Five-channel tunable W-band Doppler backscattering system in the experimental advanced superconducting tokamak

A 5-channel Doppler backscattering system has been designed and installed in the Experimental Advanced Superconducting Tokamak (EAST). Through an I/Q-type double sideband modulator and a frequency multiplier, an array of finely spaced (Δf = 400 MHz) frequencies that span 1.6 GHz has been created. The center of the array bandwidth is tunable within the range of 75-97.8 GHz, which covers most of the W band (75-110 GHz). The incident angle can be adjusted from -4° to 12°, and the wavenumber range is 4-15 cm^-1 with a wavenumber resolution of Δk/k ≤ 0.35. Ray tracing is used to calculate the scattering location and the scattering wavenumber. This article details the hardware design, the ray tracing, and the preliminary experimental results from EAST plasmas.

Free electrons excited SPASER

Surface plasmon amplification by stimulated emission of radiation (SPASER) is discovered and used for realizing lasers at nanometer scale. The conventional gain media that are applied in SPASER are solid materials, such as organic dye or semiconductor, which limits the frequency range of SPASER. The free electrons could be considered as a kind of gain medium for emitting radiation. Here, we investigate theoretically the SPASER, which is excited by free electrons. We also demonstrate the tunable, deep-ultraviolet, and ultracompact laser numerically by having free electrons interact with surface plasmon polariton mode supported on metal surface. The output power density could reach about 30 W/μm² and the wavelength in deep ultraviolet could be widely tuned by varying the electron energy. This work offers a way of realizing integrated free electron laser in the ultraviolet frequency region.

[Interpretation of allergic rhinitis and its impact on asthma (ARIA)]

Allergic rhinitis and its impact on asthma (ARIA) has been the most preferred reference for national guidelines. The ARIA 2010 revision is the first evidence-based clinical guideline in the field of allergies, which has great influence in the world. The ARIA 2016 revision continues the basic framework of the 2010 revision, which focuses on six controversial clinical issues in the treatment of allergic rhinitis.It aimed to provide clear informationand systematic treatment for patients, clinicians and health policy makers. The interpretation of the ARIA 2016 revision will help domestic otolaryngologist, respiratory doctors, and allergy practitioners understand the latest guidelines for AR drug treatment in the world.

A novel, tunable, multimodal microwave system for microwave reflectometry system

Based on a new technique, a tunable, multi-channel system that covers the Q-band (33-55 GHz) is presented in this article. It has a potential use of the Doppler backscattering system diagnostic that can measure the turbulence radial correlation and the perpendicular velocity of turbulence by changing the incident angle. The system consists primarily of a double-sideband (DSB) modulation and a multiplier, which creates four probing frequencies. The probing frequency enables the simultaneous analysis of the density fluctuations and flows at four distinct radial regions in tokamak plasma. The amplitude of the probing frequency can be adjusted by the initial phase of the intermediate frequency (IF) input from the double-sideband, and the typical flatness is less than 10 dB. The system was tested in the lab with a rotating grating, and the results show that the system can operate in the frequency range of 33-55 GHz with a Q-band multitude and that the power of each channel can be adjusted by the phase of the IF input of DSB.

[Efficacy analysis of the endovascular treatment for 175 unruptured vertebrobasilar dissecting aneurysms]

Objective: To analyze the clinical characteristics, clinical effect and follow-up outcome of the different endovascular treatment techniques in the treatment of unruptured vertebrobasilar dissecting aneurysms (VBDAs). Methods: The clinical data of 160 consecutive patients (175VBDAs) from January 2012 to December 2016 in Beijing Tiantan hospital were retrospectively analyzed.All of the 175 aneurysms were treated with endovascular embolization, including 115 stent-assisted coils, 27 simple stents, 21 blood flow diverting devices, and 12 parent arteries occlusion.The imaging and clinical follow-up were performed after the operation. Results: Headache including cervical-occipital pain(43.1%)was the most common clinical manifestation.The incidence of perioperative complications was 3.75%, no intraoperative bleeding and no deaths.The imaging findings of 113 aneurysms were followed up for (9.9±7.3) months.Of the 71 stent-assisted coils, 62 recovered well and 9 relapsed; of the 19 aneurysms treated with simple stent, 4 recovered well, 11 improved, 2 stable and 2 relapsed; of the 15 aneurysms treated by the blood flow diverting devices, 4 recovered and 11 improved; all of the 8 aneurysms with parent arteries occlusion recovered well.A total of 144 patients were follow-up (17.3±16.6) months by the Modified Rankin Scale(mRS) score: 140 patients were 0-2 score and 4 patients were 3-6 score. Conclusions: The clinical manifestations of the unruptured VBDAs are complex, and the headache is the most common clinical symptom.Endovascular treatment for the treatment of unruptured VBDAs is safe and feasible.The principle of individualization should be followed during embolization.

Association between bedtime and self-reported illness among college students: a representative nationwide study of China

OBJECTIVE

This study was to examine the association between bedtime and self-reported illness among Chinese college students.

