[Experts consensus on MRI examination specification and diagnostic criteria of temporomandibular joint disc displacement]

The document represented the consensus amongst the professionals from the Society of TMD & Occlusion, Chinese Stomatological Association and provided guidelines with the MRI examination specification and diagnostic criteria of temporomandibular joint disc displacement.

Limited Protection Conferred by Recombinant Newcastle Disease Virus Expressing Infectious Bronchitis Spike Protein

Recombinant Newcastle disease virus (NDV) LaSota (LS) expressing secreted trimeric spike (S)-ectodomain (Se) of infectious bronchitis virus (IBV) (rLS/IBV.Se) was developed and evaluated for protection conferred against IBV challenge. The IBV S-ectodomain protein, which is S excluding the transmembrane anchor and short cytoplasmic domain of S2, expressed from recombinant LS corresponds to an Arkansas (Ark)-type IBV. In a first experiment, chickens were primed at 1 day of age or primed at 1 day of age and boosted at 14 days of age with 10⁴ 50% embryo infectious doses (EID₅₀)/bird of rLS/IBV.Se and challenged with a virulent Ark strain. A single vaccination proved completely ineffective at protecting chickens against challenge, whereas priming and boosting reduced clinical signs and tracheal lesions but did not reduce viral load in lachrymal fluids. In experiment 2, the vaccine dose was increased to 10⁷ EID₅₀/bird and a different virulent Ark strain was used for challenge. In addition, chickens were singly immunized on either day 1 or day 10 after hatch. NDV antibody levels detected in vaccinated chickens were moderate, with hemagglutination inhibition titers varying between 4 and 5 log₂. Slightly higher antibody levels to NDV were observed in chickens vaccinated on day 10 versus day 1 but without the difference achieving statistical significance. In contrast, antibody responses measured using recombinant IBV S1 protein-coated ELISA plates were significantly greater in chickens vaccinated on day 10 than on day 1. The use of a higher rLS/IBV.Se dose substantially enhanced the success of a single vaccination compared to experiment 1. Signs and tracheal lesions were reduced more effectively in chickens vaccinated at day 10 after hatch. However, as in experiment 1, vaccination did not reduce the viral loads in tear fluids of challenged chickens. Similar results, in which no reduction in viral load in the trachea was apparent from rLS/IBV.S vaccination, have been obtained by others. Further work is needed to understand the immune responses induced by this recombinant virus that seems to provide some protection against the disease but does not reduce viral loads in the upper respiratory tract.

Effects of spatial variation in water quality and hydrological factors on environmental flows

Environmental flow is the quantity, timing, and quality of water flows required to sustain freshwater and estuarine ecosystems and the human livelihoods and well-being that depend on these ecosystems. Environmental flows (e-flows) are crucial parameters for ecosystem restoration. Understanding the effects of spatial variation in the hydrological and water quality factors on e-flows aids the determination of recovery prior areas and helps to improve the success rate of ecosystem restoration projects. However, few studies have investigated the effects, which severely hinder the restoration of aquatic ecosystems and the sustainable use of water resources in inland waters. This paper therefore presents a framework for studying such effects. Spatial autocorrelation, a geostatistical method, is used to analyze the spatial variation in the hydrological and water quality factors and to further analyze the effects of various factors on the spatial heterogeneity of e-flows. Four different methods including the Tennant method, wetted perimeter method, AEHRA, and integrated water quality method are integrated to comprehensively evaluate e-flows. The former three methods consider the demands of biota on the streamflow, whereas the latter considers the demands on both the streamflow and the water quality. The results show that the Tennant and wetted perimeter methods, which focus on the statistics of only streamflow, result in similar spatial distribution of e-flows; the AEHRA and integrated water quality method, which consider the effects of water quality and other hydrological factors such as flow velocity and water depth on fish, also result in a similar spatial variation. Consideration of both demands on the hydrological factors and the water quality environmental factors makes the integrated water quality method more practical, particularly in developing regions with excessive pollutant discharge into rivers. In addition, spatial variation in the hydrological and water quality factors influenced the presence of principal fish species and consequently affected the e-flows. Of the 37 water quality factors identified, water transparency had a negative impact on e-flow because the increase in transparency could reduce the number of principal fish species. Of the four hydrological factors, flow velocity and river width had positive impacts on fish because the increase in flow velocity can provide breeding sites and habitats for more fish, respectively, both of which result in increases in the numbers of principal fish species. We found that spatial variation in the hydrology and water quality factors had a profound impact on the living environments of aquatic organisms; negative changes in these factors lowered the survival probability of principal species, which changed the hierarchy and structure of the ecosystems and thus led to variation in e-flows. The results can provide priori knowledge for e-flow methods selection and a reference for ecosystem restoration helping improve the success rate of project elsewhere in the world.

Wide Operational Windows of Edge-Localized Mode Suppression by Resonant Magnetic Perturbations in the DIII-D Tokamak

Edge-localized mode (ELM) suppression by resonant magnetic perturbations (RMPs) generally occurs over very narrow ranges of the plasma current (or magnetic safety factor q_{95}) in the DIII-D tokamak. However, wide q_{95} ranges of ELM suppression are needed for the safety and operational flexibility of ITER and future reactors. In DIII-D ITER similar shape plasmas with n=3 RMPs, the range of q_{95} for ELM suppression is found to increase with decreasing electron density. Nonlinear two-fluid MHD simulations reproduce the observed q_{95} windows of ELM suppression and the dependence on plasma density, based on the conditions for resonant field penetration at the top of the pedestal. When the RMP amplitude is close to the threshold for resonant field penetration, only narrow isolated magnetic islands form near the top of the pedestal, leading to narrow q_{95} windows of ELM suppression. However, as the threshold for field penetration decreases with decreasing density, resonant field penetration can take place over a wider range of q_{95}. For sufficiently low density (penetration threshold) multiple magnetic islands form near the top of the pedestal giving rise to continuous q_{95} windows of ELM suppression. The model predicts that wide q_{95} windows of ELM suppression can be achieved at substantially higher pedestal pressure in DIII-D by shifting to higher toroidal mode number (n=4) RMPs.

One-year implant survival following lateral window sinus augmentation using plasma rich in growth factors (PRGF): a retrospective study

Background

The aim of this study was to assess one-year implant survival after lateral window sinus augmentation using PRGF combined with various bone grafting materials.

