Effect of oviposition by Bactrocera dorsalis on the antioxidant activity of orange juice

Among fruits and fruit products, oranges and orange juice are the most widely consumed worldwide. However, the effects of pest infestation of oranges on the quality of orange juice are not yet known. To evaluate the effect of the oriental fruit fly Bactrocera dorsalis on the antioxidant activity of orange juice, we measured changes in the vitamin C (Vc) concentration, total phenol content, and antioxidant activity of orange juice after the introduction of fruit fly eggs. Ten days after the eggs were introduced (larvae removed), the concentration of Vc in orange juice was 18.65 µg/mL, which was 9.16 µg/mL lower than that measured in healthy orange juice. In addition, the total phenol content decreased by 46.519 mg Gallic Acid Equivalents (GAE)/g to 9.748 mg GAE/g. Furthermore, the free-radical scavenging activity decreased from 22.297% to 5.393%. Correlation analysis indicated significant correlations between Vc concentration, total phenol content, and antioxidant activity of orange juice after B. dorsalis infestation. The decrease in Vc concentration, total phenol content and free-radical scavenging activity indicated that B. dorsalis changed the quality of orange juice by affecting the antioxidant activity of the juice after the oranges were infested.

Pseudomonas aeruginosa PcrV and Psl, the Molecular Targets of Bispecific Antibody MEDI3902, Are Conserved Among Diverse Global Clinical Isolates

Background

Bispecific antibody MEDI3902, targeting the Pseudomonas aeruginosa type 3 secretion system (PcrV) and Psl exopolysaccharide, is currently in phase 2b development for prevention of nosocomial pneumonia in patients undergoing mechanical ventilation. We surveyed a diverse collection of isolates to study MEDI3902 epitope conservation and protective activity.

Methods

P. aeruginosa clinical isolates (n = 913) were collected from diverse patients and geographic locations during 2003-2014. We conducted whole-genome sequencing; performed PcrV and Psl expression analyses via immunoblotting and enzyme-linked immunosorbent assay, respectively; performed crystallography to determine the MEDI3902 PcrV epitope, using anti-PcrV Fab and PcrV components (resolved at 2.8 Å); and evaluated MEDI3902 protective activity against select isolates in vitro and in vivo.

Results

Intact psl operon and pcrV genes were present in 94% and 99% of isolates, respectively, and 99.9% of isolates contained at least one of the genetic elements. Anti-Psl binding was confirmed in tested isolates harboring a complete Psl operon or lacking nonessential psl genes. We identified 46 PcrV variant sequences, and MEDI3902-PcrV contact residues were preserved. MEDI3902 maintained potent in vivo activity against various strains, including strains expressing only a single target.

Conclusions

Psl and PcrV are highly prevalent in global clinical isolates, suggesting MEDI3902 can mediate broad coverage against P. aeruginosa.

[The application of Chinese version of anterior skull base questionnaire (ASBQ) in patients with anterior and middle skull base tumors]

Objective: To develop the Chinese version of anterior skull base questionnaire(ASBQ) and to verify its application in patients with anterior and middle skull base tumors. Methods: The following steps were finished including getting the permission from the author of the original English scale, translating and back-translating, tentative test, discussing the consequence and cultural debugging. From October 2016 to December 2018, 51 patients with skull base tumors from Xuanwu Hospital and China-Japan Friendship Hospital were enrolled as an experimental group, aged from 24 to 70 years old, with 19 males and 32 females, which included 27 patients with anterior skull base tumor and 24 patients with middle skull base tumor. From December 2016 to January 2018, 46 healthy volunteers were selected as a control group, aged from 18 to 36 years old, including 26 females and 20 males. The subjects in the test group and the control group were rigorously tested with official manuscripts and judged whether the manuscript was applicable. The SPSS 22.0 statistical software was used to analyze the data of the test group, the anterior skull base group, the middle skull base group and the control group to evaluate the performance of the scale. Results: Both the rate of the recovery and efficiency in experimental group, anterior skull base group and middle skull base group were 100%, with the average time of completion of (8.7±3.2), (11.2±4.0) and (7.3±2.1) min, respectively in each group. The r value of test-retest reliability was 0.96, 0.99 and 0.97 in experimental group, anterior skull base group and middle skull base group, with the split-half reliability coefficient of 0.91, 0.90 and 0.96, with the entire scale Cronbach's coefficient of 0.91, 0.95 and 0.93, respectively. The content validity and the construct validity of the scale were good enough, and the criteria validity was-0.483,-0.509 and -0.489 in experimental group, anterior skull base group and middle skull base group. The scale could well distinguish the difference of the quality of life between the preoperative and postoperative patients in experimental group and the middle skull base group. The difference of the quality of life in anterior skull base group was not found between preoperative and postoperative patients. Conclusion: The Chinese version of ASBQ has good reliability and validity, which is suitable for a wide range of Chinese patients with anterior and middle skull base tumors to assess their quality of life.