METHODS

Participants were 11,942 students, who were identified through a multistage survey sampling process. Sleep and illness status were obtained by self report. Both unadjusted and adjusted methods were considered in the analyses.

RESULTS

The logistic regression model found that late bedtime was positively associated with self reported short and long-term illness (OR: 3.70 and 1, 79) after adjusting for demographic characteristics, short sleep duration, and mental disorders.

CONCLUSIONS

This study is the first to find a positive relationship between late bedtime and self reported illnesses in China or elsewhere. The findings underscore the importance of educating college students about the importance of sleep.

Chemically linked metal-matrix nanocomposites of boron nitride nanosheets and silver as thermal interface materials

Herein, novel hybrid nanocomposite thermal interface materials (TIMs) relying on the chemical linkage of silver, boron nitride nanosheets (BNNSs), and organic ligands are reported. These TIMs were prepared using a co-electrodeposition/chemisorption approach where the electrolytic reduction of silver ions into silver nano-/micro-crystals was coupled with the conjugation of ligand-coated nanosheets onto silver crystals. Furthermore, the influence of the bond strength of silver/nanosheet links on the thermal, mechanical, and structural properties is investigated using a combination of techniques including laser flash analysis, phase-sensitive transient thermoreflectance, nanoindentation, and electron microscopy. The internal nanostructure was found to be strongly dependent on the linker chemistry. While the chemical grafting of 4-cyano-benzoyl chloride (CBC) and 2-mercapto-5-benzimidazole carboxylic acid (MBCA) on BNNSs led to the uniform distribution of functionalized-nanosheets in the silver crystal matrix, the physical binding of 4-bromo-benzoyl chloride linkers on nanosheets caused the aggregation and phase separation. The thermal conductivity was 236-258 W m^-1 K and 306-321 W m^-1 K for physically and chemically conjugated TIMs, respectively, while their hardness varied from 400-495 MPa and from 240 to 360 MPa, respectively. The corresponding ratio of thermal conductivity to hardness, which is a critical parameter controlling the performance of TIMs, was ultrahigh for the chemically conjugated TIMs: 1.3 × 10^-6 m² K^-1 s for MBCA-BNNS and 8.5 × 10^-7 m² K^-1 s for CBC-BNNS. We anticipate that these materials can satisfy some of the emerging thermal management needs arising from the improved performance and efficiency, miniaturization, and/or high throughput of electronic devices, energy storage devices, energy conversion systems, light-emitting diodes, and telecommunication components.

Preparation, characterization, and pharmacokinetics in swine of a florfenicol enteric formulation prepared using hot-melt extrusion technology

The objective of this work was to manufacture an enteric formulation of florfenicol (FF) using hot-melt extrusion (HME) technology and to evaluate its in vitro dissolution and in vivo pharmacokinetics. For the HME process, hypromellose acetate succinate LG (HPMCAS-LG) was the enteric polymer mixed with FF, and the two components were extruded with a standard screw configuration at a speed of 50 rpm. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), powder X-ray diffraction (PXRD), and Fourier transform infrared spectroscopy (FT-IR) were performed to characterize the HME extrudate. The release percentage of the enteric formulation in the acidic stage was <10% of the loaded FF, whereas that in the phosphate buffer stage was >80%. Pharmacokinetic evaluations in swine revealed that the enteric formulation had a longer t_1/2λ and MRT than commercially available FF powder (FULAIKA^® ), indicating that the novel formulation exhibited enteric and sustained release properties. Compared with the commercial product, the relative bioavailability of the enteric formulation reached up to 117.2%. This study suggests that this formulation may have potential for future commercialization.

The viable circulating tumor cells with cancer stem cells feature, where is the way out?

With cancer stem cells (CSCs) became the research hotspot, emerging studies attempt to reveal the functions of these special subsets in tumorigenesis. Although various approaches have been used in CSCs researches, only a few could really reflect or simulate the microenvironment in vivo. At present, CSCs theories are still difficult to apply for clinical remedy because CSCs subpopulations are always hard to identify and trace. Thus an ideal approach for clinicians and researchers is urgently needed. Circulating tumor cells (CTCs), as the method of noninvasive-liquid biopsy, could be detected in the peripheral blood (PB) from many tumors and even could be treated as procurators for CSCs deeper researches from patient-derived sample. However, CTCs, as a diagnostic marker, also raise much controversy over theirs clinical value. Mechanisms causing CTCs to shed from the tumor have not been fully characterized, thus it is unclear whether CTCs represent the entire makeup of cancer cells in the tumor or only a subset. The heterogeneity of CTCs also caused different clinical outcomes. To overcome these unsolved problems, recently, CTC researches are not just depend on enumerations, whereas those CTC subsets that could expand in vitro may play a pivotal role in the metastatic cascade. Here, we retrospect the CTC developmental history and discourse upon the enrichment of viable CTCs in functional assays, probe the further avenue at the crossroad.

Interleukin-6 is both necessary and sufficient to produce perioperative neurocognitive disorder in mice

BACKGROUND

Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic target for PND in a mouse model.