Material and Methods

This was a retrospective chart review and radiographic analysis of patients that had undergone lateral window sinus augmentation with PRGF and had dental implants placed at least 6 months post augmentation. All implants included were followed up for at least one year after placement. Demographic, sinus and implant related characteristics (residual ridge height, sinus membrane perforation, type of graft material, implant length and width and ISQ at placement) were analyzed.

Results

A total of 31 patients with 39 sinus augmentations and 48 implants were included. The mean follow up was 22.8 ± 9.9 months. Implant survival was 95.8%, with 2 implants overall failing. Among all the variables assessed, the only one found to be associated with an increased risk for implant failure was the use of xenograft as bone grafting material in the sinus.

Conclusions

Within the limitations of this study, dental implants placed in maxillary sinuses grafted with PRGF in combination with bone grafting materials, exhibit high implant survival rates after at least one year follow up.

Key words:PRGF, sinus graft, growth factors, implant survival, platelet concentrates.

Attitude and knowledge for menopause management among health professionals in mainland China

OBJECTIVE

This study aims to understand the attitude of health-care professionals (HPs) in mainland China toward menopause management (MM) as well as the knowledge they have received regarding MM during training.

METHODS

An anonymous survey recruited 3709 medical workers nationwide (including physicians, orthopedists, obstetricians and gynecologists, and general practitioners) through online surveys and on-site interviews at professional meetings.

RESULTS

Of the 3709 questionnaires completed, 3426 questionnaires met the inclusion criteria. Of the participants, 1532 HPs had not received menopause management training (MMT) in nearly 1 year. Among the residents and physician assistants, 103 reported they were not familiar with MM. Satisfyingly, 98.3% of HPs considered it very important or essential to accept MM. Although most interviewees replied some correct menopausal knowledge, nearly half of them could not correctly identify the contraindications for menopause hormone therapy (MHT). Additionally, 73.1% of HPs would advise patients with premature ovarian insufficiency to receive hormone replacement therapy at least until the average age of menopause.

CONCLUSION

This survey indicated that HPs have some knowledge regarding MM, but a gap remains to master the basic theory of MHT. In order to manage the growing menopausal population in China, creating more in-depth educational MMT programs for HPs is necessary.

[Establishment of a recombinase-aided isothermal amplification assay for nucleic acid detection of Echinococcus multilocularis and its preliminary application]

OBJECTIVE

To establish a rapid nucleic acid detection technique for identification of Echinococcus multilocularis based on the recombinase aided isothermal amplification assay (RAA) and assess its diagnostic efficiency.

METHODS

The mitochondrial gene sequence of E. multilocularis (GenBank accession number: AB018440) was used as a target sequence. The primers were designed according to the RAA reaction principle and synthesized, and RAA was performed using the generated primers. E. multilocularis genomic DNA at various concentrations and the pMD19-T (Simple) vector containing various copies of the target gene fragment were amplified using RAA to evaluate its sensitivity for detection of E. multilocularis, and RAA was em- ployed to detect the genomic DNA of E. granulosus G1 genotype, Taenia saginata, T. asiatica, T. multiceps, Dipylidium caninum, Toxocara canis, Trichuris trichiura, Giardia lamblia, Fasciola hepatica, Paragonimus westermani, Fasciola gigantica and Clonorchis sinensis to evaluate its specificity. In addition, the optimized RAA was employed to detect nine tissue specimens of E. granulosus-infected animals, 3 fecal samples from E. granulosus-infected dogs and 2 fecal samples from field infected dogs to examine its reliability and feasibility.

RESULTS

The established RAA was able to detect the specific target gene fragment of E. multilocularis within 40 min. The lowest detect limit of RAA was 10 pg if E. multilocularis genomic DNA served as a template. If the re- combinant plasmid was used as a template, the minimally detectable copy number of RAA was 104. In addition, RAA was nega- tive for the genomic DNA of E. granulosus G1 genotype, T. saginata, T. asiatica, T. multiceps, D. caninum, T. canis, T. trichiura, G. lamblia, F. hepatica, P. westermani, F. gigantica and C. sinensis. The established RAA was positive for detection of the tissue specimens of infected animals, and simulated and field dog stool samples.

CONCLUSIONS

A rapid, sensitive and specific RAA is established, which shows promising values in identification of E. multilocularis and gene diagnosis of alveolar echinococcosis.

NWChem: Past, present, and future

Specialized computational chemistry packages have permanently reshaped the landscape of chemical and materials science by providing tools to support and guide experimental efforts and for the prediction of atomistic and electronic properties. In this regard, electronic structure packages have played a special role by using first-principle-driven methodologies to model complex chemical and materials processes. Over the past few decades, the rapid development of computing technologies and the tremendous increase in computational power have offered a unique chance to study complex transformations using sophisticated and predictive many-body techniques that describe correlated behavior of electrons in molecular and condensed phase systems at different levels of theory. In enabling these simulations, novel parallel algorithms have been able to take advantage of computational resources to address the polynomial scaling of electronic structure methods. In this paper, we briefly review the NWChem computational chemistry suite, including its history, design principles, parallel tools, current capabilities, outreach, and outlook.

MiR-543 functions as tumor suppressor in ovarian cancer by targeting TWIST1

MicroRNAs (miRNAs) have been demonstrated to have promoting or inhibiting effects on the tumorigenesis of multiple cancers, including ovarian cancer (OC), by regulating its downstream target genes. In the presented experiment, our aim was to explore the role of miR-543 in OC cell proliferation and invasion. Results of quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot revealed that miR-543 have lower expression levels, while Twist homolog 1 (TWIST1) was expressed with higher levels in OC tissues and cells. Furthermore, the effects of abnormal miR-543 expression in OC cell proliferation and invasion were detected by CCK-8 and Transwell assay. According to luciferase reporter assay results, TWIST1 was identified as a downstream target of miR-543 in OC, and a negative correlation was observed between TWIST1 and miR-543 expression by Spearman's correlation analysis in OC tissues. In addition, TWIST1 may reverse the miR-543 suppression effect on OC cell proliferation and invasion. To sum up, miR-543 may promote OC cell proliferation and invasion by targeting TWIST1.