Ab initio determination of atomic structure of Zn-Zr precipitates in a Mg-Nd-Zn-Zr alloy

The atomic structure of nanometre-sized Zn-Zr precipitates in a Mg alloy is determined by combining tilt series of micro-beam electron diffraction with atomic resolution Z-contrast imaging. The stoichiometry of the Zn-Zr precipitates is Zn₂Zr₃ with a primitive tetragonal structure (space group P4₂/mnm, a = b = 0.761 nm, c = 0.682 nm). There are 20 atoms in the unit cell of tetragonal Zn₂Zr₃, comprising 12 Zr atoms at the 4d, 4f, 4g positions and eight Zn atoms at the 8j positions.

Towards label-free distributed fiber hydrogen sensor with stimulated Raman spectroscopy

Hydrogen detection is of great importance in chemical and energy industries. Optical fiber hydrogen sensors show flexibility and compactness, and have the potential for distributed analysis. However, traditional fiber sensors encounter a challenge with light interacting with hydrogen directly because hydrogen only displays weak quadrupole absorption, and metallic palladium and platinum thin-film coatings are typically used as an optically detectable label. Here, based on stimulated Raman spectroscopy in hollow-core photonic crystal fibers, we investigate the label-free optical fiber distributed hydrogen sensors operating in the optical telecommunication band. The approach of distributed Raman measurement represents a new paradigm in fiber sensors, potentially allowing distributed chemical analysis in gas or liquid phase with high sensitivity and selectivity.

Bridging the translational gap: Implementation of multimodal small animal imaging strategies for tumor burden assessment in a co-clinical trial

In designing co-clinical cancer studies, preclinical imaging brings unique challenges that emphasize the gap between man and mouse. Our group is developing quantitative imaging methods for the preclinical arm of a co-clinical trial studying immunotherapy and radiotherapy in a soft tissue sarcoma model. In line with treatment for patients enrolled in the clinical trial SU2C-SARC032, primary mouse sarcomas are imaged with multi-contrast micro-MRI (T1 weighted, T2 weighted, and T1 with contrast) before and after immune checkpoint inhibition and pre-operative radiation therapy. Similar to the patients, after surgery the mice will be screened for lung metastases with micro-CT using respiratory gating. A systems evaluation was undertaken to establish a quantitative baseline for both the MR and micro-CT systems against which others systems might be compared. We have constructed imaging protocols which provide clinically-relevant resolution and contrast in a genetically engineered mouse model of sarcoma. We have employed tools in 3D Slicer for semi-automated segmentation of both MR and micro-CT images to measure tumor volumes efficiently and reliably in a large number of animals. Assessment of tumor burden in the resulting images was precise, repeatable, and reproducible. Furthermore, we have implemented a publicly accessible platform for sharing imaging data collected during the study, as well as protocols, supporting information, and data analyses. In doing so, we aim to improve the clinical relevance of small animal imaging and begin establishing standards for preclinical imaging of tumors from the perspective of a co-clinical trial.