METHODS

Following institutional approval, adult (12-14 weeks) male C57/Bl6 mice were pretreated with the IL-6 receptor (IL6R) blocking antibody tocilizumab prior to open tibia fracture with internal fixation under isoflurane anaesthesia. Inflammatory and behavioural responses in a trace fear conditioning (TFC) paradigm were assessed postoperatively. Separately, the effects of IL-6 administration or of depletion of bone marrow-derived monocytes (BM-DMs) with clodrolip on the inflammatory and behavioural responses were assessed. Blood brain barrier disruption, hippocampal microglial activation, and infiltration of BM-DMs were each assessed following IL-6 administration.

RESULTS

The surgery-induced decrement in freezing time in the TFC assay, indicative of cognitive decline, was attenuated by tocilizumab (P<0.01). The surgery-induced increase in pro-inflammatory mediators was significantly reduced by tocilizumab. Exogenously administered IL-6 significantly impaired freezing behaviour (P<0.05) and up-regulated pro-inflammatory cytokines; both responses were prevented by depletion of BM-DMs. IL-6 disrupted the blood brain barrier, and increased hippocampal activation of microglia and infiltration of BM-DMs.

CONCLUSIONS

IL-6 is both necessary and sufficient to produce cognitive decline. Following further preclinical testing of its perioperative safety, the IL6R blocker tocilizumab is a candidate for prevention and/or treatment of PND.

High Expression of Nuclear Factor of Activated T Cells in Chinese Primary Non-Small Cell Lung Cancer Tissues

Purpose

Nuclear factor of activated T cells (NFAT) has been reported to be involved in the development of various types of cancer including adenocarcinoma of the breast. This research was the first to investigate NFAT protein expression in primary non-small cell lung cancer (NSCLC) tissues from Chinese patients.

Methods

NFAT protein expression was determined in 130 surgically resected primary NSCLC and matched normal tissues by immunohistochemical analysis. The association between NFAT expression and clinical categorical variables was further analyzed with the SPSS software.

Results

We found that NFAT expression was much higher in 85 tumor tissues (65.4%) and lower in 45 tumor tissues (34.6%) compared with the matched normal tissues. Further statistical analysis by the chi-square test showed that high expression of NFAT proteins was significantly associated with tumor differentiation (p=0.045), invasion (p=0.031), histology (p<0.0001), tumor size (p=0.038) and cigarette smoking history (p=0.024). However, there was no correlation between the expression of NFAT proteins and pTNM classification, and no difference in 5-year survival rate between patients with high or low expression of NFAT proteins. Multivariate logistic regression analysis for the correlation between NFAT protein expression levels and various characteristics showed a significant association with histology (p=0.008, OR=0.273).

Conclusion

Our results revealed that high NFAT expression was present in Chinese NSCLCs and that NFAT expression might be involved in the process of human lung cancer development.

Electronic characterization of silicon intercalated chevron graphene nanoribbons on Au(111)

The intrinsic electronic structure of chevron graphene nanoribbons are revealed through in situ silicon intercalation.

[Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 27 cases]

Objective: To study the clinicopathologic characteristics and diagnostic criteria of primary mediastinal B-cell lymphoma (PMBL), and to distinguish PMBL from classic Hodgkin lymphoma(CHL) and systemic diffuse large B-cell lymphoma(DLBCL). Methods: The clinical features, histologic findings, results of immunohistochemical study and prgnosis in 27 PMBL cases were analyzed, with review of literature. Results: The age of patients ranged from 19 to 82 years (median age 34 years). All cases were located in the mediastinum and frequently accompanied by superior vein cava syndrome. Histologically, the tumor cells were pleomorphic and diffusely distributed. Clear cytoplasm and spindle tumor cells were seen in some cases. Varying amount of sclerosing stroma with collagen deposition was seen.Immunohistochemical study showed that the tumor cells were positive for CD20(100%, 27/27), CD30 (64.0%, 16/25), CD23 (77.3%, 17/22) and p63 (16/19). Clonal B cell gene rearrangement was seen. Conclusions: PMBL is a subtype of diffuse large B-cell lymphoma with various histomorphology. Immunohistochemistry can help to confirm the diagnosis, and the prognosis is better than diffuse large B cell lymphoma, not otherwise specified.

Deleting the first disulphide bond in an arenicin derivative enhances its expression in Pichia pastoris

The marine antimicrobial peptide NZ17074, a variant of arenicin-3 from Arenicola marina that has broad antimicrobial activity and high bioavailability, can be designed to treat bacterial and fungal diseases. To reduce the toxicity of NZ17074, N6 was designed by replacing a cysteine in positions 3 and 20 with alanine, fused to the C-terminus of the small ubiquitin-like modifier tag (SUMO), and expressed in yeast. SUMO-N6 yielded as much as 921 mg l^-1 at 72 h after induction in a fermentor and increased 1·8-fold over SUMO-NZ17074. After cleavage with 30% formic acid and purification by a Sephadex G-25 column, 9·7 mg of the recombinant peptide N6 (rN6) was obtained from one-litre fermentation broth, increasing 1·4-fold over NZ17074. Compared to NZ17074, rN6 displayed almost identical antimicrobial activity with a minimal inhibitory concentration of 0·5, 0·25-0·5, 4, 0·25-16 and 16 μg ml^-1 against Escherichia, Salmonella, Pseudomonas, Staphylococcus and Streptococcus strains. Our results indicate that the first disulphide bond, Cys3-Cys20, in NZ17074 is not necessary for antimicrobial activity and that its deletion might reduce toxicity to host cells. These findings may help design new antimicrobial peptides harbouring fewer disulphide bridges and may have more potent activity.

