose a novel method to assess the convective dispersion (D) and velocity (v) of the contrast bolus spreading through the prostate from three-dimensional (3D) DCE-US recordings. By assuming that D and v are locally constant, we solve the convective-dispersion equation by minimizing the corresponding regularized least-squares problem. 3D multiparametric maps of D and v were compared with 3D histopathology retrieved from the radical prostatectomy specimens of six patients. With a pixel-wise area under the receiver operating characteristic curve of 0.72 and 0.80, respectively, the method shows diagnostic value for the localization of PCa.

Current Research and Prospects on Postmortem Interval Estimation

The researches on postmortem interval （PMI） estimation are very important and meaningful in forensic science. PMI estimation is also an important issue that must be solved in practice of forensic pathology. There are many defects existing in traditional methods for PMI estimation, so it is imperative to introduce new pathways. With the emergence of various new technologies, the researches on PMI estimation have a tendency from simple to complex with a growth of data. The present review firstly summarizes a series of methods used for PMI estimation, and then gives an outlook for the application of artificial intelligence algorithms in this field.

[Effects of Temperature on FTIR Spectral Characteristics of Renal Tissue in Rats after Death]

OBJECTIVES

To analyse the Fourier transform infrared （FTIR） spectral data of renal tissue at different temperatures in rats after death, and to explore the effects of temperature on the FTIR spectral characteristics of renal tissue.

METHODS

The rats were sacrificed by cervical dislocation and placed at 4 ℃, 20 ℃ and 30 ℃. The FTIR spectral data of renal tissue were collected at different time points and analysed by data mining method.

RESULTS

The principal component analysis （PCA） results showed that there were significant trends of clustering in the samples of partial time point at 4 ℃, 20 ℃ and 30 ℃. Partial least square （PLS） regression models were established with the spectral data at three temperature groups. The performance of PLS regression models in 20 ℃ and 30 ℃ groups were more superior than that in 4 ℃ group, and the stability of the model in 20 ℃ group was better than that in 30 ℃ group.

CONCLUSIONS

There are differences in the FTIR spectral characteristics of renal tissue of rats after death at different temperatures. Temperature has a major impact on the performance of FTIR spectral PLS regression model. Therefore, in order to improve the accuracy of postmortem interval estimation, the effects of temperature on the model should be considered in the related study by spectral method.

Abstract 95: Heparan sulfate and glypican-1 mediate renal carcinoma metastasis

The surface proteoglycan/glycoprotein layer (glycocalyx) on tumor cells has been associated with cellular functions that can potentially enable invasion and metastasis. In addition, aggressive renal carcinoma cells (SN12L1) with high metastatic potential have enhanced invasion rates compared to low metastatic (SN12C) cells in response to interstitial flow stimuli in vitro. Our previous studies suggest that heparan sulfate (HS) and hyaluronic acid (HA) in the glycocalyx play an important role in this flow mediated mechanotransduction and upregulation of invasive and metastatic potential. In our recent study, SN12L1 cells were genetically modified to suppress HS production by knocking down its synthetic enzyme NDST1. Using modified Boyden chambers with defined interstitial flow, we showed that flow-enhanced invasion is suppressed in HS deficient cells. We also examined two prominent HSPGs on renal carcinoma cells, glypican-1 and syndecan-1, and one prominent HA receptor, CD44. We observed higher glypican-1 levels in flow dependent SN12L1 cells when compared to SN12C cells. Caki-1 (highly metastatic) cells did not display flow-dependent invasion in vitro and did not display elevated glypican-1 compared to low metastatic Caki-2 cells. However, we did observe significantly increased HS, HA, syndecan-1 and CD44 in Caki-1 compared to Caki-2 cells suggesting an alternative mechanism for reported higher metastatic rates in these cells. All of our data are consistent with the hypothesis that glypican-1 is the core protein responsible for flow sensing in metastatic cancer cells. This is also consistent with observations in endothelial cells. To assess the ability of tumor cells to metastasize in vivo, parental or HS knockdown SN12L1 cells expressing fluorescent reporters were injected into kidney capsules in SCID mice. Histological analysis confirmed that there was a large reduction (95%) in metastasis to distant organs by tumors formed from knockdown cells compared to control cells with intact HS. The reduction was even greater (98%) in lungs where most of the metastases from the control cells were observed. The ability of these knockdown cells to invade surrounding tissue was also impaired. The substantial inhibition of metastasis and invasion upon reduction of HS suggests an active role for the tumor cell glycocalyx and glypican-1 in tumor progression.

