[Application of dental floss traction-assisted endoscopic submucosa dissection to rectal neuroendocrine neoplasm]

Objective: To evaluate the safety and efficacy of dental floss traction-assisted endoscopic submucosal dissection (DFS-ESD) for rectal neuroendocrine neoplasm (NEN). Methods: A retrospective cohort study was performed. Clinical data of rectal NEN patients undergoing ESD at Endoscopy Center of Zhongshan Hospital, Fudan University from January 2016 to December 2017 were retrospectively analyzed. Inclusion criteria: 1) age of 18 to 80 years old; 2) maximal diameter of lesions <1.5 cm; 3) tumor locating in the submucosa without invasion into the muscularis propria; 4) no enlarged lymph nodes around bowel and in abdominal cavity; 5) ESD requested actively by patients. A total of 37 patients were enrolled, including 23 male and 14 female cases with mean age of (56.0±11.3) years. All the lesions were single tumor of stage T1, and the mean size was 0.8±0.2(0.5-1.2) cm. Postoperative pathology revealed all samples as neuroendocrine tumors (NET). Seventeen patients received DFS-ESD treatment (DFS-ESD group) and 20 patient received conventional ESD treatment (conventional ESD group). In DFS-ESD group, after the mucosa was partly incised along the marker dots, the endoscopy was extracted, and the dental floss was tied to one arm of the metallic clip. When the endoscope was reinserted, the hemoclip was attached onto the incised mucosa; another hemoclip was attached onto normal mucosa opposite to the lesion in the same way. The submucosa was clearly exposed with the traction of dental floss and the resection could proceed. The conventional ESD group received the traditional ESD operation procedure. The operation time, modified operation time (remaining time after excluding the assembly time of dental floss traction in DFS-ESD group), en bloc resection rate, R0 resection rate, morbidity of operative complication, recurrence and metastasis were compared between two groups. Results: The average tumor size was (0.8±0.2) cm in DFS-ESD group and (0.7±0.2) cm in conventional ESD group (t=0.425, P=0.673). According to postoperative pathological grading of rectal neuroendocrine neoplasm, 13 were G1 and 4 were G2 in DFS-ESD group, while 17 cases were G1 and 3 cases were G2 in conventional ESD group without significant difference (P=0.680). There were no significant differences in baseline data between in the two groups (all P>0.05). All the basal resection margins were negative, the en bloc resection rate was 100% and the R0 resection rate was 100%. Pathological results showed tumor tissue close to the burning margin in 5 cases of conventional ESD group and in 2 cases of DFS-ESD group (P=0.416). The operation time was (17.9±6.6) minutes in conventional ESD group and (14.7±3.3) minutes in DFS-ESD group (t=1.776, P=0.084). The modified operation time of DFS-ESD group was (11.9±2.8) minutes, which was significantly shorter than (17.9±6.6) minutes in conventional ESD group (t=3.425, P=0.002). The hospital stay was (2.3±0.6) days and (2.0±0.5) days in conventional ESD group and DFS-ESD group, respectively, without significant difference (t=1.436, P=0.160). No patient was transferred to surgery, and no delayed bleeding or perforation occurred in either group. There was no recurrence or primary tumor-related death, and all the patients recovered well during a follow-up period of 14(1-24) months. Conclusion: Dental floss traction-assisted ESD for rectal neuroendocrine neoplasm can simplify operation and ensure negative basal margin.

Acanthopanax senticosus polysaccharide suppressing proliferation and metastasis of the human non-small cell lung cancer NCI-H520 cells is associated with Wnt/β-catenin signaling