SIGNIFICANCE AND IMPACT OF THE STUDY

Disulphide bond formation is an important step in the protein expression and can also influence protein secretion. A deletion of the first disulphide bond in NZ17074 increased the secreted level of target protein, and its antimicrobial activity was almost unaffected by the deletion of the first disulphide bond. The first disulphide bond in NZ17074 is favourable for correctly forming another disulphide bond during expression but not necessary for its activity. This may help design and produce a novel class of antimicrobial peptides harbouring fewer disulphide bridges to save the cost.

Dendritic Cells from Rheumatoid Arthritis Patient Peripheral Blood Induce Th17 Cell Differentiation via miR-363/Integrin αv/TGF-β Axis

Dendritic cells (DCs) are critical regulators of immune responses. This study was to observe the effect of DCs from peripheral blood on the differentiation of Th17 in patients with rheumatoid arthritis (RA). Peripheral blood samples were collected from 30 patients with RA and 20 healthy controls, respectively. Flow cytometry results showed that in contrast to Treg cells, the proportion of Th17 cells in T cells and the Th17/Treg ratio were both increased in patients with RA. The RT-PCR results showed that Foxp3、ROR γt and miR-363 expression in PBMC of patients with RA were reduced, but the ITGAV expression was increased, which was negatively related to miR-363 expression. IL-17, TGF-β and IL-6 levels detected by ELISA were increased in peripheral blood serum of patients with RA. Moreover, we noted that the CD11C⁺ αν⁺ /CD11C⁺ DCs ratio was obvious increased in patients with RA and has positive correlation to the Th17/Treg ratio. In cocultured system, Th17 cell differentiation was significantly inhibited in the presence of ITGF-β suggesting that Th17 cell differentiation was controlled by active TGF-β (aTGF-β). After DCs transfecting with miR-363 mimics and cocultured with T cells, Th17 cell number, IL-17 level and ROR-γt expression were significantly reduced in the presence of latent TGF-β (ITGF-β). In addition, the integrin αv protein expression was both reduced in the presence of aTGF-β or ITGF-β. These data demonstrated that DCs induced Th17 cell differentiation through miR-363/Integrin αv/TGF-β pathway in patients with RA.

An eight-channel Doppler backscattering system in the experimental advanced superconducting tokamak

Doppler backscattering system can measure the perpendicular velocity and fluctuation amplitude of the density turbulence with intermediate wavenumber. An eight-channel Doppler backscattering system has been installed in the Experimental Advanced Superconducting Tokamak (EAST), which can probe eight different radial locations simultaneously by launching eight fixed frequencies (55, 57.5, 60, 62.5, 67.5, 70, 72.5, 75 GHz) into plasma. The quasi-optical system consists of circular corrugated waveguide transmission, a fixed parabolic mirror, and a rotatable parabolic mirror which are integrated with quasi-optics front-end of the profile reflectometer inside the vacuum vessel. The incidence angle can be chosen from 5° to 12°, and the wavenumber range is 2-15/cm with the wavenumber resolution Δk/k≤0.21. Ray tracing simulations are used to calculate the scattering locations and the perpendicular wavenumber. The dynamic range of this new eight-channel Doppler backscattering system can be as large as 40 dB in the EAST. In this article, the hardware design, the ray tracing, and the preliminary experimental results in the EAST will be presented.

Efficacy and safety of tacrolimus in systemic lupus erythematosus patients with refractory thrombocytopenia: a retrospective study

Objective

We evaluated the efficacy and safety of tacrolimus in systemic lupus erythematosus patients with refractory thrombocytopenia.

Methods

We retrospectively reviewed the data for 20 systemic lupus erythematosus patients with refractory thrombocytopenia and treated with tacrolimus during the period January 2013 to January 2015. In addition to glucocorticoids, all patients were treated with tacrolimus, 1 mg taken twice daily. The clinical effect of tacrolimus treatment in patients was evaluated by analysis of platelet counts at baseline and after one, three and six months of tacrolimus treatment. Levels of anti-double-stranded DNA antibodies and complement C3, C4 were determined individually.

Results

After one month of tacrolimus treatment, three patients (15%) did not respond, three patients (15%) achieved a complete response and the other 14 patients (75%) achieved a partial response. After three months of tacrolimus treatment, the platelet counts of all patients were significantly improved. A partial response was seen in 14 patients (75%) and the complete response rate increased to 25% (five patients). After six months, all patients attained partial response or complete response without relapse, and the rate of complete response increased to 75%. Compared to pretreatment, anti-double-stranded DNA antibody levels and the disease activity index score were markedly decreased after tacrolimus treatment. The levels of serum C3 and C4 were increased significantly ( P < 0.05).