Current PCR-based methods for the detection of mycotoxigenic fungi in complex food and feed matrices

Mycotoxins are toxic secondary fungal metabolites produced by certain types of filamentous fungi, such as Aspergillus, Fusarium, and Penicillium spp. Mycotoxigenic fungi and their produced mycotoxins are considered to be an important issue in food and feed safety due to their toxic effects like carcinogenicity, immunosuppression, neurotoxicity, nephrotoxicity, and hepatotoxicity on humans and animals. To boost the safety level of food and feedstuff, detection and identification of toxins are essential at critical control points across food and feed chains. Zero-tolerance policies by the European Union and other organizations about the extreme low level of tolerance of mycotoxins contamination in food and feed matrices have led to an increasing interest to design more sensitive, specific, rapid, cost-effective, and safer to use mycotoxigenic fungi detection technologies. Hence, many mycotoxigenic fungi detection technologies have been applied to measure and control toxins contamination in food and feed substrates. PCR-based mycotoxigenic fungi detection technologies, such as conventional PCR, real-time PCR, nested PCR, reverse transcriptase (RT)-PCR, loop-mediated isothermal amplification (LAMP), in situ PCR, polymerase chain reaction-denaturing gradient gel electrophoresis (PCR DGGE), co-operational PCR, multiplex PCR, DNA arrays, magnetic capture-hybridization (MCH)-PCR and restriction fragment length polymorphism (RFLP), would contribute to our understanding about different mycotoxigenic fungi detection approaches and will enhance our capability about mycotoxigenic fungi identification, isolation and characterization at critical control points across food and feed chains. We have assessed the principles, results, the limit of detection, and application of these PCR-based detection technologies to alleviate mycotoxins contamination problem in complex food and feed substrates. The potential application of these detection technologies can reduce mycotoxins in complex food and feed matrices.

Parasitological and molecular detection of human fascioliasis in a young man from Guizhou, China

A 24-year-old man born in Guizhou province was diagnosed with obstructive jaundice and bile duct stones in 2013. Four living trematodes were found during laparotomy and cholecystectomy. Based on the morphology and molecular genetics analysis of internal transcribed spacer and pcox1 genes of the flatworm specimens, the trematodes from the patient were confirmed to be Fasciola hepatica. This report provided the clinical and molecular diagnosis information on human fascioliasis, which is an emerging sanitary problem still ignored in China. Human fascioliasis constantly occurs due to climatic changes and frequency of human travel. Therefore, it deserves more attention from physicians working in both developing and developed countries.

Chinese women with 29-30 FMR1 CGG repeats have an earlier menopause

Purpose: A strong, well-established non-linear relationship exists between fragile X mental retardation (FMR1) premutation and menopausal age. The aim of this study is to evaluate whether this relationship continues into the normal CGG repeat range.Methods: FMR1 CGG repeats of 111 Chinese postmenopausal women from a prospective cohort and the relationship with age at menopause were analyzed. Associations of FMR1 genotypes with annually measured estradiol and follicle stimulating hormone (FSH) levels were also assessed.Results: One premutation and two intermediate carriers were identified, with a prevalence of 0.90% and 1.80%, respectively. The age at menopause differed with statistical significance (p = 0.007) between women carrying bi-allelic 29-30 repeats (49.66 ± 3.26 years) and those carrying a different number of repeats (51.26 ± 2.74 years). Age at menopause among subgroups (≤28, 29-30, and ≥31 repeats) of alleles 1 and 2 were also different (p = 0.014, p = 0.044). FSH trajectories to final menstrual period differed between women with the bi-allelic 29-30 repeats and others (p = 0.019).Conclusions: Women with 29-30 FMR1 CGG repeats may experience menopause approximately 2 years earlier than those carrying ≤28 or ≥31 CGG repeats, and have a longer FSH fluctuant period.

Using social media for smoking cessation interventions: a systematic review

Background:

Previous studies have shown that smoking tobacco significantly increases both incidence and mortality rates for many diseases. Social media has become one of the most influential platforms for various smoking cessation interventions. However, results from smoking cessation interventions have differed from study to study. Limited studies have summarised cessation outcomes from social media–based interventions. Therefore, the objective of this review is to explore the effectiveness of using social media for smoking cessation.

Methods:

We searched PubMed, MEDLINE, PsycINFO, and CINAHL for articles between June 2008 and June 2018, and also assessed the references of selected articles. We included studies that used social media as intervention platforms, provided a baseline assessment before the intervention, and provided smoking cessation outcomes after the intervention.

Results:

We identified 13 original studies that enrolled between 16 and 1698 participants; 7-day Point Prevalence Abstinence (PPA) rate was the most frequently used measure of abstinence, with a range of 7%–75%, regardless of the measurement time, study design, and analysis methods. Social media–based smoking cessation interventions were effective, because (1) smokers reported higher 7-day PPA rates after intervention compared to baseline and (2) smokers reported higher 7-day PPA rates in intervention groups than in control groups. Moreover, at each time point, approximately half of all smokers in studies reporting abstinence were found to be biochemically abstinent. There were no significant differences in the effectiveness of smoking cessation outcomes between those that used existing popular social networking platforms (e.g. Pechmann et al’s studies) and those that used individually designed interactive platforms (e.g. MyLastDip, iQuit system, Quitxt system).

Conclusions:

This review highlights the effectiveness of social media–based smoking cessation intervention studies. Due to the widespread use of social media, as well as its low cost, we suggest embedding smoking cessation interventions within existing popular social media platforms.

[Influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China]

Objective: To analyze influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China. Methods: We recruited 2 180 participants aged 65 years and older in 8 longevity areas from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey in 2017. Multivariate logistic regression analysis was performed to evaluate the relationships of socio-demographic characteristics, behavioral lifestyle, chronic disease prevalence, functional status, family and social support with depressive symptoms in the elderly. Results: The detection rate of depression symptoms was 15.0% in the elderly aged 65 years and older in 8 longevity areas of China, and the detection rate of depression symptoms was 11.5% in men and 18.5% in women. Multivariate logistic regression analysis results showed that the detection rate of depressive symptoms was lower in the elderly who had regular physical exercises (OR=0.44, 95%CI: 0.26-0.74), frequent fish intakes (OR=0.57, 95%CI: 0.39-0.83), recreational activities (OR=0.65, 95%CI: 0.44-0.96), social activities (OR=0.28, 95%CI: 0.11-0.73) and community services (OR=0.68, 95%CI: 0.50-0.93). The elderly who were lack of sleep (OR=2.04, 95%CI: 1.49-2.80), had visual impairment (OR=1.54, 95%CI: 1.08-2.18), had gastrointestinal ulcer (OR=2.97, 95%CI: 1.53-5.77), had arthritis (OR=2.63, 95%CI: 1.61-4.32), had higher family expenditure than income (OR=1.80, 95%CI: 1.17-2.78) and were in poor economic condition (OR=4.58, 95%CI: 2.48-8.47) had higher detection rate of depressive symptoms. Conclusion: The status of doing physical exercise, fish intake in diet, social activity participation, sleep quality or vision, and the prevalence of gastrointestinal ulcers and arthritis were associated with the detection rate of depressive symptoms in the elderly.

[Identification of gene biomarkers to predict responses to neoadjuvant chemoradiotherapy in patients with rectal cancer and pathways enrichment analysis]

Objective: To screen out the potential gene biomarkers to predict responses to neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer and to explore the main downstream pathways of resistance. Methods: The gene expression profiles (GSE35452) of locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from 46 specimens (24 responders, TRG 0/1, and 22 non-responders, TRG 2/3) were downloaded from the GEO database. The differentially expressed genes were identified to screen out the potential biomarkers by use of the GCBI platform. GO and KEGG pathways enrichment analysis were performed to integrate enrichment results of differentially expressed genes. Signal-signal interaction network was constructed and analyzed to screen out potential main downstream pathways. Results: A total of 1079 differentially expressed genes were screened, including 657 up-regulated and 422 down-regulated ones. Among these genes, REG4 had the maximum fold change value of -6.029 491. In GO term, these differentially expressed genes were mainly enriched in molecule metabolic process, cell cycle, DNA-dependent transcription, signal transduction and apoptotic process. The KEGG pathways enrichment analysis showed that the differentially expressed genes were enriched in 65 KEGG pathways, including metabolic pathways, cell cycle and metabolism pathways. Signal-signal interaction network analysis showed that MAPK signaling pathway and cell cycle pathway might play a determinant role in the development of neoadjuvant chemoradiotherapy resistance. Further analysis showed that CDKN1B, CDKN2A, RBL1, TFDP1, CCND2, CCNE2, CDC6 and CDK6 in cell cycle might induce chemoradiotherapy resistance by blocking G1/S phase cell cycle arrest, decreasing the apoptosis of tumor cells and increasing S phase ratio of chemoradiotherapy resistance. Conclusion: G1/S phase cell cycle arrest blocking plays an important role in the development of chemoradiotherapy resistance in patients with rectal cancer. Moreover, the key genes, such as REG4, may be useful in predicting responses to neoadjuvant chemoradiotherapy.

The emission of γ-Ray beams with orbital angular momentum in laser-driven micro-channel plasma target

We investigated the emission of multi-MeV γ-Ray beams with orbital angular momentum (OAM) from the interaction of an intense circularly polarized (CP) laser with a micro-channel plasma target. The driving laser can generate high energy electrons via direct laser acceleration within the channel. By attaching a plasma foil as the reflecting mirror, the CP laser is reflected and automatically colliding with the electrons. High energy gamma-photons are emitted through inverse Compton scattering (ICS) during collision. Three-dimensional particle-in-cell simulations reveal that the spin angular momentum (SAM) of the CP laser can be transferred to the OAM of accelerated electrons and further to the emitted gamma-ray beam. These results may guide future experiments in laser-driven gamma-ray sources using micro-structures.

Low expression of microRNA-1266 promotes colorectal cancer progression via targeting FTO

OBJECTIVE

To explore the role of microRNA-1266 in colorectal cancer (CRC) and its underlying mechanism.

PATIENTS AND METHODS

The expression level of microRNA-1266 in 48 CRC tissues and paracancerous tissues was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). The relationship between microRNA-1266 expression and basic characteristics of CRC patients was analyzed. The effect of microRNA-1266 on the viability of CRC cells was detected by cell counting kit-8 (CCK-8) assay. Subsequently, a potential target gene for microRNA-1266 was predicted through bioinformatics. Finally, the binding condition between microRNA-1266 and the target gene was verified by RNA binding protein immunoprecipitation (RIP) and luciferase reporter gene assay, respectively.

RESULTS

MicroRNA-1266 was lowly expressed in 48 cases of CRC tissues than that of paracancerous tissues. Clinical data demonstrated that microRNA-1266 expression was correlated to tumor size and TNM of CRC patients. Knockdown of microRNA-1266 promoted proliferation of CRC cells. FTO was predicted to be the target gene for microRNA-1266, which was negatively regulated by microRNA-1266.

CONCLUSIONS

MicroRNA-1266 is lowly expressed in CRC tissues than that of paracancerous tissues. Lowly expressed microRNA-1266 promotes the occurrence and progression of CRC by directly targeting FTO.

An indel polymorphism in the 3' untranslated region of HMGB1 confers risk for hepatocellular carcinoma by regulating HMGB1 transcriptional activity in a Chinese population

The present study aimed to assess the association of rs34000982 polymorphism located in the 3'untranslated region (3'UTR) of high mobility group box 1 (HMGB1) gene and the risk of hepatocellular carcinoma (HCC), and further to explore the underlying mechanism. Genomic DNA was extracted from peripheral blood of 320 patients with HCC and 360 matched controls. Rs34000982 polymorphism was genotyped by a polymerase chain reaction-polyacrylamide gel electrophoresis assay. The genotype-phenotype association of HMGB1 mRNA and protein expression in HCC tissues with different genotypes was detected by quantitative (q) PCR assay and western blot. Vectors containing the insertion (ins)/ins or deletion (del)/del genotype of the rs34000982 polymorphism were constructed and the HMGB1 transcriptional activity affected by the rs34000982 polymorphism was detected by the luciferase assay. It was identified that the ins/ins genotype of rs34000982 significantly increased the risk of HCC compared with the del/del genotype. Further the qPCR results demonstrated that the HMGB1 mRNA expression level in HCC tissues with ins/ins genotype was 2.24 times that of HCC tissues with ins/del and del/del genotypes and there was a similar trend at protein level. In addition, the insertion allele of rs34000982 disturbed the binding of miR-636 with the 3'UTR of HMGB1, thereby increasing HMGB1 transcriptional activity in vitro. These data suggest that the rs34000982 polymorphism may contribute to HCC susceptibility, in full or at least partially through the effect on HMGB1 transcriptional activity by disturbing the binding of miR-636 with the 3'UTR of HMGB1.