[The association between plasma levels of 20 amino acids and risk of diabetes]

Objective: To investigate the association between the plasma levels of 20 amino acids and the risk of diabetes in middle-aged and elderly population. Methods: This study was a part of the Chinese multi-provincial cohort study conducted in communities of Shougang. In 2007 and 2012, the population was investigated for diabetes and other risk factors. Blood samples collected from 475 people were tested for various amino acid levels by liquid chromatography-tandem mass spectrometry. A multivariate logistic regression analysis was used to analyze the association between plasma amino acid levels and diabetes risk. Results: The age of the selected population at baseline was (58.7±6.3) years, and the blood glucose level at baseline was (5.68±1.34) mmol/L. Among them, 56 (11.79%) subjects were diabetes. Multivariate logistic regression analyses showed that after adjusting for age, gender, body mass index, systolic blood pressure and dyslipidemia, individuals with plasma branched-chain amino acid (valine, leucine and isoleucine) and cysteine in the highest tertile levels were at high risk of diabetes with the ORs of 3.61 (95% CI 1.48-8.80), 3.27 (95% CI 1.34-7.99), 2.46 (95% CI 1.04-5.84) and 2.09 (95% CI 1.02-4.27), respectively. After 5 years' followed up, 5.73% (24/419) subjects developed diabetes. Compared with those in the lowest tertile, individuals with plasma branched-chain amino acid (total concentration), phenylalanine, and tyrosine levels at baseline in the highest tertile had 3.69 times, 3.61 times and 4.14 times higher risk to develop new diabetes, respectively. In contrast, individuals with plasma glycine level in the highest tertile had only 76% (OR 0.24, 95% CI 0.06-0.91) risk for the development of diabetes compared with those with plasma glycine level in the lowest tertile. Conclusions: The increase in plasma branched-chain amino acid and cysteine levels is significantly associated with an increase in incident diabetes. Subjects with higher levels of branched-chain amino acids and aromatic amino acids (phenylalanine, tyrosine) had a significantly higher risk of developing new-onset diabetes, while those with higher glycine levels had a significantly lower risk of developing diabetes in 5 years.

NGF increases FGF2 expression and promotes endothelial cell migration and tube formation through PI3K/Akt and ERK/MAPK pathways in human chondrocytes

OBJECTIVE

Vascular invasion is observed at the osteochondral junction in osteoarthritis (OA). Nerve growth factor (NGF) as an angiogenic factor is expressed in OA. This study is to investigate the effects of NGF on angiogenesis in vitro in human chondrocytes.

DESIGN

Articular cartilages of knee joints were harvested from healthy and OA patients. Expressions of NGF and tropomyosin-related kinase A (TrkA) were detected by western blot, Safranin-O and fast green staining and immunohistochemistry in cartilage. Expression of fibroblast growth factor 2 (FGF2) was detected by western blot in cultured chondrocytes. Chondrocytes were transfected by lentiviral vectors to knock down TrkA. Migration and tube formation of human microvascular endothelial cell (HMVEC) were assessed by using transwell co-culture with chondrocyte after treatment of NGF.

RESULTS

We confirmed expressions of NGF and TrkA were significantly up-regulated in OA. NGF induced expression of FGF2 in a time- and dose-dependent manner. Angiogenic activities of endothelial cells were greatly enhanced after co-cultured with NGF pre-treated chondrocytes, while knock-down of TrkA significantly abolished the above effects. We further found that NGF-induced expression of FGF2 promoted angiogenic activities of endothelial cells through PI3K/Akt and ERK/MAPK signaling pathways.

CONCLUSIONS

NGF promotes expression of FGF2 in vitro via PI3K/Akt and ERK/MAPK signaling pathways in human chondrocytes and it increases angiogenesis, which is mediated by TrkA. NGF could be responsible for vascular up-growth from subchondral bone in OA.

Abstract P5-03-06: Overcoming MEK inhibitor resistance in triple-negative breast cancer by targeting myeloid cell leukemia-1 (MCL1), an anti-apoptotic protein

Background: Triple-negative breast cancer (TNBC), which affects over 170 000 women worldwide every year, is considered the most arduous to treat subtype of breast cancer. With no targeted therapy, high rates of drug resistance and rapid metastasis, TNBC carries a poor prognosis. The MEK-ERK-MAPK signaling cascade is known to play a role in numerous cancers. Despite the lack of activating Ras/MAPK mutations in breast cancer, transcriptional signatures of this pathway are prevalent in TNBC. Our previous work showed that TNBC patients with tumors overexpressing ERK2 had a lower overall survival rate than did patients with low-ERK2-expressing tumors. MEK inhibitors selumetinib (AZD6244) and pimasertib (AS703026) are active in preclinical models, but not as single agents in the clinic. Using a synthetic lethal siRNA screen, we identified myeloid cell leukemia-1 (MCL1) as a potential contributor to selumetinib resistance. Mcl-1 is an anti-apoptotic protein that is highly amplified in numerous human cancers. It is associated with cell immortalization, transformation, and chemoresistance. Patients with TNBC tumors expressing high levels of Mcl-1 have lower overall survival and distant-metastasis-free survival rates. We hypothesized that Mcl-1 promotes MEK inhibitor resistance in TNBC.