Citation Format: Henry Qazi, Heriberto Moran, Limary M. Cancel, Mariya Mayer, Sylvie Roberge, Peigen Huang, Lance L. Munn, John M. Tarbell. Heparan sulfate and glypican-1 mediate renal carcinoma metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 95.

[Epidemiology related to soil-borne nematode disease in Danzhou city, Hainan province]

Objective: To understand the prevalence, trend and related factors on soil-borne nematode in Danzhou city to provide information for prevention and control of the disease. Methods: According to the guidelines set by the National National soil-borne nematode technical solutions, one village was randomly chosen from every township as the monitoring location, in the east, west, south and north parts of Danzhou city. A total of 200 residents aged 3 years and over were randomly selected in each monitoring site, with modified Kato thick smear and Cellophane tape anal swab used for microscopy. Results: In this survey, we retrospectively analyzed the rates on soil borne nematode infection in five monitoring locations of Danzhou city and the results showed that the overall positive rates of infection was 19.5% (195/1 000). Comparing with the previous surveys, rates on soil-borne parasites infection were decreasing. The main types of soil-borne nematode infection appeared as roundworm, whipworm, hookworm and pinworm in Danzhou city, with rate of hookworm-egg infection ranking the highest (42.5%, 85/200) in Dacheng. The infection rate was seen significantly higher in females than males. People aged over 60 and between 3-10, had a higher rates of infection. Rate on multiple infections reached 16.9%, including 5 triple infection cases. Conclusion: Rates of infection on soil-borne nematodes in Danzhou city showed a decreasing trend from 2013 to 2016 with hookworm and whipworm as the major ones.

Laser-Induced Skyrmion Writing and Erasing in an Ultrafast Cryo-Lorentz Transmission Electron Microscope

We demonstrate that light-induced heat pulses of different duration and energy can write Skyrmions in a broad range of temperatures and magnetic field in FeGe. Using a combination of camera-rate and pump-probe cryo-Lorentz transmission electron microscopy, we directly resolve the spatiotemporal evolution of the magnetization ensuing optical excitation. The Skyrmion lattice was found to maintain its structural properties during the laser-induced demagnetization, and its recovery to the initial state happened in the sub-μs to μs range, depending on the cooling rate of the system.

Abstract P2-02-11: Not presented

This abstract was not presented at the symposium.

Abstract P2-05-12: Not presented

This abstract was not presented at the symposium.

[Research Progress of MALDI-TOF-IMS in Biomedicine and Its Application Prospect in Forensic Sciences]

Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry （MALDI-TOF-IMS） can analysis unknown compounds in sections and obtain molecule imaging by scanning biological tissue sections, which has become a powerful tool for the research of biomarker, lipid distribution and drug metabolism, etc. This article reviews the application of this technique in protein identification, clinical application, drug discovery, lipid research and brain injury.

Structural responses of metallic glasses under neutron irradiation

Seeking nuclear materials that possess a high resistance to particle irradiation damage is a long-standing issue. Permanent defects, induced by irradiation, are primary structural changes, the accumulation of which will lead to structural damage and performance degradation in crystalline materials served in nuclear plants. In this work, structural responses of neutron irradiation in metallic glasses (MGs) have been investigated by making a series of experimental measurements, coupled with simulations in ZrCu amorphous alloys. It is found that, compared with crystalline alloys, MGs have some specific structural responses to neutron irradiation. Although neutron irradiation can induce transient vacancy-like defects in MGs, they are fully annihilated after structural relaxation by rearrangement of free volumes. In addition, the rearrangement of free volumes depends strongly on constituent elements. In particular, the change in free volumes occurs around the Zr atoms, rather than the Cu centers. This implies that there is a feasible strategy for identifying glassy materials with high structural stability against neutron irradiation by tailoring the microstructures, the systems, or the compositions in alloys. This work will shed light on the development of materials with high irradiation resistance.