[Expression discordances and clinical values of ER, PR, HER-2 and Ki-67 in primary and metastatic breast cancer]

Objective: To investigate the expression discordances of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor2 (HER-2) and Ki-67 in primary and metastatic breast cancer specimens and explore the clinical significances. Methods: Biopsies of metastatic lesions were performed in 203 patients with breast cancer recurrence and metastasis indicated by physical examination and/or imaging examination. We confirmed pathological properties and assessed the expressions of ER, PR, HER-2 and Ki-67 in primary and metastatic lesions, their relationships with prognosis were also analyzed. Results: Biopsy failed in 3 patients, the pathology and immunohistochemitry results of metastatic lesions were not obtained. One person was diagnosed as tuberculosis and another was primary lung cancer. Among the 198 cases of primary and metastatic lesions, the discordance rates of ER, PR, HER-2 and Ki-67 were 27.3%, 34.3%, 11.8% and 15.1%, respectively.The expressions of ER, HER-2 and Ki-67 were not significantly different between the primary and metastatic lesions, however, the expressions of PR were more likely to turn negative in the metastases (P<0.001). The disease-free survival (DFS) of patients with ER, PR positive, HER-2 negative and low expression of Ki-67 in metastatic lesion was much longer (P<0.05). Conclusions: The expressions of ER, PR, HER-2 and Ki-67 in metastatic lesions are associated with the prognosis of breast cancer patients.Their expression discordances between primary and metastatic lesions can guide the treatment and evaluate the risks of recurrence and prognosis.

Efficacy of Proximal Resin Infiltration on Caries Inhibition: Results from a 3-Year Randomized Controlled Clinical Trial

This study reports 3-y outcomes of a split-mouth randomized clinical trial. Resin infiltration’s capacity to arrest caries lesion progression in noncavitated proximal lesions is affirmed. Forty-two consented young adults, blinded to tooth surface allocation, were treated with resin infiltration on 1 randomly selected surface and concurrently experienced a mock infiltration procedure on another. Both treatments were provided as an adjunct to the currently accepted standard-of-care regimen (periodic prophylaxis and serial fluoride varnish applications) appropriate for the management of high caries risk. Challenging periods of low oral hygiene compliance were expected. The primary outcome measure was 3-y radiographic lesion progression. Blinded investigators evaluated each study surface for lesion progression with a series of images obtained at intervals over the 3-y course of study. Proportions of progressing lesions were compared with McNemar’s test. Twenty-nine noncavitated lesion pairs in permanent posterior teeth demonstrating caries penetrating into inner enamel or outer dentin were included in the analyses. No adverse events were reported. Radiographic progression was recorded in 4 of 29 infiltrated lesions (14%) and 14 of 29 control lesions (48%, P < .003). Adjunct resin infiltration demonstrated a high 3-y efficacy of 71% (relative risk reduction). The prevented fraction was 86% for infiltration versus 52% for controls. Resin infiltration was 100% successful in arresting caries progression in inner enamel lesions (E2) and 64% in outer dentin lesions (D1). Supplementary microinvasive resin infiltration is significantly more efficacious in reducing proximal lesion progression than management by standard noninvasive therapy alone. Long-term results may shed light on whether this represents the arrest or delay of the caries disease process (ClinicalTrials.gov NCT01584024).

[Level and trend of cardiovascular disease mortality in China from 2002 to 2016]

Objective: To investigate the level and trend of cardiovascular disease mortality in China from 2002 to 2016. Methods: Using data of China Health Statistics Yearbook (2003-2012) and China's Health and Family Planning Statistical Yearbook (2013-2017),we calculated the age-standardized mortality rates (ASMR) in China. Joinpoint regression model was employed to estimate the annual percent change (APC) and average annual percent change (AAPC) of cardiovascular disease ASMR. Results: (1)The ASMR of cardiovascular disease were 225.65/100 thousands, 242.74/100 thousands, 214.63/100 thousands, 240.97/100 thousands, 195.24/100 thousands, 201.50/100 thousands, 208.83/100 thousands, 248.44/100 thousands, 261.38/100 thousands, 231.98/100 thousands, 210.25/100 thousands, 237.80/100 thousands, 235.21/100 thousands, 237.58/100 thousands,and 237.25/100 thousands from 2002 to 2016, and there was no significant difference in ASMR of cardiovascular disease (AAPC=0.2%, P>0.05) . The ASMR of chronic rheumatic heart disease decreased significantly (AAPC=-4.5%,P<0.05). There were no significant differences in ASMR of cerebrovascular disease, hypertensive heart disease, and ischemic heart disease (AAPC=0, P>0.05; AAPC=2.0%, P>0.05; AAPC=4.3%, P>0.05, respectively). (2) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in city and country (AAPC=-0.7%, P>0.05; AAPC=0.8%, P>0.05, respectively). The ASMR of chronic rheumatic heart disease decreased significantly in city and rural area (AAPC=-4.4%, P<0.05; AAPC=-4.6%, P<0.05, respectively). (3) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in male and female (AAPC=-0.3%,P>0.05; AAPC=-0.2%,P>0.05,respectively). The ASMR of chronic rheumatic heart disease decreased significantly in female (AAPC=-4.2%, P<0.05). The ASMR of ischemic heart disease increased significantly in male and female (AAPC=4.7%,P<0.05; AAPC=5.2%,P<0.05,respectively). (4) The ASMR of cardiovascular disease showed a significant upward trend in residents aged 15 to 34 from 2002 to 2016 (AAPC=3.1, P<0.05). There were no significant differences in ASMR of cardiovascular disease in residents aged 35 to 64 and ≥65 (AAPC=-0.1%, P>0.05; AAPC=-0.2%, P>0.05, respectively). Conclusion: The ASMR of cardiovascular disease in China remains stable during 2002 to 2016, and the ASMR of cardiovascular disease shows upward trend among young people.