Conclusions

Our survey revealed that a six-month course of tacrolimus is a safe and effective treatment for systemic lupus erythematosus patients with refractory thrombocytopenia.

Cancer-FOXP3 directly activated CCL5 to recruit FOXP3+Treg cells in pancreatic ductal adenocarcinoma

Forkheadbox protein 3 (FOXP3), initially identified as a key transcription factor for regulatory T cells (Treg cells), was also expressed in many tumors including pancreatic ductal adenocarcinoma (PDAC). However, its role in PDAC progression remains elusive. In this study, we utilized 120 PDAC tissues after radical resection to detect cancer-FOXP3 and Treg cells by immunohistochemistry and evaluated clinical and pathological features of these patients. Cancer-FOXP3 was positively correlated with Treg cells accumulation in tumor tissues derived from PDAC patients. In addition, high cancer-FOXP3 expression was associated with increased tumor volumes and poor prognosis in PDAC especially combined with high levels of Treg cells. Overexpression of cancer-FOXP3 promoted the tumor growth in immunocompetent syngeneic mice but not in immunocompromised or Treg cell-depleted mice. Furthermore, CCL5 was directly trans-activated by cancer-FOXP3 and promoted the recruitment of Treg cells from peripheral blood to the tumor site in vitro and in vivo. This finding has been further reinforced by the evidence that Treg cells recruitment by cancer-FOXP3 was impaired by neutralization of CCL5, thereby inhibiting the growth of PDAC. In conclusion, cancer-FOXP3 serves as a prognostic biomarker and a crucial determinant of immunosuppressive microenvironment via recruiting Treg cells by directly trans-activating CCL5. Therefore, cancer-FOXP3 could be used to select patients with better response to CCL5/CCR5 blockade immunotherapy.

The mediating role of sleep quality on the relationship between perceived stress and depression among the elderly in urban communities: a cross-sectional study

OBJECTIVE

This study aims to investigate the relationship between perceived stress, sleep quality, and depression among the elderly in urban communities, and further to determine whether sleep quality can serve as a mediator among the elderly in urban communities.

STUDY DESIGN

A cross-sectional survey.

METHODS

Between May and July in 2015, we conducted a cross-sectional survey among 1050 community residents aged ≥60 years from Liaoning province, China. The Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Epidemiological Studies Depression Scale were used to estimate perceived stress, sleep quality, and depression, respectively. The data were analyzed with correlation, multiple linear regression, and structural equation modeling.

RESULTS

Of the 1050 participants surveyed, 1032 completed responses were ultimately acquired (98.3% effective response rate) and were included in the data analysis. Results revealed that the scores of perceived stress and sleep quality were positively correlated with Epidemiological Studies Depression Scale score. Sense of uncontrol, sense of nervous, sleep duration, and daytime dysfunction were identified as significant predictors of depression among the elderly. The effect of perceived stress on depression was partly mediated by sleep quality.

CONCLUSIONS

Our study reveals that not all dimensions of sleep quality are relevant factors affecting depression in the elderly, and there may be partial mediation effects of sleep quality, mainly through sleep duration and daytime dysfunction, within the impact of perceived stress on depression. This signifies that coping with perceived stress can be expected to ameliorate the severity of depression in the elderly by the intermediary role of sleep quality as well as the direct effect. However, longitudinal research is needed to confirm these findings and to investigate other mediators between perceived stress and depression among the elderly.

Epidermal Inorganic Optoelectronics for Blood Oxygen Measurement

Flexible and stretchable optoelectronics, built-in inorganic semiconductor materials, offer a wide range of unprecedented opportunities and will redefine the conventional rigid optoelectronics in biological application and medical measurement. However, a significant bottleneck lies in the brittleness nature of rigid semiconductor materials and the performance's extreme sensitivity to the light intensity variation due to human skin deformation while measuring physical parameters. In this study, the authors demonstrate a systematic strategy to design an epidermal inorganic optoelectronic device by using specific strain-isolation design, nanodiamond thinning, and hybrid transfer printing. The authors propose all-in-one suspension structure to achieve the stretchability and conformability for surrounding environment, and they propose a two-step transfer printing method for hybrid integrating III-V group emitting elements, Si-based photodetector, and interconnects. Owing to the excellent flexibility and stretchability, such device is totally conformal to skin and keeps the constant light transmission between emitting element and photodetector as well as the signal stability due to skin deformation. This method opens a route for traditional inorganic optoelectronics to achieve flexibility and stretchability and improve the performance of optoelectronics for biomedical application.