Disrupting G6PD-mediated Redox homeostasis enhances chemosensitivity in colorectal cancer

Glucose-6-phosphate dehydrogenase (G6PD) is a key enzyme that generates NADPH to maintain reduced glutathione (GSH), which scavenges reactive oxygen species (ROS) to protect cancer cell from oxidative damage. In this study, we mainly investigate the potential roles of G6PD in colorectal cancer (CRC) development and chemoresistance. We discover that G6PD is overexpressed in CRC cells and patient specimens. High expression of G6PD predicts poor prognosis and correlated with poor outcome of oxaliplatin-based first-line chemotherapy in patients with CRC. Suppressing G6PD decreases NADPH production, lowers GSH levels, impairs the ability to scavenge ROS levels, and enhances oxaliplatin-induced apoptosis in CRC via ROS-mediated damage in vitro. In vivo experiments further shows that silencing G6PD with lentivirus or non-viral gene delivery vector enhances oxaliplatin anti-tumor effects in cell based xenografts and PDX models. In summary, our finding indicated that disrupting G6PD-mediated NADPH homeostasis enhances oxaliplatin-induced apoptosis in CRC through redox modulation. Thus, this study indicates that G6PD is a potential prognostic biomarker and a promising target for CRC therapy.

MicroRNA-378 enhances radiation response in ectopic and orthotopic implantation models of glioblastoma

Glioblastoma multiforme (GBM) is the most common and highly malignant primary brain tumor, which is virtually incurable due to its therapeutic resistance to radiation and chemotherapy. To develop novel therapeutic approaches for treatment of GBM, we examined the role of miR-378 on tumor growth, angiogenesis, and radiation response in ectopic and orthotopic U87 glioblastoma models. Cell and tumor growth rates, in vitro and in vivo radiation sensitivities, and tumor vascular density were evaluated in U87-GFP and U87-miR-378 tumor lines. Ectopic tumor response to radiation was evaluated under normal blood flow and clamp hypoxic conditions. Results show that in vitro, miR-378 expression moderately increased cell growth rate and plating efficiency, but did not alter radiation sensitivity. U87-miR-378 tumors exhibited a higher transplantation take rate than U87-GFP tumors. In vivo, under oxygenated condition, subcutaneous U87-miR-378 tumors receiving 25 Gy showed a tendency for longer tumor growth delay (TGD) than control U87-GFP tumors. In contrast, under hypoxic condition, U87-miR-378 xenografts exhibited substantially shorter TGD than U87-GFP tumors, indicating that under normal blood flow conditions, U87-miR-378 tumors were substantially more oxygenated than U87-GFP tumors. Intracranial multi-photon laser-scanning microscopy demonstrated increased vascular density of U87-miR-378 versus control U87-GFP tumors. Finally, miR-378 increased TGD following 12 Gy irradiation in U87 intracranial xenografts, and significantly prolonged survival of U87-miR-378 tumor-bearing mice (P = 0.04). In conclusion, higher miR-378 expression in U87-miR-378 cells promotes tumor growth, angiogenesis, radiation-induced TGD, and prolongs survival of orthotopic tumor-bearing hosts. Regulation of VEGFR2 by miR-378 significantly increased vascular density and oxygenation in U87 xenografts.

Effects of IL-10 on iron metabolism in LPS-induced inflammatory mice via modulating hepcidin expression

OBJECTIVE

Body's iron metabolism is at one dynamic balance status, and abnormal iron metabolism may lead to renal anemia. Inflammation stimuli may lead to abnormal iron metabolism and aggravation of chronic failure anemia. Hepcidin can regulate iron metabolic homeostasis, further mediating renal anemia. Interleukin-10 (IL-10) is an inflammatory inhibitor, but with an unclear function in the regulation of hepcidin expression.

MATERIALS AND METHODS

BALB/c mice were randomly assigned into three groups: control group; lipid polysaccharide (LPS) group, which received 0.1 mg/kg LPS via tail veins; IL-10 group with 0.2 mg/kg IL-10 injection after LPS. Red blood cell count (RBC), hemoglobulin (Hb), hematocrit (HCT), mean corpuscular volume (MCV) and iron content in hemoglobulin were measured. Real-time PCR quantified hepcidin mRNA expression in all groups. Enzyme linked immunosorbent assay (ELISA) tested serum hepcidin, IL-6 and tumor necrosis factor-α (TNF-α) levels. Western blot analyzed expression of mouse transferrin receptor 2 (TfR2) and hepcidin signal pathway molecule STAT3.

RESULTS

LPS model group had lower RBC, Hb, HCT, MCV and iron content in Hb, plus elevated hepcidin, IL-6, TNF-α, TfR2 and STAT3 expression (p < 0.05 compared to the control group). IL-10 treatment group significantly facilitated RBC, Hb, HCT, MCV and Hb iron contents in LPS-induced inflammatory model mice, which also had lower hepcidin, IL-6, TNF-α, TfR2 or STAT3 expression (p < 0.05 compared to LPS group).