[Interfacility transport with extracorporeal membrane oxygenation in pediatric patients: a multicenter study in China]

Objective: To investigate application and safety of pediatric interfacility-transport with extracorporeal membrane oxygenation (ECMO) in China. Methods: The data of 48 patients transported inter-hospital from February 2016 to May 2018 were collected from the following 4 centers: pediatric intensive care unit (PICU) of Bayi Children's Hospital Affiliated to the 7th Medical Center of PLA General Hospital, Pediatric Hospital of Fudan University, Henan Provincial People's Hospital and Children's Hospital of Zhejiang University School of Medicine. The data of patients' characteristics, ECMO mode and wean rate, and mortality were reviewed, which was further compared with the data of 57 compatible inner-hospital ECMO cases with t test, Rank sum test or chi-square test. Results: All the 48 interfacility-transports were accomplished by ambulance on land, with an average transfer distance of (435±422) km. The incidence of ECMO complications was 13% (6 case), without death. There were no significant differences in lactic acid, PaO(2) or SaO(2) before and after transport (4.0 (2.0, 7.5) vs. 3.0 (1.5, 6.0) mmol/L, Z=-1.579, P>0.05; 112(47, 405) vs. 166(122, 240) mmHg (1 mmHg=0.133 kPa), Z=-0.104, P>0.05; 0.97±0.02 vs. 0.96±0.03, t=1.570, P>0.05). Instead, PaCO(2) and pH were significantly different ((47±8) vs. (42±5) mmHg, t=2.687, P<0.05; 7.3±0.2 vs. 7.5±0.2, t=3.379, P<0.05). The total ECMO weaned rate was 73% (35/48) and the survival rate was 67% (32/48). No significant differences in demographic characteristics, ECMO mode or duration, transport distance or duration, or complications existed between the survival group and the death group (7/25 vs. 2/14, χ(2)=0.615, P>0.05; 4/28 vs. 2/14, χ(2)=0, P>0.05; (405±404) vs. (493±465) km, t=0.525, P>0.05; (5±4) vs. (5±5) h, t=0.388, P>0.05; 166 (128, 239) vs. 187(52, 405) h, Z=-0.104, P>0.05; 3/32 vs. 3/16, χ(2)=0.734, P>0.05). The lowest lactate value in survival group before ECMO transport was significantly lower than that in the death group ((5±5) vs. (8±6) mmol/L, t=2.151, P<0.05). There were neither significant differences in age, ECMO mode or support pattern (9/39 vs. 15/42, χ(2)=0.845, P>0.05; 6/42 vs. 7/50, χ(2)=0.001, P>0.05; 29/19 vs. 38/19, χ(2)=0.441, P>0.05), nor in ECMO weaned rate, survival rate or complications between interfacility-transport group and inner-hospital group (35/48 vs. 37/57, χ(2)=0.775, P>0.05; 32/48 vs. 35/57, χ(2)=0.313, P>0.05; 20/48 vs. 22/57, χ(2)=0.102, P>0.05). Conclusion: With appropriate transport equipment and mature teams who handle problems timely during the transport, critically ill children could be safely transported to the destination with ECMO.

[Cognitive level of first aid knowledge regarding small area burn among 2 723 child caregivers in Shanghai: a cross-sectional survey and analysis]

Objective: To assess the cognitive level of first aid knowledge regarding the small area burn among the child caregivers in Shanghai and improve the level of first aid for small area burn in children. Methods: From November 2017 to March 2018, 7 municipal districts in Shanghai were selected according to the random number table, from which 2 750 students of 4 nurseries, 5 kindergartens, 6 primary schools, and 2 junior middle schools were selected by adopting the convenience sampling method. Each student was limited to one caregiver as the research object. A cross-sectional survey was conducted on the cognitive level of first aid knowledge regarding small area burn among the caregivers with self-designed questionnaire through WeChat and Tencent QQ. The age, burn experience, and scarring after burns in children, the prevalence rate of burn in children of different age groups, the educational background of caregivers and their social relationship with their children, and the measures taken by caregivers firstly after small area burn occurred among their children were recorded. The choices of applying the folk prescription drugs to the wounds of their children made by caregivers and those with different educational backgrounds were recorded. The choices of applying daily necessities to the wound of their children made by caregivers were recorded. The caregivers' knowledge of standard first aid measures for small area burn, and the knowledge of caregivers with different educational backgrounds of all standard first aid measures for small area burn were recorded. The caregivers' choices of hospitals for treatment the first time, and the choices of going to the Grade Ⅲ Level A hospital with burn specialty for treatment made by caregivers with different knowledge levels about first aid measures for small area burn and those by caregivers whose children did or didn't have burn experience were recorded. The caregivers' choices of different types of medical institutions with burn specialty or specialized in burn treatment, and choices of going to burn department of comprehensive Grade Ⅲ Level A hospital for treatment made by caregivers with different knowledge levels about first aid measures for small area burn were recorded. Data were processed with Pearson chi-square test and partitions of chi-square test. Results: The effective recovery rate of questionnaire was 99.0% (2 723/2 750). The ages of children were mainly 6-11 years [64.7% (1 762/2 723)]The prevalence of burn in children was 19.4% (527/2 723). There was no statistically significant difference in the overall comparison of burn prevalence of children among the age groups (χ(2)=1.424, P>0.05). The percentage of scar formation after burn in children was 27.3% (144/527). The education backgrounds of caregivers were mainly undergraduate [40.2% (1 094/2 723)], and their social relationships with children were mainly children's mothers [74.6% (2 030/2 723)]. Assuming that their children suffered from minor burns, the measures firstly taken by 74.0% (2 016/2 723) of the caregivers was to immediately access cool running water and remove clothing on the wound of children. Totally 19.2% (523/2 723) of the caregivers chose to apply folk prescription drugs for their burn children by themselves, and the percentage of caregivers with education background of junior middle school choosing to apply folk prescription drugs for their burn children by themselves was significantly higher than that of caregivers with education background of junior college, undergraduate, or graduate (χ(2)=18.502, 20.642, 13.319, P<0.05). Totally 49.2% (1 340/2 723) of caregivers chose to daub many kinds of daily necessities for their burn children by themselves. Totally 39.2% (1 068/2 723) of caregivers knew all standard first aid measures for small area burn, the percentage of caregivers with education background of undergraduate knowing all standard first aid measures for small area burn was significantly higher than that of caregivers with education background of senior high school and secondary specialized school (χ(2)=11.234, P<0.05). Assuming that their children suffered from minor burns, 39.0% (1 063/2 723) of the caregivers chose to go to the nearest hospital for treatment the first time, the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment the first time was similar with that of caregivers who did not know/did not fully know (χ(2)=3.528, P>0.05), and the percentage of caregivers whose children had burn experience choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment in the first time was similar with that of caregivers whose children didn't have burn experience (χ(2)=3.521, P>0.05). Among all medical institutions with burn specialty or specialized in burn treatment, 28.0% (762/2 723) of the caregivers chose to go to comprehensive Grade Ⅲ Level A hospital for treatment, and the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to comprehensive Grade Ⅲ Level A hospital for treatment was significantly higher than that of caregivers who did not know/did not fully know (χ(2)=4.890, P<0.05). Conclusions: The caregivers of children are mainly children's mothers with education background of undergraduate in Shanghai, and caregivers' cognitive levels of first aid knowledge regarding the small area burn are low. Only a few caregivers know all standard first aid measures for small area burn, and there are still some caregivers who have the wrong idea of applying folk prescription drugs or daily necessities for children by themselves. The publicity and education of basic first aid knowledge of burn should be strengthened through various channels such as burn simulation exercise and network, and caregivers should be guided to take their children to hospitals with burn specialty for treatment after occurrence of burn in children, so as to obtain more professional medical treatment.

