Next-generation sequencing-based typing of a new allele HLA-DQB1*03:01:01:20 in a Chinese family

DQB1*03:01:01:20 showed one nucleotide difference when compared to DQB1*03:01:01:01 at 224 (C>T).

The role of m6A RNA methylation in cancer

N6-methyladenosine (m6A), the most abundant internal modification of RNA in eukaryotic cells, has gained increasing attention in recent years. The m6A modification affects multiple aspects of RNA metabolism, ranging from RNA processing, nuclear export, RNA translation to decay. Emerging evidence suggests that m6A methylation plays a critical role in cancer through various mechanisms. Moreover, m6A methylation has provided more possibilities for the early diagnosis and treatment of cancers. In this review, we focus on m6A-associated mechanisms and functions in several major malignancies and summarize the dual role of m6A methylation as well as its prospects in cancer.

Abstract P1-10-04: Racial and ethnic differences in weight gain during and after chemotherapy among women with early-stage breast cancer

Objective

Clinically significant weight gain of ≥5% from baseline has been commonly reported during chemotherapy treatment for early stage breast cancer and persisting after completion. Based on the known poorer outcomes associated with weight gain after a breast cancer diagnosis, we evaluated differential weight gain by race/ethnicity as a potential explanation for disparities in breast cancer clinical outcomes among racial/ethnic minorities compared to non-Hispanic white women.

Methods

We conducted a retrospective cohort study among women diagnosed with stage I-III breast cancer between 2007 and 2016, who received chemotherapy at Columbia University Medical Center (CUMC) in New York, NY. We extracted data on demographics, clinical characteristics, chemotherapy regimens, and height/weight from the electronic health records. Our main exposure variable of interest was race/ethnicity. The outcome variable was dichotomized as ≥5% weight gain or stable weight (defined as <5% weight gain or loss/≥5% weight loss) from baseline at 3, 6, 12, and 18 months after initiating chemotherapy. We used multinomial logistic regression analyses to determine the association between race/ethnicity and weight gain before and after adjusting for confounders.

Results

Among 789 evaluable women, median age was 55 years (range, 19-92) and the study cohort was racially/ethnically diverse: 39.8% non-Hispanic white, 30.4% Hispanic, 18.0% non-Hispanic black, 10.4% Asian, and 1.4% other. Mean baseline body mass index (BMI) was highest among black women (30.7 kg/m2 ± 7.0), followed by Hispanic (29.4 kg/m2 ± 5.2), non-Hispanic white (27.9 kg/m2 ± 6.9), and Asian (25.5 kg/m2 ± 5.4) women. The proportion of women with ≥5% weight gain increased over time with 13.6% at 3 months, 15.2% at 6 months, 19.0% at 12 months, and 23.6% at 18 months. Compared to non-Hispanic whites, Asian women had a 63% lower odds of ≥5% weight gain (95% Confidence Interval [CI]: 0.15-0.92) at 3 months after initiating chemotherapy. No statistically significant associations were found between other racial/ethnic groups and ≥5% weight gain. Factors associated with weight gain after chemotherapy included younger age at diagnosis, lower baseline BMI, longer duration of chemotherapy, and having Medicaid insurance coverage.

Conclusions

Race/ethnicity was not significantly associated with weight gain after chemotherapy among women with early stage breast cancer. Socioeconomic status (SES) rather than race/ethnicity may be a contributing factor in disparities in weight gain and breast cancer clinical outcomes. Future weight loss programs should target younger, pre-menopausal women and those with lower SES.

Citation Format: Wu R, Crew KD. Racial and ethnic differences in weight gain during and after chemotherapy among women with early-stage breast cancer [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 P1-10-04.

Risk of systemic lupus erythematosus in patients with human papillomavirus infection: a population-based retrospective cohort study

Background: Viral infection contributing to systemic lupus erythematosus (SLE) development has been largely reported. However, the SLE risk in patients with human papillomavirus (HPV) infection is unknown. Methods: Data were retrieved from the Longitudinal Health Insurance Database (2000) in Taiwan. We identified 43,567 patients with HPV infection and 174,268 age- and sex-matched uninfected controls from 2002 to 2012. Individuals were followed up from index date (first date of diagnosis with HPV) until the occurrence of SLE, at the end of the study (December 2013), or when they were withdrawn from the insurance program. The incidence rate ratio (IRR) was calculated using the univariate Poisson regression. The adjusted hazard ratios (aHRs) were calculated, and sensitive and subgroups analyses were also conducted. Results: Compared with the non-HPV controls, the IRR of SLE in HPV patients was 1.52 (95% confidence interval (CI): 1.09–2.12). The risk of SLE in HPV-infected individuals was significantly high (aHR: 1.48, 95% CI: 1.06–2.06) after adjusting for age, sex, and comorbidities. Men aged between 16 and 45 years were more susceptible to developing SLE (aHR: 21.57, 95% CI: 2.52–184.60, p = 0.0051). Conclusion: Our study showed a significantly higher risk of SLE among HPV-infected patients, especially in men aged between 16 and 45 years.

Evidence for a quantum spin Hall phase in graphene decorated with Bi2Te3 nanoparticles

Realization of the quantum spin Hall effect in graphene devices has remained an outstanding challenge dating back to the inception of the field of topological insulators. Graphene's exceptionally weak spin-orbit coupling-stemming from carbon's low mass-poses the primary obstacle. We experimentally and theoretically study artificially enhanced spin-orbit coupling in graphene via random decoration with dilute Bi₂Te₃ nanoparticles. Multiterminal resistance measurements suggest the presence of helical edge states characteristic of a quantum spin Hall phase; the magnetic field and temperature dependence of the resistance peaks, x-ray photoelectron spectra, scanning tunneling spectroscopy, and first-principles calculations further support this scenario. These observations highlight a pathway to spintronics and quantum information applications in graphene-based quantum spin Hall platforms.