Methods/Results: To model MEK inhibitor resistance, we established selumetinib- and pimasertib-resistant clones of SUM-149 and MDA-MB-231 TNBC cells by continuous exposure to increasing concentrations of inhibitors over a six month period. We confirmed the onset of MEK resistance by demonstrating that resistant cells, in comparison to the parental cells, exhibited no change in cell proliferation upon treatment with the MEK inhibitors. Resistant cells also displayed more effective cell migration and mammosphere formation than parental cells, suggesting a higher fraction of tumor-initiating cells.

We found Mcl-1 to be highly expressed in 83% (15 of 18) of TNBC cell lines but only 30% (3 of 10) of other breast cancer cell lines. Resistant cells had higher levels of Mcl-1 than did parental cells. To determine whether Mcl-1 is required for MEK sensitivity, we treated parental and resistant cells with either selumetinib or pimasertib together with S63845, a highly specific Mcl-1 inhibitor. The Mcl-1 inhibitor restored MEK sensitivity in both resistant cell lines. After treatment with the Mcl-1 inhibitor, the resistant SUM-149 and MDA-MB-231 cells had similar cell proliferation rates to those of their parental counterparts. Similar studies were done using an siRNA against Mcl-1.

Conclusion: Our data demonstrate that Mcl-1 may promote TNBC resistance to MEK inhibitors and that Mcl-1 is a promising target for combination therapy. We will continue to explore the mechanisms of MEK inhibitor resistance by screening for additional genes/pathways involved. Our long-term goal is to design rational combination approaches to counteract the emergence of resistance by using novel molecularly targeted therapeutics.

Citation Format: Gagliardi M, Chauhan G, Pitner MK, Iles L, Qi Y, Pusztai L, Tripathy D, Bartholomeusz G, Bartholomeusz C. Overcoming MEK inhibitor resistance in triple-negative breast cancer by targeting myeloid cell leukemia-1 (MCL1), an anti-apoptotic protein [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 P5-03-06.

[Association between long-term blood pressure change and the incidence of cardiovascular diseases: a population-based cohort study]

Objective: To explore the association between long-term changes in blood pressure (BP) levels and the incidence of cardiovascular diseases (CVD). Methods: A total of 5 752 participants, who participated baseline examination in 1992-1993 and re-examination in 2007, were followed up till December 31, 2013 according to the study protocol of the Chinese Multi-provincial Cohort Study. Participants were stratified by baseline BP and re-examination BP and cross-combined into 9 subgroups. The 20-year incidence of acute cardiovascular events, acute coronary heart disease (CHD) and acute stroke events were analyzed and association between disease incidence and 15-year changes in BP were determined using the competing risk regression model. Results: (1) There were 523 CVD events (170 CHD, 373 stroke) during the 20 years follow up. The number of participants with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) of <130/80 mmHg (1 mmHg=0.133 kPa), 130-139/80-89 mmHg, and hypertension were 2 892 (50.3%), 1 328 (23.1%) and 1 532 (26.6%), respectively. (2) Among participants with baseline SBP of 130-139 mmHg or DBP of 80-89 mmHg, 870 (65.5%) progressed to hypertension and 279 (21.0%) maintained at the same stratum over a 15-year follow up period. (3) After adjustment for age, sex, body mass index, smoking status, diabetes, total cholesterol, and high-density lipoprotein cholesterol at baseline, participants maintained SBP/DBP at 130-139/80-89 mmHg had a higher risk of developing acute cardiovascular events, CHD and stroke with the hazard ratios (HR) and 95% confidence interval (95%CI) of 2.04 (1.16, 3.57), 3.29 (1.30, 8.35) and 1.63 (0.80, 3.33), compared with those who maintained their SBP < 130 mmHg and DBP <80 mmHg. Participants whose BP increased from 130-139/80-89 mmHg to hypertension over the follow up period had 2.81-fold (1.84, 4.29), 3.17-fold (1.43, 7.03) and 2.71-fold (1.65, 4.44) higher risk for the incidence of acute cardiovascular events, CHD, and stroke, respectively, compared with participants who maintained their SBP <130 mmHg and DBP <80 mmHg. Conclusions: Participants with SBP/DBP of 130-139/80-89 mmHg have a high long-term risk for progression to hypertension. Sustained exposure to SBP/DBP of 130-139/80-89 mmHg or higher increases the risk of CVD incidence, and our results highlight the importance of early prevention for participants with this BP stratum.