CONCLUSIONS

IL-10 can improve iron metabolism and alleviate anemia via suppressing inflammatory factor, modulating STAT3 signal pathway, down-regulating hepcidin expression and inhibiting TfR expression.

Cost-effectiveness analysis of fulvestrant versus anastrozole as first-line treatment for hormone receptor-positive advanced breast cancer

Although recent studies demonstrated that fulvestrant is superior to anastrozole as first-line treatment for hormone receptor (HR)-positive advanced breast cancer, the cost-effectiveness of fulvestrant versus anastrozole remained uncertain. Thus, the current study aimed to evaluate the cost-effectiveness of fulvestrant compared with anastrozole in the first-line setting. A Markov model consisting of three health states (stable, progressive and dead) was constructed to simulate a hypothetical cohort of patients with HR-positive advanced breast cancer. Costs were calculated from a Chinese societal perspective. Health outcomes were measured in quality-adjusted life-year (QALY). The incremental cost-effectiveness ratio (ICER) was expressed as incremental cost per QALY gained. Model results suggested that fulvestrant provides an additional effectiveness gain of 0.11 QALYs at an incremental cost of $32,654 compared with anastrozole, resulting in an ICER of $296,855/QALY exceeding the willingness-to-pay threshold of $23,700/QALY. Hence, fulvestrant is not a cost-effective strategy compared with anastrozole as first-line treatment for HR-positive advanced breast cancer.

[Related factors for severe liver fibrosis in chronic hepatitis C patients with remunerated blood donation history in Jurong of Jiangsu province]

Objective: The incidence of liver fibrosis in patients with chronic hepatitis C is high. Without effective treatment, it would lead to liver cirrhosis. This study is to identify the related factors for the incidence of liver fibrosis in patients with chronic hepatitis C in order to make early intervention treatment and reduce the case fatality rate. Methods: This cross-sectional survey was conducted in adults aged ≥50 years with local residence for more than 5 years in Jurong of Jiangsu province from March to May in 2015, the patients infected with hepatitis C virus through remunerated blood donation were screened and included in the analysis. Descriptive statistical analysis was done to compare the differences in the incidence of liver fibrosis among the patients with different age, sex and education level or co-infected with hepatitis B virus or not. The risk factors for severe liver fibrosis were identified with univariate and multivariate logistic regression analysis. Liver fibrosis was diagnosed by using FIB-4 index method. Results: A total of 719 patients with chronic hepatitis C were surveyed. Severe liver fibrosis developed in 285 of the 719 patients, in whom 21.84% was males. Multivariate logistic regression analysis showed that the patients with higher education level (OR=0.65, 95%CI: 0.47-0.90) and with access of antiviral therapy (OR=0.33, 95%CI: 0.22-0.49) had lower risk for severe liver fibrosis, the patients with high fasting blood glucose level (OR=1.80, 95% CI: 1.19-2.77) and abnormal white blood cell count (OR=2.77, 95% CI: 1.95-3.90) had higher risk for severe liver fibrosis. Conclusions: The incidence of severe liver fibrosis in patients with hepatitis C was affected by many factors. Higher education level and antiviral therapy were the protective factors, but high fasting blood glucose level and abnormal white blood cell count were the risk factors.

[Correlation of matrix metalloproteinase-9 polymorphisms with chronic periodontitis in Uygur adults]

Objective: To investigate the association between matrix metalloproteinase-9 (MMP-9) polymorphisms and chronic periodontitis in Uygur adults. Methods: A total of 196 patients with chronic periodontitis and 97 healthy controls were selected from 2 500 Uygur people. Buccal swab samples were taken, the genomic DNA was extracted and the genotype distribution and allele frequency of MMP-9 were determined by PCR-restriction fragment length polymorphism (PCR-RFLP). The distribution of genotypes, allele frequencies and risk factors were analyzed by chi-square test and multiple logistic regression. Results: Significant difference was found between healthy controls and the mild periodontitis and moderate to severe periodontitis in the MMP-9 1562C/T CC genotype expression (χ(2)=9.901, P=0.002; χ(2)=13.397, P< 0.001), and detectable rate of MMP-9 1562C/T CC genotype in the three groups was 31.3%(30/96), 53.5% (53/99), 27.8%(27/97), respectively. The detectable rate of CT genotype expression in the three groups were 65.6% (63/96), 45.5% (45/99), 69.1% (67/97) respectively and there was significant difference between healthy controls and mild periodontitis and between the mild periodontitis and moderate to severe periodontitis (χ(2)=8.025, P=0.005; χ(2)=11.159, P<0.001). There was also significant difference in allele frequency between healthy controls and mild periodontitis and between mild periodontitis and moderate to severe periodontitis (χ(2)=6.270, P=0.012; χ(2)=8.184, P=0.004). Logistic analysis showed that age under 35 years old was the protective factor of chronic periodontitis (OR=0.061, 95% CI=0.035-0.108, P<0.001) while the male and CT genotype were the risk factors of chronic periodontitis (OR=2.392, 95%CI=1.496-3.819, P<0.001; OR=1.280, 95%CI=0.794-2.067, P=0.031). Conclusions: The susceptibility to chronic periodontitis in Uygur adults in Moyu county of Xinjiang is related to the age and gender and polymorphism of MMP-9. The age over 35 years old, male and CT genotype may be the risk factors of chronic periodontitis in Uygur adults.