Common themes and challenges in hemophilia care: a multinational perspective

OBJECTIVE

To identify ways that provision of hemophilia care can be maximized at the local level, irrespective of available resources or cultural or geographic challenges.

METHODS

The SHIELD group used its multinational experience to share examples of local initiatives that have been employed to deliver optimal hemophilia care.

RESULTS

The examples were reviewed and categorized into four key themes: guidelines and algorithms for delivery of care; collaboration with patients and allied groups for care and education; registries for the monitoring of treatment and outcomes and health care planning and delivery; and opportunities for personalization of care. These themes were then incorporated into a road map for collaborative care in hemophilia that reflected the contribution of best practice.

DISCUSSION

Differing healthcare reimbursement systems, budgetary constraints, and geographical and cultural factors make it difficult for any country to fully deliver ideal care for people with hemophilia. The SHIELD approach for collaborative care provides illustrative examples of how four key themes can be used to optimize hemophilia care in any setting.

ABBREVIATIONS

AHCDC: Association of Hemophilia Clinic Directors of Canada; AICE: Italian Association of Hemophilia Centres; ATHN: American Thrombosis and Hemostasis Network; EAHAD: European Association for Haemophilia and Allied Disorders; EHC: European Hemophilia Consortium; FIX: Coagulation Factor IX; FVIII: Coagulation Factor VIII; HAL: Haemophilia Activity List; HJHS: Haemophilia Joint Health Score; HTC: Hemophilia Treatment Centre; HTCCNC: Hemophilia Treatment Centre Collaborative Network of China; MASAC: Medical and Scientific Advisory Council; MDT: Multidisciplinary team; NHD: National Haemophilia Database; NHF: National Hemophilia Foundation; PK: Pharmacokinetics; POCUS: Point of care ultrasound; PWH: People with haemophilia; SHIELD: Supporting Hemophilia through International Education, Learning and Development; WFH: World Federation of Hemophilia.

Increased serum periostin concentrations are associated with the presence of diabetic retinopathy in patients with type 2 diabetes mellitus

PURPOSE

To determine the association between serum periostin and the presence of diabetic retinopathy (DR).

METHODS

Serum periostin was detected in 114 healthy subjects, 122 patients with type 2 diabetes mellitus (T2DM) and 159 patients with DR and compared among groups. Clinical data and other laboratory measurements such as glycated hemoglobin (HbA1c), lipid profiles, serum creatinine (Cr) and high-sensitivity CRP (hsCRP) were also collected and compared among groups. For subgroup analysis, patients with DR were divided into a non-proliferated diabetic retinopathy (NPDR) group and a proliferated diabetic retinopathy (PDR) group. Multivariate analysis was performed using logistic regression models.

RESULTS

The serum periostin level was significantly higher in patients with diabetic retinopathy compared with healthy subjects and patients with T2DM (both P < 0.001, respectively). Also, the periostin level was significantly higher in the PDR group compared to the NPDR group (P = 0.044). Multivariate logistic regression revealed that serum periostin was independently associated with the presence of DR in patients with T2DM (P < 0.001). The receiver operating characteristic (ROC) curves for DR development using serum periostin showed that the area under the receiver operating characteristic curves (AUC) was 0.838 (P < 0.001).

CONCLUSIONS

The current study demonstrated that serum periostin is significantly associated with the presence of DR in patients with T2DM and is an independent risk factor of DR.

[Comparison of effects of oleic acid and palmitic acid on lipid deposition and mTOR / S6K1 / SREBP-1c pathway in HepG2 cells]

Objective: To explore the effects of oleic acid and palmitic acid on lipid deposition and mTOR/S6K1/SREBP-1c pathways in HepG2 cells. Methods: The model of steatosis was established with induction of oleic acid and palmitic acid and was intervened by rapamycin. The changes in lipid droplets were observed after staining the cells with oil Red O. Intracellular triglyceride (TG) contents in cells were measured by TG kit. mTOR, S6K1, and SREBP-1c mRNA expression levels were detected using QRT-PCR. Western blot was used to determine protein expression levels of mTOR, S6K1 and SREBP-1c. Results: Both fatty acids increased lipid droplets in HepG2 cells. Fatty degeneration with elevated TG occurred with significant changes in oleic acid group lipids. Rapamycin alleviated lipid deposition caused by oleic acid and palmitic acid and inhibited their induction of increased expression of mTOR, S6K1, and SREBP-1c. QRT-PCR and Western blot results showed that mRNA and protein expressions of mTOR, S6K1, and SREBP-1c in oleic acid and palmitic acid group were significantly higher than the control group (P < 0.05). The increase was more pronounced in the palmitic acid group (P < 0.05); however, after rapamycin intervention, the expression of mRNA and protein in the three groups were significantly lower (P < 0.05), and the change in palmitic acid group was more pronounced (P < 0.05). Conclusion: Oleic acid and palmitic acid can induce lipid deposition in HepG2 cells and increase expression of every component of mTOR/S6K1/SREBP-1c pathway; however, Oleic acid-induced lipid deposition is more pronounced, and the mTOR, S6K1, and SREBP-1c pathway change is more obvious in palmitic acid. Rapamycin has high potent inhibitory effect on palmitic acid-induced lipid deposition. These results specify that lipid synthesis involved in the mTOR/S6K1/SREBP-1c pathways are mainly associated to palmitic acid in HepG2 cells, whereas other signaling pathway may mediate oleic acid-induced lipid synthesis.