[Assessment and surgical treatment for 58 substernal goiter]

Objective: To investigate the diagnosis and treatment of substernal goiter. Methods: A total of 58 cases with substernal goiters undergoing surgery between January 2005 and December 2015 were analysed retrospectively. There were 10 males and 48 females and their age ranged from 38 to 82 years with a median age of 58 years. According to enhanced CT and clinical signs of substernal goiters, there were 40 cases for typeⅠ, 17 cases for type Ⅱ, and 1 case for type Ⅲ. Results: Patients with typeⅠand Ⅱ substernal goiters (8 cases of papillary carcinoma) underwent low neck and collar-type incision, and patients with type Ⅲ substernal goiters received carotid chest surgery. The use of harmonic scalpel in sternal goiter surgery provided with clearer surgical field, less bleeding. All the operations were successful, and recurrent laryngeal nerve was visually identified in all patients. Postoperative complications included trachyphonia (2 cases), without difficult breathing and tracheal stenosis. Conclusions: Enhanced CT is the best means of preoperatively assessment of substernal goiter. It is feasible to treat patients with typeⅠand Ⅱ substernal goiters by lower neck and collar-type incision. Use of harmonic scalpel in substernal goiter surgery can reduce operation time and bleeding.

Abstract P6-09-20: Clinical utility of PgR with various cutpoints using 3 commercial assays relative to 15yr survival

Introduction:

Hormone receptors ER and PgR are routinely assessed by pathologists using immunohistochemical (IHC) assays to guide treatment decisions. Patients who are hormone receptor positive are offered hormonal therapy, such as tamoxifen, which improves survival. Although both ER and PgR are evaluated, ER is primarily utilized for patient management as the clinical utility of PgR has not been clearly established according to CAP/ASCO guidelines. Notably, a meta-analysis by the Early Breast Cancer Trialists' Collaborative Group reported that PgR status was not significantly predictive of response to adjuvant tamoxifen, suggesting that PgR may not have a role in breast cancer management. More recently, the level of PgR expression has been hypothesized to be important in predicting response to endocrine therapy, where high PgR levels are more indicative of estrogen-dependent tumors, and thus more sensitive to hormonal treatment.

In this study, we evaluate PgR expression using the current cut-point (Allred&gt;2), as well as an optimized cut-point (Allred&gt;5 to identify PgR high tumors), with regards to 15yr disease-free survival (DFS) and disease-specific overall survival (DSOS) using three commercially available ready-to-use (RTU) IHC assays from Dako, Leica and Ventana in an ER+ cohort.

Methods:

The Calgary tamoxifen breast cancer cohort (Calgary cohort) is a TMA series that includes 532 patients diagnosed with primary breast cancer (1985-2000) who received tamoxifen treatment regardless of hormone receptor status. All RTU assays followed vendor recommended protocols. Specific details regarding the cohort and IHC assays have been previously described (Kornaga et al. Mod Path 2016). All analyses were performed using Stata 12, and multivariate models were adjusted for age, grade, size, lymph node and HER2 status. ER status was defined by the corresponding vendor specific IHC assay.

Results:

Multivariate models looking at DFS are presented in Table 1. None of the assays were significant when the clinical cut-point was used; however, when the optimized cut-point was investigated, all assays found high expression of PgR was significantly associated with improved DFS. Table 2 presents the multivariate models looking at DSOS. Similarly, PgR was not found to be associated with improved DSOS using the current cut-point. When the optimized cut-point was examined, Dako and Leica assays were significantly associated with improved DSOS: The Ventana assay did not reach significance.

Table 1 PgR15YR DFS CutpointHR95% CIp-valueDako&gt;20.830.40-1.730.624Dako&gt;50.560.35-0.910.020Leica&gt;21.130.45-2.830.792Leica&gt;50.520.30-0.890.017Ventana&gt;20.730.32-1.670.460Ventana&gt;50.570.34-0.970.037

Table 2 PgR15YR DSOS CutpointHR95% CIp-valueDako&gt;20.740.33-1.650.464Dako&gt;50.550.32-0.950.031Leica&gt;20.880.35-2.220.780Leica&gt;50.440.24-0.790.006Ventana&gt;20.590.25-1.370.218Ventana&gt;50.630.35-1.150.134

Conclusions:

High PgR expression (Allred&gt;5) is associated with improved 15yr DFS and DSOS in a tamoxifen-treated cohort, where PgR positivity defined using current guidelines is not associated with improved DFS or DSOS. Additionally, differences were noted between the vendor RTU assays with regards to DSOS.

Citation Format: Kornaga EN, Paterson AHG, Feng X, Morris DG, Magliocco AM, Klimowicz AC. Clinical utility of PgR with various cutpoints using 3 commercial assays relative to 15yr survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-20.

Anti-Aging Effect of Riboflavin Via Endogenous Antioxidant in Fruit fly Drosophila Melanogaster

OBJECTIVES

This study investigated the effect of riboflavin on aging in Drosophila melanogaster (fruit fly).

DESIGN

Experimental study.

SETTING

Naval Medical Research Institute.

PARTICIPANTS

Fruit fly Drosophila melanogaster.

INTERVENTION

After lifelong supplement of riboflavin, the lifespan and the reproduction of fruit flies were observed. Hydrogen peroxide (H2O2) was used to mimic oxidative stress damage to fruit flies and the survival time was recorded.