MicroRNA-378 enhances inhibitory effect of curcumin on glioblastoma

Glioblastoma multiforme is the most aggressive and common primary brain tumor, and is virtually incurable due to its therapeutic resistance to radiation and chemotherapy. Curcumin is a well-known phytochemical exhibiting antitumor activity on many human cancers including glioblastoma multiforme. Given the unique miRNA expression profiles in cancer cells compared to non-cancerous cells, we investigated whether these miRNA could be used to cancer therapy. In this report we show that miR-378, a glioblastoma multiforme down regulated miRNA, may enhance the inhibitory effect of curcumin on this cancer growth. Our results indicated that the inhibitory effect of curcumin was enhanced in miR-378-expressing stable U87 cells in vitro and in vivo, compared to control cells. MiR-378 was found to target p-p38 expression, underlying the observed phenotypic changes. Thus, we concluded that miR-378 enhances the response of glioblastoma multiforme to curcumin treatment, by targeting p38.

ITD mutation in FLT3 tyrosine kinase promotes Warburg effect and renders therapeutic sensitivity to glycolytic inhibition

Internal tandem duplication (ITD) mutation in Fms-like tyrosine kinase 3 gene (FLT3/ITD) represents an unfavorable genetic change in acute myeloid leukemia (AML) and is associated with poor prognosis. Metabolic alterations have been involved in tumor progression and attracted interest as a target for therapeutic intervention. However, few studies analyzed the adaptations of cellular metabolism in the context of FLT3/ITD mutation. Here, we report that FLT3/ITD causes a significant increase in aerobic glycolysis through AKT-mediated upregulation of mitochondrial hexokinase (HK2), and renders the leukemia cells highly dependent on glycolysis and sensitive to pharmacological inhibition of glycolytic activity. Inhibition of glycolysis preferentially causes severe ATP depletion and massive cell death in FLT3/ITD leukemia cells. Glycolytic inhibitors significantly enhances the cytotoxicity induced by FLT3 tyrosine kinase inhibitor sorafenib. Importantly, such combination provides substantial therapeutic benefit in a murine model bearing FLT3/ITD leukemia. Our study suggests that FLT3/ITD mutation promotes Warburg effect, and such metabolic alteration can be exploited to develop effective therapeutic strategy for treatment of AML with FLT3/ITD mutation via metabolic intervention.

Abstract A45: Obesity-induced inflammation and desmoplasia promote pancreatic cancer progression and resistance to chemotherapy

Introduction: With the current epidemic of obesity, the majority of pancreatic cancer patients are overweight or obese at diagnosis. Importantly, obesity worsens treatment outcomes in pancreatic cancer patients. Therefore, understanding the mechanisms that underlie the poorer prognosis of obese cancer patients is of paramount importance. Obesity causes inflammation and fibrosis in the normal pancreas due to the accumulation of dysfunctional hypertrophic adipocytes. Importantly, desmoplasia—a fibro-inflammatory microenvironment—is a hallmark of pancreatic ductal adenocarcinoma (PDAC), and we have shown that activation of pancreatic stellate cells (PSCs) via angiotensin-II type 1 receptor (AT1) pathway is a major contribution to tumor desmoplasia. Whether obesity affects inflammation, PSCs and desmoplasia in PDACs, and interferes with delivery and response of chemotherapeutics is currently unknown.