Antigen I/II mediates interactions between Streptococcus mutans and Candida albicans

Streptococcus mutans and Candida albicans are frequently co-isolated from dental plaque of children with early childhood caries (ECC) and are only rarely found in children without ECC, suggesting that these species interact in a manner that contributes to the pathogenesis of ECC. Previous studies have demonstrated that glucans produced by S. mutans are crucial for promoting the formation of biofilm and cariogenicity with C. albicans; however, it is unclear how non-glucan S. mutans biofilm factors contribute to increased biofilm formation in the presence of C. albicans. In this study we examined the role of S. mutans antigen I/II in two-species biofilms with C. albicans, and determined that antigen I/II is important for the incorporation of C. albicans into the two-species biofilm and is also required for increased acid production. The interaction is independent of the proteins Als1 and Als3, which are known streptococcal receptors of C. albicans. Moreover, antigen I/II is required for the colonization of both S. mutans and C. albicans during co-infection of Drosophila melanogaster in vivo. Taken together, these results demonstrate that antigen I/II mediates the increase of C. albicans numbers and acid production in the two-species biofilm, representing new activities associated with this known S. mutans adhesin.

Calhm2 governs astrocytic ATP releasing in the development of depression-like behaviors

Extracellular ATP is a widespread cell-to-cell signaling molecule in the brain, where it functions as a neuromodulator by activating glia and neurons. Although ATP exerts multiple effects on synaptic plasticity and neuro-glia interactions, as well as in mood disorders, the source and regulation of ATP release remain to be elaborated. Here, we define Calhm2 as an ATP-releasing channel protein based on in vitro and in vivo models. Conventional knockout and conditional astrocyte knockout of Calhm2 both lead to significantly reduced ATP concentrations, loss of hippocampal spine number, neural dysfunction and depression-like behaviors in mice, which can be significantly rescued by ATP replenishment. Our findings identify Calhm2 as a critical ATP-releasing channel that modulates neural activity and as a potential risk factor of depression.

[Long-term prognostic value of lowering in free triiodothyronine in patients with hypertrophic cardiomyopathy]

Objective: To determine whether thyroid hormone (TH) level could also be an independent and incremental predictor of adverse events in patients with hypertrophic cardiomyopathy (HCM). Methods: A total of 982 consecutive patients with HCM at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013 were included in the present study, and followed up till the end of December 2016. The patients were divided into three groups according to the levels of free triiodothyronine (FT₃): the group 1 (FT₃≤4.28 pmol/L, n=335), the group 2 (FT₃>4.28-<4.79 pmol/L, n=310), and the group 3 (FT₃ 4.79-6.30 pmol/L, n=337). Results: After a follow-up period of (53.8±14.1) months, 39 patients (4.0%) either suffered death with all causes or received a cardiac transplantation (7.8%, 2.9% and 1.2% of the patients in the group 1, group 2 and group 3, respectively). A multivariable Cox regression analysis revealed that FT₃≤4.28 pmol/L was associated with a significantly higher risk of all-cause mortality or cardiac transplantation (HR 8.83, 95% CI 1.115- 69.905,P=0.039) in HCM patients. Conclusions: Low levels of FT₃ is a risk factor of adverse events for patients with HCM, indicting a role of FT₃ as a marker for assessing the risk of long-term adverse events in these patients.

[Value of N-terminal pro-B-type natriuretic peptide on long-term outcome of patients with hypertrophic cardiomyopathy]

Objective: To determine the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the long-term outcome of patients with hypertrophic cardiomyopathy (HCM) . Methods: NT-proBNP was measured in 831 consecutive patients with HCM at Fuwai Hospital from October 2009 to December 2013 and patients were followed up clinically for (53.3±15.4) months. Patients were divided into 3 groups according to NT-proBNP values: NT-proBNP<860 pmol/L (n=276) , 860 pmol/L≤NT-proBNP≤1 905 pmol/L (n=278) , NT-proBNP>1 905 pmol/L (n=277) . The related baseline data, laboratory examination and echocardiographic results were compared among groups. The primary endpoints of this study were all-cause mortality and cardiac transplantation. Cox proportional hazards model was used to estimate hazard ratio (HR) . Kaplan-Meier analysis was used to evaluate the survival status of patients among the 3 groups. Results: During a median follow-up of (53.3±15.4) months, all-cause mortality or cardiac transplantation occurred in 37 patients (4.5%) , event rate was 1.4% (4/276) , 4.0% (11/278) and 7.9% (22/277) in patients with NT-proBNP<860 pmol/L, 860 pmol/L≤NT-proBNP≤1 905 pmol/L and NT-proBNP>1 905 pmol/L, respectively. Multivariable Cox regression analysis identified that age (HR 1.066, 95%CI 1.027-1.107) and NT-proBNP (HR 1.026, 95% CI 1.010-1.042) were independent predictors of all-cause mortality or cardiac transplantation. Among the 3 groups, the survival rate of the NT-proBNP<860 pmol/L group was the highest,and that of the NT-proBNP>1 905 pmol/L group was the lowest (P<0.01) . Conclusions: The level of NT-proBNP provides clinically relevant information for long-term adverse events risk stratification in patients with HCM.