MEASUREMENTS

The activity of copper-zinc-containing superoxide dismutase (SOD1), manganese containing SOD (SOD2) and catalase (CAT) and lipofuscin (LF) content were determined.

RESULTS

Riboflavin significantly prolonged the lifespan (Log rank χ2=16.677, P<0.001) and increased the reproductive capacity (P<0.01 for day 15; P<0.05 for day 30) of fruit flies by lifelong supplement. The survival time of fruit flies damaged by H2O2 was significantly prolonged (Log rank χ2=15.886, P<0.001), the activity of SOD1 (P<0.01) and CAT (P<0.01) was enhanced, and the accumulation of LF (P<0.01) was inhibited by riboflavin supplement.

CONCLUSION

Riboflavin prolonged the lifespan and increased the reproduction of fruit flies through anti-oxidative stress pathway involving enhancing the activity of SOD1 and CAT and inhibiting LF accumulation. Riboflavin deserves more attention for slowing human aging.

Outcomes of standard dose EC-MPS with low exposure to CsA in DCD renal transplantation recipients with DGF

AIMS

The lower limit of exposure to cyclosporine A (CsA) has not yet been established in donation after cardiac death (DCD) renal transplantation recipients with delayed graft function (DGF) receiving enteric-coated mycophenolate sodium (EC-MPS) therapy. Stable and adequate mycophenolic acid (MPA) dosing may facilitate lower CsA exposure after DCD renal transplantation in recipients with DGF without compromising safety.

METHODS

A 12-month, single-centre open-label prospective trial was performed in our centre. According to their DGF risk index using the previous DGF prediction models, we divided up the patients on oral CsA into either a DGF group (n = 26) and no DGF group (n = 48). All of the patients initially received the standard EC-MPS dosing (1440 mg/day). The initial dose of CsA in the low risk of DGF group was 4.5 mg/kg/day and in the high risk of DGF group was 2.5 mg/kg/day. Efficacy parameters, safety and tolerability were assessed over a 12-month study period.

RESULTS

The incidence of DGF was 18.5% in the 162 DCD recipients. Between the DGF group and the no DGF group, the 1-year patient survival and graft survival were not significantly different. The incidence of BPAR was higher in the DGF group (26.9% vs. 8.3%, p = 0.032). Most patients in the DGF group had recovery of renal function after 1 month. The adverse events between the two groups were not significantly different. The daily EC-MPS doses of the DGF group were significantly higher than the no DGF group before the 6-month follow-up period. There were no significant differences between the two groups regarding the mean AUC levels during the follow-up period.

CONCLUSIONS

These results show that low expose CsA with standard dosing of EC-MPS and thymoglobulin was efficacious, safe and well-tolerated in DCD renal transplant recipients with DGF in China. Furthermore, stable and adequate MPA exposure helped to reduce the dose of and exposure to CsA. Thus, this may lead to less-induced nephrotoxicity and better renal function recovery.

[MGMT expression in primary central nervous system diffuse large B cell lymphoma and its relationship with prognosis]

Objective: To study the correlation between MGMT expression, clinicopathologic features and post-chemotherapy prognosis in patients with primary central nervous system lymphoma diffuse large B-cell lymphoma (PCNS-DLBCL). Methods: MGMT expression was detected in 76 cases of PCNS-DLBCL by EnVision method with immunohistochemical staining.Follow-up data including treatment response and overall survival time, were analyzed. Results: The rate of MGMT expression in PCNS-DLBCL was 67.1%(51/76). The MGMT expression rate in male patients was higher than that in female(P<0.05). Univariate analysis showed that these clinical pathological characteristics affected the overall survival of PCNS-DLBCL patients, including age and Hans algorithm, although no statistical significance was detected(P value was 0.065 and 0.069 respectively). The overall survival of the patients with positive MGMT and aged over 60 years was shorter after chemotherapy than those without chemotherapy (P=0.022). In the patients aged over 60 years, the prognosis of MGMT-positive patients was significantly better than MGMT-negative patients (P=0.044). Conclusions: The expression of MGMT is more commonly found in male patients. In the patients aged over 60 years with the same therapy, the prognosis is better in the MGMT-negative ones. Detection of MGMT protein expression can provide some guidance in choice of treatment modalities in PCNS-DLBCL patients.

Sodium-glucose co-transporter-2 inhibitors suppress atrial natriuretic peptide secretion in patients with newly diagnosed Type 2 diabetes

AIMS

To observe changes in atrial natriuretic peptide levels after treatment with sodium-glucose co-transporter-2 inhibitors in patients with newly diagnosed type 2 diabetes.

METHODS

A total of 28 patients with newly diagnosed Type 2 diabetes and HbA_1c levels of 58 -91 mmol/mol (7.5-10.5%) were randomly selected to receive sodium-glucose co-transporter-2 inhibitor treatment (n = 18) or placebo (n = 10) for 24 weeks. We analysed atrial natriuretic peptide concentrations, using an enzyme-linked immunosorbent assay. In addition, sodium and HbA_1c levels were measured at baseline, 12 weeks and 24 weeks and blood lipid levels and insulin sensitivities at baseline and 24 weeks.