Lung cancer (LC) is the highest lethality in all tumors. Non-small cell lung cancer (NSCLC) accounts for about 80% of all LC. Acanthopanax senticosus polysaccharide (ASPS) is extracted from the root of Acanthopanax senticosus (AS). Herein, we examined the effect and molecular mechanism of ASPS on NSCLC. The proliferation, invasion and migration of NCI-H520 cells were detected by cell counting kit-8 (CCK-8), transwell assay and wound healing assay, respectively. The epithelial-mesenchymal transition (EMT) and Wnt/β-catenin pathway-related factors were evaluated using quantitative real-time PCR (QRT-PCR) and western blot assay. Our results observed that ASPS significantly decreased the proliferation of cells at 24 and 48 h. Moreover, ASPS markedly repressed the invasion and migration capacities of cells in a concentration-dependent manner. Besides, ASPS obviously down-regulated the levels of matrix metalloproteinase-2 (MMP-2), MMP-9, fibronectin 1 (FN1), vimentin, wnt3a, phosphorylated-glycogen synthase kinase 3β (p-GSK3β) and cyclin D1, whereas, up-regulating E-cadherin level. The level of GSK3β was not changed in the different groups. ASPS conspicuously inhibited the abilities of proliferation and metastasis in human non-small cell lung cancer cell line NCI-H520 possibly by suppressing Wnt/β-catenin pathway mediated-EMT.

Long-term hydrolytically stable bond formation for future membrane-based deep ocean microfluidic chemical sensors

Future ocean profiling of dissolved inorganic carbon and other analytes will require miniaturised chemical analysis systems based on sealed gas membranes between two fluid channels. However, for long-term deployment in the deep ocean at high pressure, the ability to seal incompatible materials represents an immense challenge. We demonstrate proof of principle high strength bond sealing. We show that polydimethylsiloxane (PDMS) is a preferred membrane material for rapid CO2 transfer, without ion leakage, and report long-term stable bonding of thin PDMS membrane films to inert thermoplastic poly(methyl methacrylate) (PMMA) patterned manifolds. Device channels were filled with 0.01 M NaOH and subjected to repeated tape pull and pressure - flow tests without failure for up to six weeks. Bond formation utilised a thin coating of the aminosilane bis-[3-trimethoxysilylpropyl]amine (BTMSPA) conformally coated onto PMMA channels and surfaces and cured. All surfaces were subsequently plasma treated and devices subject to thermocompressive bond annealing. Successful chemically resistant bonding of membrane materials to thermoplastics opens the possibility of remote environmental chemical analysis and offers a route to float-based depth profiling of dissolved inorganic carbon in the oceans.

Multi-population GWAS and enrichment analyses reveal novel genomic regions and promising candidate genes underlying bovine milk fatty acid composition

Background

The power of genome-wide association studies (GWAS) is often limited by the sample size available for the analysis. Milk fatty acid (FA) traits are scarcely recorded due to expensive and time-consuming analytical techniques. Combining multi-population datasets can enhance the power of GWAS enabling detection of genomic region explaining medium to low proportions of the genetic variation. GWAS often detect broader genomic regions containing several positional candidate genes making it difficult to untangle the causative candidates. Post-GWAS analyses with data on pathways, ontology and tissue-specific gene expression status might allow prioritization among positional candidate genes.

Results

Multi-population GWAS for 16 FA traits quantified using gas chromatography (GC) in sample populations of the Chinese, Danish and Dutch Holstein with high-density (HD) genotypes detects 56 genomic regions significantly associated to at least one of the studied FAs; some of which have not been previously reported. Pathways and gene ontology (GO) analyses suggest promising candidate genes on the novel regions including OSBPL6 and AGPS on Bos taurus autosome (BTA) 2, PRLH on BTA 3, SLC51B on BTA 10, ABCG5/8 on BTA 11 and ALG5 on BTA 12. Novel genes in previously known regions, such as FABP4 on BTA 14, APOA1/5/7 on BTA 15 and MGST2 on BTA 17, are also linked to important FA metabolic processes.

Conclusion

Integration of multi-population GWAS and enrichment analyses enabled detection of several novel genomic regions, explaining relatively smaller fractions of the genetic variation, and revealed highly likely candidate genes underlying the effects. Detection of such regions and candidate genes will be crucial in understanding the complex genetic control of FA metabolism. The findings can also be used to augment genomic prediction models with regions collectively capturing most of the genetic variation in the milk FA traits.

Electronic supplementary material

The online version of this article (10.1186/s12864-019-5573-9) contains supplementary material, which is available to authorized users.