Abstract PD7-02: Value-based medicine: Are the 2013 guidelines for HER2 testing clinically significant and cost effective?

Background: In the U.S., around 252,710 new breast cancer cases will be diagnosed in the year 2017. About 15-20% of these patients will be candidates for treatment with Her-2 directed therapy. The College of American Pathologists (CAP) published initial guidelines for immunohistochemistry (IHC) in 2003 with revisions in 2007 and 2013. 2013 guidelines define 3+(positive) as &gt;10% intense complete membrane staining similar to 2003; &gt;30% complete in 2007. Equivocal 2+ category in 2013 includes incomplete staining &gt; 10% for the first time; this was negative in 2003 and 2007.Hypothesis: The 2013 guidelines do not result in more true positives but increased equivocal cases resulting in clinical uncertainty and increased cost. Methods : A retrospective analysis was performed of all IHC and FISH testing done at a single institution with a single pathology reader from 2003-2016. Criteria for IHC and FISH positivity were followed for each time period and compared to one another for positive and negative HER2 expression. The equivocal categories than compared for outcome by FISH. Ultimate numbers for percentage in each category compared for statistical significance. Results:

IHC NegativeEquivocalPositiveTotal(1) 2003279, 70.6%71, 17.9%45, 11.3%395(2) 2007187, 71.6%49, 18.7%25, 9.5%261(3) 2013181, 61.7%79, 26.9%33, 11.2%293Total647199103949Chi-SquareDFValueProbOverall410.40.03 Period 1 vs 220.50.75Period 1 vs 328.20.01Period 2 vs 326.40.04

IHC Equivocal Reflex to FISH NegativeEquivocalPositiveTotal(1) 200358, 82.8%1, 1.4%11, 15.7%70(2) 200734, 80.9%0, 0.0%8, 19.0%42(3) 201362, 82.6%6, 8.0%7, 9.3%75Total154726187DF4Chi-Square8.3Asymptotic Pr&gt; ChiSq0.08Exact Pr ≥ ChiSq0.07

When further analysis was carried out, period 1 and 2 were added together and compared to period 3. When all positives and negatives were compared, there was no statistical difference between the periods. However in the equivocal category, Period 1 and 2 were statistically different than period 3. In fact the only change in period 3 was the increase in the equivocal cases (same case-equivocal IHC and FISH).

Conclusion: In the 2013 CAP guidelines, 2+ IHC now includes incomplete staining in &gt;10% of cells. This does not result in more positive cases as was the intention but an increase in the equivocal category by 8.19%. This adds to clinical uncertainty as to how to treat this group of patients. A send out for FISH is labor intensive, slow and costs on average of $650/case. With over 250,000 new cases expected this year in the U.S. this cost exceeds $13million. From all our data, the best parameters for IHC testing would be; positive-strong, complete staining in &gt;10% cells and equivocal to eliminate the incomplete staining category. This would yield the highest number of true positives by FISH and almost eliminate ultimate equivocal cases.

Citation Format: Sharma A, Vadehra D, Talal K, Hegde P, Wu R, Tannenbaum S. Value-based medicine: Are the 2013 guidelines for HER2 testing clinically significant and cost effective? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-02.

The microenvironment of classical Hodgkin lymphoma: heterogeneity by Epstein-Barr virus presence and location within the tumor

This corrects the article DOI: 10.1038/bcj.2016.26.

Clinical Complications of Combined Phacoemulsification and Vitrectomy for Eyes with Coexisting Cataract and Vitreoretinal Diseases

Purpose

To discuss the intraoperative and postoperative complications of combining phacoemulsification and foldable intraocular lens (IOL) implantation with pars plana vitrectomy in eyes with significant cataract and coexisting vitreoretinal diseases.

Methods

This retrospective study consisted of 186 eyes of 149 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with clear corneal phacoemulsification and foldable IOL implantation. Main outcome measures were the intraoperative and postoperative complications at from 6 to 56 months.

Results

The most common intraoperative complication was iatrogenic retinal hole (5.3%), transient corneal edema (3.2%), and posterior capsule break (2.1%). The most common postoperative complication was posterior capsule opacification (21.5%) and elevated intraocular pressure (9.7%), macular edema (8.1%), fibrinous reaction (6.9%), vitreous hemorrhage (3.7%), posterior synechiae (3.7%), and recurrent retinal detachment (3.2%). Postoperatively, in 162 eyes (87.1%), visual acuity improved by 3 lines or more on the Snellen chart. In 14 eyes (7.5%), vision remained within 3 lines of preoperative levels and in 10 eyes (5.3%), vision had decreased at the last follow-up.

Conclusions

Postoperative complications did not increase significantly in the combined phacoemulsification and vitreoretinal surgery. Combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective in treating vitreoretinal abnormalities coexisting with cataract. Based on extensive experience with the combined procedure, the authors suggest that combined surgery is recommended in select patients having simultaneous vitreoretinal pathologic changes and cataract.