Impact of spatial variations in water quality and hydrological factors on the food-web structure in urban aquatic environments

Global aquatic ecosystems are essential to human existence and have deteriorated seriously in recent years. Understanding the influence mechanism of habitat variation on the structure of the food-web allows the effective recovery of the health of degraded ecosystems. Whereas most previous studies focused on the selection of driving habitat factors, the impact of habitat variation on the food-web structure was rarely studied, resulting in the low success rate of ecosystem restoration projects globally. This paper presents a framework for exploring the effects of spatial variations in water quality and hydrological habitat factors on the food-web structure in city waters. Indices for the evaluation of the food-web structure are first determined by integrating model-parameter extraction via literature refinement. The key water quality and hydrological factors are then determined by coupling canonical correspondence analysis with partial least squares regression. Their spatial variation is investigated using spatial autocorrelation. Finally, fuzzy clustering is applied to analyze the influence of the spatial variations in water quality and hydrological factors on the food-web structure. The results obtained in Ji'nan, the pilot city of water ecological civilization in China, show that the Shannon diversity index, connectance index, omnivory index, and the ratio of total primary production to the total respiration are important indicators of food-web structural change. They show that the driving factors affecting the aquatic food-web structure in Ji'nan are hydrological factors (e.g., river width, water depth, and stream flow), physical aspects of water quality (e.g., air temperature, water temperature, electrical conductivity, and transparency), and chemical aspects (e.g., potassium, dissolved oxygen, calcium, and total hardness). They also show that the stability of the food-web is more prone to spatial variations in water quality than in hydrological factors. Higher electrical conductivity, potassium, total hardness, and air temperature lead to deteriorated food-web structures, whereas better transparency improves structure and stability. We found that water and air temperature are the most important factors in the spatial variation of the food-web structure in the study area, followed by total hardness. Transparency is the least important factor. Large disparities and varied spatial distributions exist in the driving effects of water quality and hydrological factors across regions attributable to differences in geographical environments, water salinity (fresh vs. sea water), and environmental factors (e.g., water pollution). The above methods and results serve as a theoretical and scientific basis for a high success rate of aquatic ecosystem restoration projects in the study area and other cities worldwide.

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.

Abstract P1-08-14: Trend of utilization of Oncotype DX testing among female hormone receptor positive breast cancer patients in 17 SEER registries, 2004-2015

Background: Oncotype DX, a 21-gene Recurrence Score (RS) assay, has been validated as assay that effectively predicts recurrence and chemotherapy (chemo) benefits for hormone receptor positive (HR+) human epidermal growth factor receptor 2 negative (HER2-) breast cancer (BC). Although guidelines recommend the test to lymph node (LN) negative (PN0) BC patients, it has also been used in patients with 1-3 positive LN (PN1) in clinical practice. The study aimed to 1) examine the trend of utilization of Oncotype DX testing for HR+ and PN0 or PN1 BC patients from 2004 to 2015, as well as the trend in patients with different clinical risk; 2) investigate the trend of having reported chemo in patients with low, intermediate, and high RS; and 3) compare cause-specific survival (CSS) and overall survival (OS) between patients who had test and those who did not.

Methods: Data from Genomic Health Inc., the sole Oncotype DX testing provider in the U.S., was linked with routinely collected data from 17 SEER registries. Women who received surgery for stage I-III, HR+ and PN0 or PN1 BC diagnosed in 2004-2015 were included. The Cochrane-Armitage trend test was conducted for trend analysis. Using the overall sample as standard population (frequency of each age-racial group in overall sample as weight), age-race standardized percentage of test use was calculated. Since HER2 data was available only after 2010, survival analysis was restricted to HR+/HER2- patients diagnosed in 2010-2014 whose BC was the only primary tumor. Patients who used and those who did not use the test were matched on propensity score, which was calculated based on age, race, marital status, insurance, grade, tumor size, surgery type, radiation, and chemo within each diagnosis year. Stratified Cox proportional hazards model was used to compare survival between two matched groups. Proportional hazard assumption was met for each model.

Results: Out of 346,380 PN0 and 103,317 PN1 patients, the percentage of using Oncotype DX test increased from 2.0% to 38.2%, and from 0.5% to 28.0% from 2004 to 2015, respectively (P-for-trend &lt; 0.0001 for each). Age-race standardized percentage of test use was the highest and increased most rapidly for tumors with intermediate clinical risk (moderately differentiated or tumor size 2.1-5.0cm) among PN0 patients, but for tumors with low clinical risk (well differentiated or tumor size ≤2.0cm) among PN1 patients. From 2004 to 2015, the percentage of having reported chemo decreased in patients with low (PN0: 14.7% to 1.8%; PN1: 27.3% to 16.2%) and intermediate RS (PN0: 36.1% to 28.6%; PN1: 60.0% to 44.7%), but increased among patients with high RS (PN0: 59.0% to 75.4%; PN1: 66.7% to 74.2%). Test use was associated with better CSS (PN0: hazard ratio [HR] 2.15, 95% CI 1.73-2.67; PN1: HR 2.83, 95% CI 2.02-3.95) and OS (PN0: HR 2.05, 95% CI 1.81-2.33; PN1: HR 2.65, 95% CI 2.10-3.35).