Genetic association of DDIT3, RPL23A, SESN2 and NR4A1 genes with milk yield and composition in dairy cattle

Previously, we identified by RNA sequencing that DDIT3, RPL23A, SESN2 and NR4A1 genes were significantly differentially expressed between the mammary glands of lactating Holstein cows with extremely high and low milk protein and fat percentages; thus, these four genes are considered as promising candidates potentially affecting milk yield and composition traits in dairy cattle. In the present study, we further verified whether these genes have genetic effects on milk traits in a Chinese Holstein population. By re-sequencing part of the non-coding and the entire coding regions of the DDIT3, RPL23A, SESN2 and NR4A1 genes, a total of 35 SNPs and three insertions/deletions were identified, of which three were found in DDIT3, 12 in RPL23A, 16 in SESN2 and seven in NR4A1. Moreover, two of the insertions/deletions-g.125714860_125714872del and g.125714806delinsCCCC in SESN2-were novel and have not been reported previously. Subsequent single SNP analyses revealed multiple significant association with all 35 SNPs and three indels regressed against the dairy production traits (P-value = <0.0001-0.0493). In addition, with a linkage disequilibrium analysis, we found one, one, three, and one haplotype blocks in the DDIT3, RPL23A, SESN2 and NR4A1 genes respectively. Haplotype-based association analyses revealed that some haplotypes were also significantly associated with milk production traits (P-value = <0.0001-0.0461). We also found that 12 SNPs and two indels (two in DDIT3, two in RPL23A, nine in SESN2 and one in NR4A1) altered the specific transcription factor binding sites in the promoter, thereby regulating promoter activity, suggesting that they might be promising potential functional variants for milk traits. In summary, our findings first determined the genetic associations of DDIT3, RPL23A, SESN2 and NR4A1 with milk yield and composition traits in dairy cattle and also suggested potentially causal variants, which require in-depth validation.

Silencing of ATPase family AAA domain-containing protein 2 inhibits migration and invasion of colorectal cancer cells

Colorectal cancer is one of the most common malignant tumors with a high rate of distant metastasis, postoperative recurrence and mortality. ATPase family AAA domain-containing protein 2 (ATAD2), a member of ATPase family, is highly expressed in various cancers, including colorectal cancer. However, whether ATAD2 plays a role in the migration and invasion of colorectal cancer cells remains unknown. In this study, we established ATAD2 knockdown in colorectal cancer cell lines by RNA interference and found that silencing of ATAD2 inhibited the migration and invasion ability of Caco-2 and SW-480 cells. Moreover, ATAD2 silencing suppressed epithelial-mesenchymal transition (EMT), and reduced the expression and enzymatic activity of matrix metalloproteinases (MMPs) in Caco-2 and SW-480 cells. In summary, our results suggest that silencing of ATAD2 inhibits migration and invasion of colorectal cancer cells by suppressing EMT and decreasing the activity of MMPs. Hence, ATAD2 could be considered as a novel molecular marker of metastatic colorectal cancer, and it may provide new insights for clinical diagnosis and treatment of colorectal cancer.

[Effects of airway management team in the treatment of severely mass burn patients combined with inhalation injury]