Long spin-flip time and large Zeeman splitting of holes in type-II ZnTe/ZnSe submonolayer quantum dots

The Zeeman splitting and degree of circular polarization (DCP) of photoluminescence (PL) from type-II submonolayer ZnTe/ZnSe quantum dots (QDs) have been investigated in magnetic fields up to 18 T. To explain the observed relative intensities and energy positions of the σ+ and the σ- PL, a non-Boltzmann distribution for holes with ultra-long spin-flip time, confined to submonolayer QDs, is proposed. The g-factor of electrons, located in the ZnSe barriers, was obtained from fitting the temperature dependence of the DCP, and its value is in excellent agreement with that of bulk ZnSe. The g-factor of type-II excitons was extracted by analyzing the Zeeman splitting, from which the g-factor of holes confined within submonolayer ZnTe QDs was found to be ~2.65 ± 0.40. This value is considerably larger than that in bulk ZnTe. Tight-binding calculations using an sp 3 s* model were employed to understand the origin of such an increase. The results of the simulation match the experiment and show that the enhancement of the hole g-factor is mostly caused by a reduced orbital contribution to Zeeman splitting arising from the submonolayer thickness of these QDs.

[The clinical characteristics, diagnosis and treatment of patients with gout in China]

Objective: To investigate the demographic characteristics, clinical features, diagnosis and treatment of patients with gout in China. Methods: Clinical data of 6 814 patients with gout from 100 hospitals in 27 provinces, municipalities or autonomous regions in China were collected and analyzed. Results: (1) The ratio of male to female in patients with gout was 14.7∶1. The mean age of onset was (48.8±15.1) years old. Mean serum urate level was (526.7±132.3) μmol/L. Patients' education background was of U-shaped distribution; (2) Hypertension was the most common comorbidity [15.8%(1 079/6 814)], then overweight or obesity [51.9%(3 536/6 814)]; (3) Alcohol and high-purine food intake were dominant triggering factors in men. The diagnosis of gout was made after onset in majority of patients with cardinal symptom arthralgia. Most patients had the disease less than 5 years, and the longer the course, the more flares in the previous year of entry; (4) Febuxostat was the mostly used urate-lowering medication. 20.7%(1 412/6 814), 10.8%(739/6 814) and 3.9%(265/6 814) of patients were followed up in 4 weeks, 12 weeks and 24 weeks after registration, and 18.9%(267/1 412), 29.1%(215/739) and 38.1%(101/265) of them reached the control target of serum urate levels, respectively. After treatment, patients' liver function was not affected, but serum creatinine levels decreased significantly. Conclusions: The proportion of gout patients who reach target serum urate level is very low. Further steps including education and survey need to be carried on.

Break-through bleeding in relation to pharmacokinetics of Factor VIII in paediatric patients with severe haemophilia A

INTRODUCTION

As the pharmacokinetics (PK) of factor VIII (FVIII) is individualized in children with haemophilia A (HA), PK parameters may be indicators of patients' bleeding phenotype and instruction for their personalized replacement program.

AIM

The aim of this study was to investigate the possible relationship between PK/FVIII level and bleeding frequency in Chinese paediatric patients with severe (HA).

METHODS

A total of 24 patients were enrolled in Beijing Children's Hospital from February to October 2015, all of whom were given 50 IU/kg of FVIII concentrates after a 72-hours washout period. Samples' activities (FVIII:C) were tested at 5 time points, using WinNonlin software for PK testing, and then the individual half-life(t_1/2 ) and the time (h) of FVIII concentrations <1 IU/dL within a week during prophylaxis were calculated. Baseline and the annual bleeding rate (ABR), annual joint bleeding rate (AJBR) were recorded and analyzed.

RESULTS

The mean t_1/2 of FVIII was 10.20 ± 2.72 hours and the mean time of FVIII <1 IU/dL in 1 week was 44.7 hours (-38.56 to 102.33 hours). A significant relationship between t_1/2 of FVIII and ABR₀ /AJBR₀ (baseline bleeding) was found (R²  = 0.75 and 0.62, P < .001). Besides, baseline and the annual bleeding rate during prophylactic treatment of haemophilia had a positive correlation with the time (hours) of FVIII <1 IU/dL in 1 week (R²  = 0.67 and 0.52, P < .001).

CONCLUSION

t_1/2 was an important indicator to prevent bleeding in severe HA; the frequency of bleeding will be reduced with the increased of t_1/2 of FVIII. The data also demonstrates that increasing the time with a FVIII<1 IU/dL is associated with an increased rate of bleeding during prophylaxis.

Localized Control of Curie Temperature in Perovskite Oxide Film by Capping-Layer-Induced Octahedral Distortion

With reduced dimensionality, it is often easier to modify the properties of ultrathin films than their bulk counterparts. Strain engineering, usually achieved by choosing appropriate substrates, has been proven effective in controlling the properties of perovskite oxide films. An emerging alternative route for developing new multifunctional perovskite is by modification of the oxygen octahedral structure. Here we report the control of structural oxygen octahedral rotation in ultrathin perovskite SrRuO_{3} films by the deposition of a SrTiO_{3} capping layer, which can be lithographically patterned to achieve local control. Using a scanning Sagnac magnetic microscope, we show an increase in the Curie temperature of SrRuO_{3} due to the suppression octahedral rotations revealed by the synchrotron x-ray diffraction. This capping-layer-based technique may open new possibilities for developing functional oxide materials.

Correspondence between the electronic structure and phase separation in a K-doped FeSe system

Phase separated potassium intercalated FeSe thin films have been synthesized by pulsed laser deposition. The coexistence of FeSe phase and 245 phase was investigated both by x-ray photoemission spectroscopy (XPS) and x-ray diffraction. The volume ratio of these two phases is sensitive to temperatures and amount of extra potassium dosing. The XPS and ultraviolet photoelectron spectroscopy results indicated that these two phases shows the different hybridization strength between adjacent Fe layer and Se layer. We infer that the layered electronic structure is the necessary condition of superconductivity in potassium-doped FeSe system, and the phase separation is driven by competition between quasi-2D and 3D bonding mode within FeSe layer. Similar competition may also be able to interpret the phase seperation in K _x Fe_2-y Se₂ bulk single crystal.