[Discussion on the transcription and circulation of "Shouzhuo Sanctum" version of Qing nang mi jue (Secret Instructions of Sore and Abscess) based on the stone tablet inscriptions and contracts]

He Gaomin, the discoverer of the book Qing nang mi jue (Secret Instructions of Sore and Abscess) considered that this book was written by Fu Shan of the late Ming and early Qing Dynasties, which was first stored secretly by Zhang Shixue, and then transcribed by "Pan zi" , and further copied by Wang Dade in the First Year of Yongzheng Reign. According to the folk literature including inscriptions on stone tablet and contracts, combining with the dictations of Zhang's descendants, suggesting that Zhang's Family was a medical family for generations and Zhang Shixue was a doctor in Miaodao Town, Jiyuan County, Huaiqing Prefecture of Henan during the reigns of the Qianlong and Jiaqing Emperor of the Qing Dynasty. He might not be earlier than the secret collection of the book by Wang Dade, and nobody knows where Zhang got the book. Zhang's family fortunes declined in the late Qing Dynasty, and the version of Qing nang mi jue preserved secretly by Zhang Shixue spread to the market and obtained by Li Yinyuan, whose son Li Qu brought it into Shanxi, and was thus found by He Gaomin.

Identification of eight new MHC-DPB1 alleles in the Tibetan macaques (Macaca thibetana)

We report here the identification of eight new Math-DPB1 alleles in the Tibetan macaques.

[Association of epicardial adipose tissue with cardiovascular risk factors and coronary artery calcification in the community residents]

Objective: This cross-sectional study aimed to address the relationship between the volume of epicardial adipose tissue (EAT) with cardiovascular risk factors and coronary artery calcification(CAC) in the community residents. Methods: Individuals were recruited from the Jidong Community (Tangshan City, Northern China) which mainly comprised employees of the Jidong Co. Ltd. and their family members. From July 2013 to August 2014, 2 647 participants aged ≥40 years were included in this study. The volume of EAT and coronary artery calcification score (CAC score) were determined by a 64-slice CT. Carotid intima-media thickness (CIMT) was measured by a trained sonographer using a high-resolution B-mode topographic ultrasound system. Venous blood samples were analyzed by automated analyzers in the central laboratory. A validated questionnaire specifically designed for this study was used to collect demographic data from all participants by trained doctors. Characteristics of study cohort were compared according to quartiles of EAT volume (n=660, 663, 662, 662, repectively). Results: (1) The mean age of participants was (55.31±7.76) years and 49.94% (n=1 322) were men. The median EAT volume (interquartile) was 129.42 (95.66, 176.51)cm(3). (2) Age, BMI, waist circumference and hip circumference, systolic blood pressure, LDL-C, triglycerides, and fasting blood glucose were significantly higher, while HDL-C level was significantly lower in participants with higher EAT volume than participants with lower EAT volume (all P<0.05). Carotid intima-media thicken (CIMT) and higher CAC score were also significantly higher in participants with higher volume of EAT. Furthermore, percentage of diabetes mellitus, hypertension, hyperlipidemia increased in proportion with increasing EAT volume (P<0.05). (3) In the linear regression, significant positive relations were found for age (β=0.019 3, 95%CI 0.017-0.021, P<0.001), waist circumference (β=0.012 7, 95%CI 0.009-0.016, P<0.001), BMI (β=0.022 4, 95%CI 0.013-0.032, P<0.001), LDL-C (β=0.048 4, 95%CI 0.021-0.076, P<0.001), and HDL-C (β=-0.098 1, 95%CI-0.164--0.032, P<0.001) was inversely related to the EAT volume. (4) Logistic regression analysis indicated that EAT volume was an independent risk factor for CAC score>0 (OR=1.233, 95%CI 1.205-1.262, P<0.001) . Conclusions: Our findings indicate that EAT volume is strongly correlated to cardiovascular risk factors and coronary calcification and is an independent risk factor of increased coronary calcification in community residents.