Experimental Design: Using mouse models of PDAC—multiple syngeneic models of PDAC: PAN02, AK4.4, KPC, iKRAS in diet-induced and genetic obese mouse models—we determined the effects of obesity on desmoplasia and inflammation, tumor growth and delivery and response to chemotherapy. We further evaluated whether the obesity-induced effects were mediated by AT1 signaling as well as via immune cell recruitment, and dissected the crosstalk between PSCs, cancer-associated adipocytes (CAAs), and tumor-associated neutrophils (TANs). In addition, we determined if an anti-diabetic drug metformin could counter these effects in vivo, and further dissected the mechanism of action in vitro.

Results: We found that obesity aggravates desmoplasia in PDACs in multiple mouse models. In addition, tumors in obese mice presented with elevated levels of activated PSCs and fibrosis, as well as inflammatory cytokines and TANs. These alterations in the tumor microenvironment in obesity associated with accelerated tumor growth, reduced tumor blood perfusion and increased hypoxia, and impaired delivery and efficacy of chemotherapeutics. Genetic ablation and pharmacological inhibition (losartan) of AT1 signaling reversed obesity-augmented desmoplasia and tumor growth, and improved the response to chemotherapy to the level observed in lean mice. We further discovered the underlying mechanisms: 1) obesity increases intra-tumor adipocytes and IL-1ß secretion by these cells; 2) increased IL-1ß induces TAN recruitment; 3) recruited TANs activate PSCs; and 4) activated PSCs enhance desmoplasia. Conversely, activated PSCs also secrete IL-1ß that recruits further TANs. Hence, inactivation of PSCs through AT1 blockade resulted in not only decreased fibrosis but also reduced IL-1ß level and TAN recruitment. Furthermore, reduction of either TANs, IL-1ß, or PSC activation reduced tumor growth in obese mice. These findings suggest that crosstalk between adipocytes, immune cells, and PSCs exacerbates desmoplasia and promotes tumor progression during obesity. Of clinical relevance, we found that metformin not only normalizes the abnormal systemic metabolism, but also alleviates the fibro-inflammatory microenvironment in pancreatic cancer in obesity/diabetes. This occurred via direct reprogramming of PSCs and immune cells by metformin. Importantly, the strategies described above were not effective in the normal weight setting.

Conclusion: Here we successfully demonstrated that targeting desmoplasia, including immunomodulation with anti-IL-1ß, or treatment with generic drugs such as losartan and metformin are potential strategies to potentiate treatments in PDAC patients with excess weight. With a better understanding of the mechanisms by which obesity promotes tumor progression and therapy resistance, we will be able to improve the current standard of care in pancreatic cancer.

Citation Format: Joao Incio, Hao Liu, Priya Suboj, Shan Min, Ivy Chen, Mei Ng, Hadi Nia, Jelena Grahovac, Shannon Kao, Suboj Babykutty, Yuhui Huang, Keehoon Jung, Nuh Rahbari, Xiaoxing Han, Vikash Chauhan, John Martin, Julia Kahn, Peigen Huang, Vikram Deshpande, James Michaelson, Cristina Ferrone, Raquel Soares, Yves Boucher, Dai Fukumura, Rakesh Jain. Obesity-induced inflammation and desmoplasia promote pancreatic cancer progression and resistance to chemotherapy. [abstract]. In: Proceedings of the AACR Special Conference on Engineering and Physical Sciences in Oncology; 2016 Jun 25-28; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2017;77(2 Suppl):Abstract nr A45.

[HCV infection status and risk factors in remunerated blood donors in Jiangsu province]

OBJECTIVE

To investigate the infection status of HCV in remunerated blood donors and risk factors in Jiangsu province.

METHODS

A Cross-sectional study was conducted among people aged >50 years. Questionnaires were used to collect the information about their demographic characteristics and risk behaviors, and venous blood samples were collected from them to detect HCV anti-body, HCV-RNA and other biochemical indicators. EpiData and Stata were used for data entry and statistical analysis.

RESULTS

The overall HCV sero-prevalence rates were 22.55% and 61.05% among remunerated blood donors. Data from multiple stepwise regression analysis showed that alanine aminotransferase(ALT)(adjusted OR=1.38, 95%CI: 1.18-1.62)and aspartate aminotransferase(AST)(adjusted OR=1.30, 95%CI: 1.10-1.54)were associated with the outcomes of HCV infection, and fasting plasma glucose(adjusted OR=1.17, 95%CI: 1.01-1.35)were associated with HCV RNA viral loads.

CONCLUSION

The prevalence of HCV infection in remunerated blood donors was high, clinical ALT, AST and fasting plasma glucose levels were associated with the risk for HCV infection and HCV RNA viral load.