Describing the quality of life of boys with haemophilia in China: Results of a multicentre study using the CHO-KLAT

INTRODUCTION

The treatment of haemophilia varies across countries and across regions within some countries. Similar variation has been observed in health-related quality of life (HR-QoL). Relatively little is known about the HR-QoL of boys with haemophilia in China.

AIM

The aim of this study was to describe the HR-QoL of boys with haemophilia in China using the Canadian Haemophilia Outcomes-Kids Life Assessment Tool (CHO-KLAT).

METHODS

Boys (4-18 years of age) with haemophilia and their parents were enroled in a cross-sectional study. All parents/guardians of study subjects were requested to complete a CHO-KLAT questionnaire during a clinic visit, and report on several other clinical and socioeconomic factors in the past year. Boys who were > 7 years also completed the CHO-KLAT.

RESULTS

A total of 269 parents of boys with haemophilia, from 13 hospitals in 12 provinces, were enroled during 2014. The boys ranged from 4.0 to 17.9 years of age; 91% had haemophilia A, most had moderate (52%) or severe (36%) disease, and most were receiving sub-optimal on-demand therapy or low-dose prophylactic therapy. Child self-report CHO-KLAT scores were available for 171 boys ≥7 years of age and ranged from 24.2 to 85.3 with a mean of 57.6 (n = 171). Parent proxy-reported CHO-KLAT scores ranged from 25.0 to 88.7 with a mean of 55.1 (n = 269).

CONCLUSION

HR-QoL scores in boys with haemophilia in China were substantially lower than reported from Canadian and European boys with haemophilia. Longer term prospective studies are required to examine the factors impacting the HR-QoL for boys with haemophilia in China.

Association between Mismatch-repair Genetic variation and the Risk of Multiple Primary Cancers: A Meta-Analysis

Microsatellites instability (MSI) is a risk factor for multiple primary cancers (MPCs). However, a variety of studies focused on the risk in the hereditary non-polyposis colorectal cancer (HNPCC) not the sporadic colorectal cancer (CRC) patients. The aim of this meta-analysis was to comprehensive overview and quantitative summary the association between MSI and risk of MPCs. A comprehensive literature search in MEDLINE, EMBASE, Web of science, ScienceDirect, Weily and OVID was conducted. Up to May 2016, we identified 22 observational studies. We calculated the summary relative risk (RR) for the risk of MPCs in MSI patients compared with microsatellites stability (MSS) patients using fixed- or random-effects models. The RR of the association between mismatch-repair gene (MMR) genotype and MPCs was 2.59 (95% confidence interval [CI], 2.06 to 3.27); the RR was 2.14 (95% CI, 1.78 to 2.57) for sporadic CRC and 5.59 (95% CI, 2.69 to 11.59) for HNPCC for the MSI versus MSS category. The subgroup analyses showed different mutant gene, mutant locus, and mutant level of MMR with different influence on the patients susceptible to MPCs. In addition, MSI genotype increase the risk of MPC was not associated with an apparently specific in regard to site, timing, age and detection method. In conclusion, this meta-analysis indicates that MSI is associated with an increased risk of MPCs both in the HNPCC and sporadic CRC patients. Our findings will form the backbone of the treatment for MSI genotype may be an important valuable strategy for MPCs prevention.

Comparative efficacy and toxicity of induction chemotherapy with concurrent stereotactic body radiotherapy and stereotactic body radiotherapy with subsequent chemotherapy in patients with clinical stage T1-3N0M0 non-small cell lung carcinoma

PURPOSE

We compared the clinical efficacy and toxicity of stereotactic body radiotherapy with induction chemotherapy and concurrent radiochemotherapy vs stereotactic body radiotherapy with subsequent chemotherapy in patients with clinical stage T1-3N0M0 non-small cell lung carcinoma.

METHODS

We retrospectively analyzed 38 patients with c-stage T1-3N0M0 non-small cell lung carcinoma who received stereotactic body radiotherapy. All patients received six cycles of chemotherapy. Fifteen of the patients were treated with three cycles of induction chemotherapy, one cycle of concurrent radiochemotherapy, and then two cycles of consolidation chemotherapy, while 23 patients received Sequential Radiotherapy/Chemotherapy.

RESULTS

Patients in the induction chemotherapy group experienced a longer duration of esophagitis (median 2 vs 0, range 0-6 vs 0-3.6 weeks, p = 0.04). We divided the patients into two groups based on their median pre-treatment tumor volume (cm³): >32.11 and ≤32.11. The tumor response rate in patients with larger tumor volume was substantially higher in the induction chemotherapy group than in the Sequential Radiotherapy/Chemotherapy group (66.67 vs 40%). Among patients with pre-treatment tumor volume (cm³) >32.11, the median local progression-free survival (LPFS) in the induction chemotherapy group and Sequential Radiotherapy/Chemotherapy group was 18 months (range 7-72 months) and 11 months (range 6-53 months), respectively. There was a statistically significant difference between the two groups (p = 0.006).

CONCLUSIONS

Simultaneous SBRT and chemotherapy can result in a longer duration of esophagitis. However, for patients with large tumor volume, ICT combined with concurrent radiochemotherapy may result in better local tumor response as well as longer LPFS and progression-free survival. To better elucidate the best treatment, further clinical trials are needed.