Conclusions: The use of Oncotype DX test has increased steadily among female HR+ BC patients since 2004. It reduced unnecessary chemo among patients with low or intermediates RS, and increased chemo use in patients with high RS. Among HR+/HER2- patients, those who used test had better CSS and OS than those who did not.

Citation Format: Zhang L, Hsieh M-C, Petkov VI, Yu Q, Wu X-C. Trend of utilization of Oncotype DX testing among female hormone receptor positive breast cancer patients in 17 SEER registries, 2004-2015 [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 P1-08-14.

Abstract P3-12-23: Utilization and survival benefit of radiation therapy among hormone receptor positive breast cancer patients with recurrence score from Oncotype DX testing

Background: Radiation therapy (RT) improves survival of breast cancer (BC) patients receiving the lumpectomy. Oncotype DX, a 21-gene Recurrence Score (RS) assay, has been validated to predict the risk of recurrence and chemotherapy benefit for hormone receptor positive (HR+) BC without metastatic lymph nodes (PN0). With increasing use of Oncotype DX, it is unclear if the utilization and survival benefit of RT vary by RS in clinical practice. This study aimed to 1) examine if the RS from Oncotype DX testing influences RT utilization among HR+ BC patients with PN0 who received lumpectomy; and 2) investigate if RT is associated with better cause-specific survival (CSS) and overall survival (OS) among patients stratified by the low, intermediate, and high RS.

Methods: Data from Genomic Health Inc., the sole Oncotype DX testing provider in the U.S., was linked with routinely collected data from 17 SEER registries. Women who were diagnosed with PN0 and HR+ BC in 2004-2015, received the lumpectomy, and had RS from Oncotype DX testing were included. Patients who had multiple tumors, received RT before or within surgery, or had less than 2 months follow-up were excluded. Patients diagnosed in 2004-2014 and followed through the end of 2015 were included in the survival analysis. RS was categorized into low (&lt;18), intermediate (18-30), and high (&gt;30). RT was categorized into yes, no or unknown. Multivariable logistic regression was applied to examine the association between RS and RT utilization. To compare survival differences, patients receiving RT and patients having no or unknown RT were matched on propensity score, which was calculated based on diagnosis year, age, race, marital status, tumor size, grade, number of lymph nodes examined, chemotherapy, and participating state. Stratified Cox proportional hazards models were used to compare CSS and OS between two matched groups. Proportional hazard assumption was evaluated.

Results: Out of 48,615 patients, 56.8% had low, 36.1% had intermediate, and 7.1% had high RS; 84.5% received RT (86.6%, 82.8%, and 76.4% in low, intermediate, and high RS patients, respectively; P &lt; 0.0001). After adjusting for covariates, patients with intermediate (odds ratio [OR] 0.75; 95% CI 0.71-0.79; P &lt; 0.0001) and high RS (OR 0.53; 95% CI 0.47-0.59; P &lt; 0.0001) were less likely to receive RT than patients with low RS. Among patients with low or intermediate RS, having no or unknown RT was associated with worse CSS (low RS: hazard ratio [HR] 6.00, 95% CI 1.77-20.37, P = 0.004; intermediate RS: HR 2.12, 95% CI 1.19-3.77, P = 0.01) and OS (low RS: HR 2.29, 95% CI 1.56-3.35, P &lt; 0.0001; intermediate RS: HR 2.22, 95% CI: 1.54-3.21, P &lt; 0.0001). RT utilization was not significantly associated with CSS or OS among patients with high RS.

Conclusions: Among HR+, PN0 BC patients receiving the lumpectomy, lower RS was associated with higher RT utilization. RT was associated with better CSS and OS among patients with low or intermediate RS. Among patients with high RS, no association between RT and survival was observed.

Citation Format: Zhang L, Hsieh M-C, Petkov VI, Wu X-C, Yu Q. Utilization and survival benefit of radiation therapy among hormone receptor positive breast cancer patients with recurrence score from Oncotype DX testing [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 P3-12-23.

The Function and Regulatory Network of Pax9 Gene in Palate Development

Cleft palate, a common congenital deformity, can arise from disruptions in any stage of palatogenesis, including palatal shelf growth, elevation, adhesion, and fusion. Paired box gene 9 (Pax9) is recognized as a vital regulator of palatogenesis with great relevance to cleft palate in humans and mice. Pax9-deficient murine palatal shelves displayed deficient elongation, postponed elevation, failed contact, and fusion. Pax9 is expressed in epithelium and mesenchyme, exhibiting a dynamic expression pattern that changes according to the proceeding of palatogenesis. Recent studies highlighted the Pax9-related genetic interactions and their critical roles during palatogenesis. During palate growth, PAX9 interacts with numerous molecules and members of pathways (e.g., OSR2, FGF10, SHOS2, MSX1, BARX1, TGFβ3, LDB1, BMP, WNT β-catenin dependent, and EDA) in the mesenchyme and functions as a key mediator in epithelial-mesenchymal communications with FGF8, TBX1, and the SHH pathway. During palate elevation, PAX9 is hypothesized to mediate the time point of the elevation event in the anterior and posterior parts of the palatal shelves. The delayed elevation of Pax9 mutant palatal shelves probably results from abnormal expressions of a series of genes ( Osr2 and Bmpr1a) leading to deficient palate growth, abnormal tongue morphology, and altered hyaluronic acid distribution. The interactions between PAX9 and genes encoding the OSR2, TGFβ3, and WNT β-catenin-dependent pathways provide evidence that PAX9 might participate in the regulation of palate fusion. This review summarizes the current understanding of PAX9’s functions and emphasizes the interactions between PAX9 and vital genes during palatogenesis. We hope to provide some clues for further exploration of the function and mechanism of PAX9, especially during palate elevation and fusion events.