Objective: To explore and analyze the effects of airway management team (AMT) in the treatment of severely mass burn patients combined with inhalation injury. Methods: The clinical data of 58 severely burned patients combined with inhalation injury hospitalized in our unit from January 2012 to August 2014, conforming to the inclusion criteria, were retrospectively analyzed. According to whether airway management was implemented by AMT or not, patients hospitalized from January 2012 to July 2014 were divided into control group (n=27), while patients in Kunshan factory aluminum dust explosion accident hospitalized on 2nd August 2014 were divided into observation group (n=31). Patients in control group received regular airway nursing carried out by nurses on duty, while patients in observation group received specialized airway concentration nursing implemented by AMT. The concrete implementation included overall assessment of patients' airway, elaborate airway care, and controlled management of mechanical ventilation. Arterial blood gas indexes and oxygenation index of patients in the two groups on post injury day (PID) 1, 7, and 14 were compared. Sputum viscosity, ventilator-associated pneumonia (VAP) occurrence rate, and ventilation time of patients in the two groups in post injury week(s) 1, 2, and 3 after admission were monitored and recorded. Survival rates of patients in the two groups were compared. Data were processed with analysis of variance for repeated measurement, t test and Bonferroni correction, chi-square test, and Wilcoxon rank sum test. Results: (1) There were no statistically significant differences in pH value, arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial oxygen saturation (SaO(2)), and oxygenation index of patients in the two groups on PID 1 (t=0.595, -0.166, 1.518, -0.828, 0.458, P>0.05). The pH values of patients in observation group on PID 7 and 14 were 7.327±0.050 and 7.367±0.043, respectively, significantly better than those in control group (7.304±0.021 and 7.390±0.029, respectively, t=-2.385, 2.391, P<0.05). The PaO(2) values of patients in observation group on PID 7 and 14 were (95.1±6.7) and (106.3±7.8) mmHg (1 mmHg=0.133 kPa), respectively, significantly higher than those in control group [(91.6±5.7) and (102.0±8.3) mmHg, respectively, t=-2.109, -2.059, P<0.05]. The PaCO(2) values of patients in observation group on PID 7 and 14 were (41±4) and (40±4) mmHg, respectively, significantly lower than those in control group [(43±5) and (43±4) mmHg, respectively, t=2.220, 2.304, P<0.05]. The SaO(2) values of patients in observation group on PID 7 and 14 were 0.95±0.04 and 0.96±0.04, respectively, significantly higher than those in control group (0.93±0.05 and 0.94±0.05, respectively, t=-2.201, -2.016, P<0.05). The oxygenation indexes of patients in observation group on PID 7 and 14 were (286±18) and (329±20) mmHg, significantly higher than those in control group [(277±14) and (306±58) mmHg, respectively, t=-2.263, -2.022, P<0.05]. (2) Sputum viscosity of patients in observation group in post injury week(s) 1, 2, and 3 were superior to that in control group (Z=-2.096, -2.076, -2.033, P<0.05). (3) VAP occurrence rate of patients in observation group was lower than that in control group, and time of mechanical ventilation of patients in observation group was shorter than that in control group (χ(2)=4.244, t=2.425, P<0.05). (4) Survival rate of patients in observation group was higher than that in control group (χ(2)=4.244, P<0.05). Conclusions: The special intensive care of airway management by AMT can effectively improve the oxygenation status of severely burned patients combined with inhalation injury, alleviate the sputum viscosity, reduce the occurrence of VAP, and shorten the time of mechanical ventilation, thus benefits the treatment of severely mass burn patients combined with inhalation injury.

Engineering Vaccines to Reprogram Immunity against Head and Neck Cancer

The recent Food and Drug Administration's approval of monoclonal antibodies targeting immune checkpoint receptors (ICRs) for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) offers exciting promise to improve patient outcome and reduce morbidities. A favorable response to ICR blockade relies on an extensive collection of preexisting tumor-specific T cells in the tumor microenvironment (TME). ICR blockade reinvigorates exhausted CD8+ T cells and enhances immune killing. However, resistance to ICR blockade is observed in about 85% of patients with HNSCC, therefore highlighting the importance of characterizing the mechanisms underlying HNSCC immune escape and exploring combinatorial strategies to sensitize hypoimmunogenic cold HNSCC to ICR inhibition. Cancer vaccines are designed to bypass the cold TME and directly deliver cancer antigens to antigen-presenting cells (APCs); these vaccines epitomize a priming strategy to synergize with ICR inhibitors. Cancer cells are ineffective antigen presenters, and poor APC infiltration as well as the M2-like polarization in the TME further dampens antigen uptake and processing, both of which render ineffective innate and adaptive immune detection. Cancer vaccines directly activate APC and expand the tumor-specific T-cell repertoire. In addition, cancer vaccines often contain an adjuvant, which further improves APC function, promotes epitope spreading, and augments host intrinsic antitumor immunity. Thus, the vaccine-induced immune priming generates a pool of effectors whose function can be enhanced by ICR inhibitors. In this review, we summarize the major HNSCC immune evasion strategies, the ongoing effort toward improving HNSCC vaccines, and the current challenges limiting the efficacy of cancer vaccines.