Quantitative Contribution of rs75017182 to Dihydropyrimidine Dehydrogenase mRNA Splicing and Enzyme Activity

Dihydropyrimidine dehydrogenase (DPD; DPYD gene) variants have emerged as reliable predictors of adverse toxicity to the chemotherapy agent 5-fluorouracil (5-FU). The intronic DPYD variant rs75017182 has been recently suggested to promote alternative splicing of DPYD. However, both the extent of alternative splicing and the true contribution of rs75017182 to DPD function remain unclear. In the present study we quantified alternative splicing and DPD enzyme activity in rs75017182 carriers utilizing healthy volunteer specimens from the Mayo Clinic Biobank. Although the alternatively spliced transcript was uniquely detected in rs75017182 carriers, canonically spliced DPYD levels were only reduced by 30% (P = 2.8 × 10^-6 ) relative to controls. Similarly, DPD enzyme function was reduced by 35% (P = 0.025). Carriers of the well-studied toxicity-associated variant rs67376798 displayed similar reductions in DPD activity (31% reduction). The modest effects on splicing and function suggest that rs75017182 may have clinical utility as a predictor of 5-FU toxicity similar to rs67376798.

Wnt5a induces ROR1 to associate with 14-3-3ζ for enhanced chemotaxis and proliferation of chronic lymphocytic leukemia cells

Wnt5a can activate Rho GTPases in chronic lymphocytic leukemia (CLL) cells by inducing the recruitment of ARHGEF2 to ROR1. Mass spectrometry on immune precipitates of Wnt5a-activated ROR1 identified 14-3-3ζ, which was confirmed by co-immunoprecipitation. The capacity of Wnt5a to induce ROR1 to complex with 14-3-3ζ could be blocked in CLL cells by treatment with cirmtuzumab, a humanized mAb targeting ROR1. Silencing 14-3-3ζ via small interfering RNA impaired the capacity of Wnt5a to: (1) induce recruitment of ARHGEF2 to ROR1, (2) enhance in vitro exchange activity of ARHGEF2 and (3) induce activation of RhoA and Rac1 in CLL cells. Furthermore, CRISPR/Cas9 deletion of 14-3-3ζ in ROR1-negative CLL cell-line MEC1, and in MEC1 cells transfected to express ROR1 (MEC1-ROR1), demonstrated that 14-3-3ζ was necessary for the growth/engraftment advantage of MEC1-ROR1 over MEC1 cells. We identified a binding motif (RSPS⁸⁵⁷SAS) in ROR1 for 14-3-3ζ. Site-directed mutagenesis of ROR1 demonstrated that serine-857 was required for the recruitment of 14-3-3ζ and ARHGEF2 to ROR1, and activation of RhoA and Rac1. Collectively, this study reveals that 14-3-3ζ plays a critical role in Wnt5a/ROR1 signaling, leading to enhanced CLL migration and proliferation.

Impaired learning and memory in rats induced by a high-fat diet: Involvement with the imbalance of nesfatin-1 abundance and copine 6 expression

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, resulting not only in liver dysfunction, glucose and lipid metabolism disorder, but also in neuropsychiatric damage. In the present study, a NAFLD rat model was established via feeding of a high-fat diet, and behaviour was observed via the open field test (OFT), the sucrose preference test (SPT), the elevated plus maze (EPM), the forced swimming test (FST) and the Morris water maze (MWM). The plasma concentrations of alanine aminotransferase (ALT), glucose, free fatty acid (FFA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were detected using chemiluminescence technique. The plasma levels of nesfatin-1, leptin and insulin were measured via enzyme-linked immunosorbent assay, and the protein expressions of p-glycogen synthase kinase-3β (GSK-3β), GSK-3β, p-β-catenin, β-catenin, cyclinD and copine 6 in the hippocampus and prefrontal cortex (PFC) were detected using western blotting. After 4 consecutive weeks of feeding with a high-fat diet, the rats showed obesity; increased plasma concentrations of ALT, glucose, FFA, TC, TG, HDL-C and LDL-C; decreased plasma levels of leptin and insulin; and inflammation and mild hepatocyte steatosis in the liver. Although there was no significant difference between groups with regard to performance in the OFT, EPM or FST, the NAFLD rats showed a decreased sucrose preference index in the SPT and impaired learning and memory in the MWM task. Moreover, the present study provides the first evidence of an increased plasma nesfatin-1 concentration in NAFLD rats, which was significantly correlated with plasma lipid concentrations and behavioural performance. Furthermore, copine 6 and p-β-catenin protein expression decreased and p-GSK-3β increased in the hippocampus and PFC of NAFLD rats. These results suggest that consuming of a high-fat diet for 4 consecutive weeks could successfully induce a NAFLD rat model. More importantly, these results provide the first evidence that impaired learning and memory in NAFLD rats was, at least partly, associated with increased plasma nesfatin-1 concentration and decreased copine 6 expression in the hippocampus and PFC.

A prospective study of health-related quality of life of boys with severe haemophilia A in China: comparing on-demand to prophylaxis treatment

INTRODUCTION

Treatment for boys with haemophilia in China is rapidly improving; however, comprehensive outcomes have not been examined prospectively.

AIM

The aim of this study was to evaluate the effect of short-term full-dose prophylaxis compared to on-demand treatment, on the Health-Related Quality of Life (HR-QoL) of boys with severe haemophilia A (HA) in China.