RESULTS

Compared with patients treated with placebo, patients who received sodium-glucose co-transporter-2 inhibitor treatment exhibited lower atrial natriuretic peptide levels (36.74 vs 56.90 pg/ml in the placebo group; P < 0.05) and higher sodium levels (144.3 vs 141.4 mmol/l in the placebo group; P < 0.01) at 24 weeks, after adjusting for baseline values. HbA_1c levels were lower after sodium-glucose co-transporter-2 inhibitor treatment compared with placebo (51 vs 60 mmol/mol; P < 0.01). No correlation was found between atrial natriuretic peptide and HbA_1c levels. Homeostatic model assessment of β-cell function values and lipid profiles were generally similar after 24 weeks of treatment with placebo or sodium-glucose co-transporter-2 inhibitor.

CONCLUSIONS

This study shows the ability of sodium-glucose co-transporter-2 inhibitors to lower atrial natriuretic peptide levels and improve glycaemic control, which may benefit the cardiovascular system.

Study of the Role of Transforming Growth Factor β-1 in Organ Damage Protection in Porcine Model of Brain Death

BACKGROUND

From the medical and ethical points of view, donation after brain death is a more acceptable organ source than that from a living donor because it has the advantage of providing multiple organs from a single donor source. Hence, it has become a more promising field of research which focuses on the protection of organs at brain death Here we investigated the role of transforming growth factor (TGF)-β1 in a porcine model of brain death.

METHODS

A porcine model of brain death was established by increasing the intracranial pressure (ICP) after which TGF-β1 was monitored by immunofluorescence at the following time points: before ICP was performed (t1), at brain death (t2), and at 3 (t3), 6 (t4), 9 (t5), and 18 (t6) hours after brain death. The data were analyzed using the fixed effect regression method and the correlation between the results was determined by Pearson analysis.

RESULTS

Our results showed that there was a significant increase in the levels of TGF-β1 (P < .05), urea (P < .01), creatinine (P < .01), and aspartate aminotransferase (AST; P < .01) during the 18-hour brain death process. There were negative correlations between TGF-β1 and urea, creatinine, alanine aminotransferase, AST, and total bilirubin. The negative correlations between TGF-β1 and creatinine and AST achieved statistical significance (P < .05).

CONCLUSIONS

These findings taken together confirm that significant damages are caused to the myocardial fiber cell and kidney glomerulus during brain death process, and that TGF-β1 is associated with the protection of these organs.

Spectroscopic determination of the composition of a 50 kV hydrogen diagnostic neutral beam

A grating spectrometer with an electron multiplying charge-coupled device camera is used to diagnose a 50 kV, 5 A, 20 ms hydrogen diagnostic neutral beam. The ion source density is determined from Stark broadened H_β emission and the spectrum of Doppler-shifted H_α emission is used to quantify the fraction of ions at full, half, and one-third beam energy under a variety of operating conditions including fueling gas pressure and arc discharge current. Beam current is optimized at low-density conditions in the ion source while the energy fractions are found to be steady over most operating conditions.

Design of Stretchable Electronics Against Impact

Stretchable electronics offer soft, biocompatible mechanical properties; these same properties make them susceptible to device failure associated with physical impact. This paper studies designs for stretchable electronics that resist failure from impacts due to incorporation of a viscoelastic encapsulation layer. Results indicate that the impact resistance depends on the thickness and viscoelastic properties of the encapsulation layer, as well as the duration of impact. An analytic model for the critical thickness of the encapsulation layer is established. It is shown that a commercially available, low modulus silicone material offers viscous properties that make it a good candidate as the encapsulation layer for stretchable electronics.

Analysis of the complete genome sequence of black queen cell virus JL1 from infected honeybees in China

There are six strains of the complete genomic sequences of black queen cell virus (BQCV) published in the GenBank, including South Africa (AF183905), South Korea (JX149531), Hungary 10 (EF517515), Poland 4 (EF517519), Poland 5 (EF517520) and Poland 6 (EF517521). Based on the six BQCV strains published in the GenBank, ten pairs of primers were designed in the present study using reverse transcription polymerase chain reaction to obtain the first complete genome sequence of a BQCV strain in China, called the BQCV China-JL1 strain (KP119603). A phylogenetic tree was then built to analyse their genetic relationships. The BQCV China-JL1 strain showed 86-93% similarity with the six strains published in the GenBank. The BQCV China-JL1 strain consisted of 8358 nucleotides (nt). The 5'-proximal open reading frame (ORF1) initiated at nt position 546 and terminated at nt position 4676, ORF3 initiated at nt position 4891 and terminated at nt position 5433, and the 3'-proximal ORF (ORF2) was located between nt positions 5750 and 8203.

A Mechanics Model for Sensors Imperfectly Bonded to the Skin for Determination of the Young's Moduli of Epidermis and Dermis

A mechanics model is developed for the encapsulated piezoelectric thin-film actuators/sensors system imperfectly bonded to the human skin to simultaneously determine the Young's moduli of the epidermis and dermis as well as the thickness of epidermis.