[Prevalence and clinical features of familial hypercholesterolemia in Chinese patients with myocardial infarction]

Objective: To analyze the prevalence and clinical features of familial hypercholesterolemia (FH) in Chinese patients with myocardial infarction (MI). Method: This retrospective study recruited a total of 2 119 consecutive patients (age (56.7±10.9) years old) undergoing coronary angiography with first MI from April 2011 to December 2016. Patients were divided into 2 groups: premature MI (male<55 years old, female<60 years old) and non-premature MI. The diagnosis of FH was established according to Dutch Lipid Clinic Network (DLCN) diagnostic criteria and referred as definite/probable FH in our study. The prevalence and clinical features of FH, including lipid level, MI characteristics and stain therapy, were explored. Multivariable logistic regression analysis was used to assess the predictive value of FH for the presence of premature MI. Results: The prevalence of definite/probable FH was 3.68% (78/2 119) in MI patients and 7.28% (68/934) in premature MI patients. Onset of MI occurred 10 years earlier in patients with definite/probable FH than those without FH ((47.9±9.4) years vs. (58.8±10.7) years, P<0.01). Additionally, we found that the risk of premature MI was significantly and independently increased in definite/probable FH patients (OR=5.32, 95%CI 2.77-10.22, P<0.01). None of FH patients reached the target of LDL-C<1.8 mmol/L under statin therapy. Conclusions: The prevalence of FH in Chinese patients with MI is not rare. Clinically, FH is linked with the early onset of MI.

Genetic association of the ACACB gene with milk yield and composition traits in dairy cattle

Previously, we re-sequenced the whole genomes of eight Holstein bulls with high or low milk protein and fat percentage, and we detected two indels in the ACACB (acetyl-CoA carboxylase beta) gene that were polymorphic between the two groups. Thus, we considered ACACB as a promising candidate gene potentially affecting milk composition traits. Herein, we verified the genetic effects of ACACB on five milk traits in a Chinese Holstein population. We identified six SNPs in the 5'-promoter region, five in the 5'- untranslated region (UTR), 11 in exons, four in the 3'-UTR and three in the 3'-flanking region by re-sequencing the entire coding and regulatory regions of ACACB. One of these SNPs (ss1987461005) is reported here for the first time, and three of the SNPs (rs109482081, rs110819816 and rs109281947) were predicted to result in amino acid replacements. Genotype-phenotype association analyses showed that all the identified SNPs, except for ss1987461005, rs208919019 and rs134447911, were significantly associated with milk yield, fat yield, fat percentage, protein yield or protein percentage (P < 0.0001 to 0.0484). Linkage disequilibrium analyses were conducted among the identified SNPs to confirm the genetic associations. Two SNPs-rs135874354 (g.66218726T>C) and rs210928430 (g.66218117G>A)-were predicted to alter transcription factor binding sites in the 5'-promoter region of ACACB. A luciferase activity assay showed that the promoter activity of haplotype TG was significantly higher than that of CG (P = 0.0002) and that the promoter activity of haplotype TA was remarkably higher than that of CA (P = 7.4285E-09), showing that the T allele of rs135874354 increased promoter activity. Thus, rs135874354 was considered to be a potentially functional mutation. Our findings have, for the first time, profiled the genetic effect of ACACB on milk production traits in dairy cattle and revealed a potentially causal mutation that requires further the in-depth validation.

Abstract P6-11-03: Association of systemic paclitaxel concentrations with severity and progression of paclitaxel-induced peripheral neuropathy

Background: Paclitaxel is commonly used in combination regimens in patients with early stage breast cancer, but its use is often limited by the development of severe paclitaxel-induced peripheral neuropathy (PIPN). Paclitaxel pharmacokinetics (PK), specifically the maximum paclitaxel concentration (Cmax) and amount of time the concentration remains above 0.05 µM (Tc&gt;0.05), have been associated with occurrence of severe, clinician-documented (NCI CTCAE) neuropathy. Patient-reported outcomes are more reliable, sensitive, and responsive than clinician-documented neuropathy, particularly for subjective toxicities. The objective of this study was to confirm that paclitaxel PK predicts occurrence and progression of patient-reported PIPN.