METHODS

Boys with severe HA (FVIII<1%) completed 3 months of on-demand treatment and 3 months of full-dose prophylaxis (25 FVIII IU per kg 3x per week). The primary outcomes were child- and parent-reported Canadian Hemophilia Outcomes - Kids Life Assessment Tool (CHO-KLAT) scores. The number and type of bleeds and Activities Scale for Kids (ASK) scores were also recorded.

RESULTS

Analyses included 23 boys between 4 and 15.9 years of age. The number of bleeds decreased by 94% on prophylaxis (P < 0.0001, Wilcoxon Signed-Rank test). The mean child-reported CHO-KLAT scores for boys ≥7 years (n = 20) was 61.4 (±10.9) during on-demand treatment and 61.9 (±11.4) following short-term prophylaxis (P = 0.72, paired t-test). The mean parent-reported CHO-KLAT score during the on-demand phase was 54.4 (±10.5) with an increase of 3.8 points (±8.1; P = 0.04, paired t-test) following prophylaxis.

CONCLUSIONS

Child-reported CHO-KLAT scores were lower in boys with severe HA in China than reported in countries with access to full-dose prophylaxis. Boys reported higher HR-QoL scores than their parents. Small improvements in ASK scores were noted following the prophylaxis phase. These changes were only significant in the parent-reported CHO-KLAT scores. Longer term prospective clinical trials are needed in China to determine the impact of prophylaxis on HR-QoL in boys with severe HA.

[Impact of atmospheric particulate matter at different period of gestation on low birth weight: a meta-analysis]

Objective: To analyze the influence of atmospheric particulate matters (PM(2.5) and PM(10)) on low-birth-weight (LBW) infants at different periods of gestation. Methods: We conducted a systematic literature search for 2 471 articles related to particulate matter and LBW published from January 1st 2000 to January 1st 2016 using the PubMed, Cochrane Library, Web of Science, Science Direct, Chinese Web of Knowledge, Wanfang and Weipu, and the keywords were" air pollution" , "adverse birth outcomes" , "adverse pregnancy outcomes" , "low birth weight/LBW" . According to criteria, 27 literatures were selected and included. Metafor package of the R 3.1.1 Software was used to check the heterogeneity and merge the effect value of the selected literatures, and sensitivity analysis and publication bias were detected and adjusted. Results: A total of 2 471 studies selected form the databases, 27 enrolled in this analysis according to the inclusion and exclusion criteria. Each 10 μg/m(3) increase in PM(2.5) was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.02(95% CI: 0.87-1.19), 1.03 (95% CI: 0.91-1.16) , 1.07 (95%CI: 1.04-1.11) and 1.09 (95%CI: 1.04-1.15), respectively. And 10 μg/m(3) increase in PM(10) was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.66 (95%CI: 1.06-2.61), 1.58 (95%CI:1.28-1.95) , 1.38 (95%CI: 1.23-1.56) and 1.04 (95%CI: 0.99-1.09), respectively. After adjusting the bias of publication, each 10 μg/m(3) increase in PM(2.5) was associated with the risk of low birth weight at 1.11 (95%CI: 1.02-1.21). Conclusion: This meta analysis supports an adverse impact of maternal exposure to particulate air pollution on low birth weight, varying in effects by exposure period.

A novel signal transduction protein: Combination of solute binding and tandem PAS-like sensor domains in one polypeptide chain

We report the structural and biochemical characterization of a novel periplasmic ligand-binding protein, Dret_0059, from Desulfohalobium retbaense DSM 5692, an organism isolated from Lake Retba, in Senegal. The structure of the protein consists of a unique combination of a periplasmic solute binding protein (SBP) domain at the N-terminal and a tandem PAS-like sensor domain at the C-terminal region. SBP domains are found ubiquitously, and their best known function is in solute transport across membranes. PAS-like sensor domains are commonly found in signal transduction proteins. These domains are widely observed as parts of many protein architectures and complexes but have not been observed previously within the same polypeptide chain. In the structure of Dret_0059, a ketoleucine moiety is bound to the SBP, whereas a cytosine molecule is bound in the distal PAS-like domain of the tandem PAS-like domain. Differential scanning flourimetry support the binding of ligands observed in the crystal structure. There is significant interaction between the SBP and tandem PAS-like domains, and it is possible that the binding of one ligand could have an effect on the binding of the other. We uncovered three other proteins with this structural architecture in the non-redundant sequence data base, and predict that they too bind the same substrates. The genomic context of this protein did not offer any clues for its function. We did not find any biological process in which the two observed ligands are coupled. The protein Dret_0059 could be involved in either signal transduction or solute transport.

[The expression and significance of S100A9 in oral squamous cell carcinoma]

Objective:This research intended to explore the expression levels of S100A9 protein in oral squamous cell carcinoma (OSCC), and to analyze its relation with clinicopathologic features in OSCC, then discuss its clinical significance in diagnosis and prognosis of OSCC. Method:Using immunohistochemistry and Western blot to examine S100A9 in 35 oral squamous cell carcinoma specimen and 30 normal oral tissue as control.Result:Expression of S100A9 in oral squamous cell carcinoma (77.1%) was obviously higher than that in normal organizations (46.7%, P< 0.05 ). Among it, expression of low differentiated group was higher than that of high differentiated group. Expression of oral squamous cell carcinoma group in Ⅲ-Ⅳ period was higher than that of Ⅰ-Ⅱ period. The above differences were statistically significant. Expression of S100A9 was not associated with patients'age and gender (P> 0.05). The difference had no statistical significance.Conclusion:Overexpression of S100A9 protein may play a vital role in the progression of OSCC, which can be served as a positive marker for the diagnosis and prognosis of OSCC.