Osteoglycin, a novel coordinator of bone and glucose homeostasis

Objective

The skeleton, which is strongly controlled by endocrine factors, has recently been shown to also play an active endocrine role itself, specifically influencing energy metabolism. However, much less is known about this role. Therefore, we sought to identify novel endocrine factors involved in the regulation of both bone mass and whole-body glucose homeostasis.

Methods

We used transcriptomic and proteomic analysis of Y1 receptor deficient osteoblasts combined with the generation of a novel osteoglycin deficient mouse model and performed comprehensive in vivo phenotype profiling, combined with osteoglycin administration in wildtype mice and human studies.

Results

Here we identify a novel role for osteoglycin, a secreted proteoglycan, in coordinating bone accretion with changes in energy balance. Using an osteoglycin knockout mouse model, we show that at a whole body level, osteoglycin acts to suppress bone formation and modulate whole body energy supplies by altering glucose uptake through changes in insulin secretion and sensitivity, as well as by altering food intake through central signaling. Examining humans following gastric surgery as a model of negative energy balance, we show that osteoglycin is associated with BMI and lean mass as well as changes in weight, BMI, and glucose levels.

Conclusions

Thus, we identify osteoglycin as a novel factor involved in the regulation of energy homeostasis and identify a role for it in facilitating the matching of bone acquisition to alterations in energy status.

•

Osteoglycin regulates insulin action, bone mass and food intake in mice.

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Osteoglycin is associated with changes in weight, BMI and glucose in obese humans.

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Osteoglycin is a downstream mediator of NPY signaling via osteoblastic Y1 receptors.

Effects of soybean isoflavones on Wnt/β-catenin and the TGF-β1 signaling pathway in renal tissue of type 2 diabetic rats

To observe the effect of Soyisoflavones (SI) on the expression of Wnt/β-catenin signaling pathway elements, transforming growth factor-β (THGF-β) and its related proteins in the renal interstitia of diabetic nephropathic (DN) rats, 48 DN rats were randomly divided into 4 groups: DN model group (group DN), soybean isoflavone treatment group (group DA), DN model group + losartan treatment group (group DL), DN model group + soybean isoflavones combined with losartan treatment group (group SL). Each group comprised 12 rats. Twelve healthy Wistar rats were selected as normal controls (group N). After 12 weeks of continuous administration of soybean isoflavone or losartan or those two combined, the body weight of rats was recorded and serum urea nitrogen (BUN) and creatinine (Scr) were measured. The expression of Wnt4, β-catenin, and TGF-β1 proteins, as well as mRNA, in the renal interstitium were detected by immunohistochemistry and real-time quantitative PCR (FQ-PCR). In all the groups, Wnt4, β-catenin and TGF-β1 protein were only expressed in renal interstitial and renal tubular epithelial cells. There was no significant difference between group DA and group DL (P>0.05). FQ-PCR results showed that Wnt4, β-catenin and TGF-β1 mRNA were consistent with the expression of these proteins in the renal tissue of each group. Soy isoflavones can reduce 24-h urinary protein quantification, alleviate renal interstitial pathological damage, and regulate the expression of Wnt4, β-catenin and TGF-β1 in the renal interstitium. This suggests that soybean isoflavones could delay the process of renal interstitial fibrosis in DN rats by decreasing the expression of Wnt4, β-catenin and TGF-β1 in the renal interstitium, thus demonstrating that soybean isoflavones plus losartan have the best protective effects against diabetes-induced renal fibrosis.

[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.

[Impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome]

Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education).At least 90 patients with ACS were consecutively enrolled from each involved hospital from April 15, 2012 to June 30, 2013. To reduce the impact of uneven distribution of inter-group variables on the results, 1∶1∶1∶1 propensity score matching method was used. The drug usage for secondary prevention and prognosis wasobtainedat 6 months after hospital discharge. Results: (1) A total of 3 391 patients were selected and 2 244 patients were included for the final analysisafter propensity score analysis. (2) At 6 months after discharge, the adherence rates of antiplatelet, statins, angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB), β-blocker and the combination of 4 medications were similar between control group and promotional calendar group (all P>0.016).The adherence rates of antiplatelet and statins were 97.0% (526/542) and 91.0% (493/542) in the education group, 3.7% and 5.5% higher than in the control group (both P<0.016). The adherence rates of statins,ACEI/ARB and combined medication were 91.0% (496/545), 68.3% (372/545) and 53.2% (290/545) in the combined intervention group,significantly higher than in the control group (5.5%,8.3% and 9.6%, all P<0.016). (3) Poisson regression analysis showed that the adherence of antiplatelet drugs in the education group was 3.4%(OR=1.034, 95%CI 1.007-1.060,P<0.05) and 3.5%(OR=1.035, 95%CI 1.007-1.063, P<0.05) higher than in the control group and the promotional calendar group, and the statins adherence rate was 5.5%(OR=1.055, 95%CI 1.012-1.101,P<0.05) higher than in the control group. The antiplatelet drug adherence rates in the combined intervention group were 3.0% (OR=1.030, 95%CI 1.002-1.058,P<0.05) and 3.1% (OR=1.031, 95%CI 1.003-1.060,P<0.05) higher than in the control group and the promotional calendar group, respectively, and statin adherence was 6.1% (OR=1.061, 95%CI 1.017-1.107,P<0.01) higher than in the control group. The adherence rates of ACEI/ARB in combined intervention group were respectively 15.4%(OR=1.154, 95%CI 1.057-1.259, P<0.01),20.0%(OR=1.200, 95%CI 1.096-1.314, P<0.01) and 25.5%(OR=1.255, 95%CI 1.142-1.380, P<0.01) higher than in the control group, promotional calendar group and education group. The adherence rates of combined medication in combined intervention group were respectively 21.6%(OR=1.216, 95%CI 1.079-1.371, P<0.01),21.5%(OR=1.215, 95%CI 1.077-1.371, P<0.01) and 27.8%(OR=1.278, 95%CI 1.126-1.450, P<0.01) higher than in the control group, promotional calendar group and education group. (4) At 6 months after discharge, the control rates of blood pressure (<140/90 mmHg,1 mmHg=0.133 kPa) in the education group were significantly higher than in the control group and promotional calendar group (78.7% (398/506) vs. 70.2%(373/531) and 71.1% (354/498) , all P<0.016),and the control rates of blood pressure in combined intervention group were higher than in the control group and promotional calendar group (78.2% (376/481) vs. 70.2%(373/531) and 71.1% (354/498) , all P<0.016).The rehospitalization rates were 7.0% (39/561) in the promotional calendar group, and 7.6% (42/561) in the education group, both significantly higher than in the control group (3.8% (21/561), all P<0.016).The rate of the low density lipoprotein cholesterol<2.07 mmol/L and the rate for all-cause mortality were similar among groups (all P>0.016) . Conclusion: Post-discharge medication adherence in ACS patients can be enhanced by either promotional calendaror nurses education strategy, and the efficacy is better by nurse education as compared with promotional calendar, the combination of both methods can further increase the post-discharge medication adherence rates in ACS patients.

Abstract P1-10-09: EPHA2-targeting enhances eicosapentaenoic acid cytotoxicity against triple-negative inflammatory breast cancer via ABCA1 inhibition–mediated membrane rigidity

Background: Effective treatment options for triple-negative inflammatory breast cancer (TN-IBC), the most aggressive form of breast cancer, are currently lacking. We previously reported that mediators of inflammation promote the growth of TN-IBC xenografts. Eicosapentaenoic acid (EPA), an omega-3 fatty acid (fish oil) with anti-inflammatory properties, is an emerging FDA-approved therapeutic with a favorable toxicology profile. Here we aimed to develop a novel approach to enhance EPA efficacy against TN-IBC by identifying a kinase inhibitor that synergizes with EPA's antitumor activity.