Methods: This observational trial enrolled patients with early stage breast cancer receiving adjuvant/neoadjuvant weekly 1-hour paclitaxel infusions (80 mg/m2 x 12 cycles) at the University of Michigan Comprehensive Cancer Center. Patients with existing neuropathy or previous neuropathic chemotherapy treatment were excluded. Paclitaxel concentration was measured via liquid chromatograph/mass spectrometry (LC/MS) in plasma samples collected at the end of (Cmax) and 16-24 hours after (Tc&gt;0.05) first infusion. Patient-reported neuropathy was collected (EORTC CIPN20) at baseline and each treatment cycle. The 8-item sensory subscale of the CIPN20 (CIPN8, range 8-32) was estimated for each patient and cycle of treatment to calculate the change from baseline (ΔCIPN8, range 0-24). The analysis was conducted using two approaches. In the first analysis, the cohort was stratified into cases and controls by the median ΔCIPN8 and in the second, each patient was described by the rate of change of CIPN8 per treatment cycle. The association of Cmax and Tc&gt;0.05 with case/control definition was tested using Wilcoxon rank sum and t-tests. Associations with rate of change of CIPN8 were tested using linear regression.

Results: 60 patients were enrolled in this observational clinical study. The mean age was 52.4 years, 93% of patients were Caucasian, and 5% had diabetes diagnosis. At baseline there was very little patient-reported neuropathy (mean baseline CIPN8=8.3). The median ΔCIPN8 was 4. Patients with ΔCIPN8&gt;4 had greater Cmax than patients with ΔCIPN8≤4 (p=0.010). In the regression modeling, there was a significant correlation between patient's Tc&gt;0.05 and the rate of increase in ΔCIPN8 (r=0.28, p=0.03).

Conclusions: Our preliminary findings suggest that a single PK sample collected at the end of the first cycle (Cmax) or 16-24 hours later (Tc&gt;0.05) are indicative of a patient's risk of experiencing PIPN during paclitaxel treatment. Ongoing modeling that accounts for dosing decreases, delays, and discontinuations will further characterize the contribution of paclitaxel pharmacokinetics to PIPN development and enable identification of genetic and metabolomic biomarkers that predict which patients experienced more severe PIPN than would be anticipated based on their paclitaxel PK.

Citation Format: Hertz DL, Kidwell KM, Vangipuram K, Sun D, Henry NL. Association of systemic paclitaxel concentrations with severity and progression of paclitaxel-induced peripheral neuropathy [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 P6-11-03.

Genome-wide association study for reproductive traits in a Large White pig population

Using the PorcineSNP80 BeadChip, we performed a genome‐wide association study for seven reproductive traits, including total number born, number born alive, litter birth weight, average birth weight, gestation length, age at first service and age at first farrowing, in a population of 1207 Large White pigs. In total, we detected 12 genome‐wide significant and 41 suggestive significant SNPs associated with six reproductive traits. The proportion of phenotypic variance explained by all significant SNPs for each trait ranged from 4.46% (number born alive) to 11.49% (gestation length). Among them, 29 significant SNPs were located within known QTL regions for swine reproductive traits, such as corpus luteum number, stillborn number and litter size, of which one QTL region associated with litter size contained the ALGA0098819 SNP for total number born. Subsequently, we found that 376 functional genes contained or were near these significant SNPs. Of these, 14 genes—BHLHA15, OCM2, IL1B2, GCK, SMAD2, HABP2, PAQR5, GRB10, PRELID2, DMKN, GPI, GPIHBP1, ADCY2 and ACVR2B—were considered important candidates for swine reproductive traits based on their critical roles in embryonic development, energy metabolism and growth development. Our findings contribute to the understanding of the genetic mechanisms for reproductive traits and could have a positive effect on pig breeding programs.