Methods and Results: Using a high-throughput siRNA screen in the TN-IBC cell line SUM149PT, we identified inhibition of ephrin type-A receptor 2 (EPHA2), an oncogenic receptor tyrosine kinase, as a target that sensitizes TN-IBC cells to EPA therapy. To determine the clinical relevance of EPHA2, we investigated a meta-analysis of breast cancer mRNA expression data sets and found that high EPHA2 tumor expression, compared with low expressing, correlated significantly with poor overall survival in TN-IBC patients (P = 0.01), while not with other subtypes. Similar findings were observed in vitro, were EPHA2 protein and mRNA overexpression occurred predominantly in the TN subtypes among 49 and 51 breast cancer cell lines (63% and 47%, respectively), highlighting EPHA2 translational potential. Functional expression studies using proliferation and apoptosis assays in vitro, and xenografts in vivo, were performed in two EPHA2-expressing TN-IBC cell lines, SUM149PT and BCX010, to validate EPHA2 as a synergistic combinational target with EPA. EPHA2 gene silencing in combination with EPA significantly reduced cell growth, and enhanced apoptosis, compared with untreated and monotherapy in vitro (P &lt; 0.05), and in vivo (P &lt; 0.001). To translate our findings to the clinic, we validated dasatinib, an FDA-approved small molecule inhibitor of EPHA2, in combination to EPA to significantly enhance apoptosis of TN-IBC cells in vitro (P &lt; 0.05) and in vivo (P &lt; 0.05), compared with untreated and monotherapies. Using membrane fluidity assessment and cholesterol quantification we determined that apoptosis induction after combination therapy was due to increased membrane rigidity and cholesterol concentrations in the plasma membrane of TN-IBC cells (P &lt; 0.05, compared with monotherapies). Finally, we discovered by western blot and gain/loss-of-expression studies that combination therapy inhibited the cholesterol efflux protein ATP-binding cassette sub-family A member 1 (ABCA1), which plays a significant role mediating increased cellular cholesterol (P &lt; 0.05), cell membrane rigidity (P &lt; 0.05), and induction of apoptosis (P &lt; 0.05) in TN-IBC after EPA and EPHA2-targeting combination therapy.

Conclusions: This is the first study demonstrating that EPA can enhance conventional targeted therapy against breast cancer. Our study provides molecular and preclinical evidence to support the development of an EPA/EPHA2-inhibition–based phase I clinical trial for patients with EPHA2-positive TN-IBC; our study further suggests the use of EPHA2 and ABCA1 protein expression as biomarkers for patient selection and therapeutic response.

Citation Format: Torres-Adorno AM, Vitrac H, Qi Y, Tan L, Levental KR, Fan Y-Y, Yang P, Chapkin RS, Eckhardt BL, Ueno NT. EPHA2-targeting enhances eicosapentaenoic acid cytotoxicity against triple-negative inflammatory breast cancer via ABCA1 inhibition–mediated membrane rigidity [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 P1-10-09.

Ultrafast Electric Field Pulse Control of Giant Temperature Change in Ferroelectrics

There is a surge of interest in developing environmentally friendly solid-state-based cooling technology. Here, we point out that a fast cooling rate (≈10^{11}  K/s) can be achieved by driving solid crystals to a high-temperature phase with a properly designed electric field pulse. Specifically, we predict that an ultrafast electric field pulse can cause a giant temperature decrease up to 32 K in PbTiO_{3} occurring on few picosecond time scales. We explain the underlying physics of this giant electric field pulse-induced temperature change with the concept of internal energy redistribution: the electric field does work on a ferroelectric crystal and redistributes its internal energy, and the way the kinetic energy is redistributed determines the temperature change and strongly depends on the electric field temporal profile. This concept is supported by our all-atom molecular dynamics simulations of PbTiO_{3} and BaTiO_{3}. Moreover, this internal energy redistribution concept can also be applied to understand electrocaloric effect. We further propose new strategies for inducing giant cooling effect with ultrafast electric field pulse. This Letter offers a general framework to understand electric-field-induced temperature change and highlights the opportunities of electric field engineering for controlled design of fast and efficient cooling technology.