[Changes of helper T lymphocytes 17 and regulatory T lymphocytes in peripheral blood of patients with extensive burn at early stage in August 2nd Kunshan factory aluminum dust explosion accident and the significance]

Objective: To explore the changes of helper T lymphocytes 17 (Th17) and regulatory T lymphocytes (Tregs) in peripheral blood of patients with extensive burn at early stage in August 2nd aluminum dust explosion accident in Kunshan factory (hereinafter referred to as Kunshan explosion accident) and the significance. Methods: Twenty patients with extensive burn in Kunshan explosion accident admitted to our department of burns and plastic surgery were enrolled in burn group, and 10 healthy adult volunteers with no history of smoking were enrolled in healthy control group. Five mL of peripheral venous blood samples were collected from patients in burn group at admission (≤post injury hour 6, PIH 6) and PIH 24, and on post injury day (PID) 7, and from volunteers in healthy control group respectively. The percentages of CD64(+) T lymphocytes, human leukocyte antigen-DR positive (HLA-DR(+) ) T lymphocytes, CD3(+) CD8(-) Th17, and CD4(+) CD25(+) Tregs in peripheral blood T lymphocytes were determined by flow cytometer. Results: (1) The percentages of CD64(+) T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(2.35±0.32)% and (4.02±0.15)%] were higher than (0.67±0.11)% of healthy volunteers in healthy control group. The percentage of CD64(+) T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.39±0.25)% ] was lower than that of healthy volunteers in healthy control group. The percentages of HLA-DR(+) T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(54±18)% and (72±17)%] were higher than (38±14)% of healthy volunteers in healthy control group. The percentage of HLA-DR(+) T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(28±15)% ] was lower than that of healthy volunteers in healthy control group. (2) The percentages of CD3(+) CD8(-)Th17 in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(4.21±0.46)% and (7.38±0.39)%] were higher than (0.98±0.09)% of healthy volunteers in healthy control group. The percentage of CD3(+) CD8(-)Th17 in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.81±0.05)% ] was lower than that of healthy volunteers in healthy control group. (3) The percentages of CD4(+) CD25(+) Tregs in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24, and on PID 7 [(1.78±0.26)%, (1.26±0.37)%, and (0.38±0.03)%] were lower than (3.24±0.52)% of healthy volunteers in healthy control group. Conclusions: The percentage of Th17 in peripheral blood T lymphocytes of patients with extensive burn at early stage in Kunshan explosion accident increased at first and then decreased compared with that of healthy volunteers, indicating that the patients' immune function increased first and then weakened. The percentages of Tregs in peripheral blood T lymphocytes at each time point were lower than the percentage of healthy volunteers, indicating that the patients' immunomodulation gradually weakened after extensive burns.

[A comparative study of therapy effects between esomeprazole plus mosapride citrate and botulinum toxin injection on vocal process granuloma]

Objective:Anti-reflux medications or botulinum toxin A injections are the main current therapies for the definite vocal process granuloma. This studies is focusing on comparing the effects of proton pump inhibitors plus prokinetic agents with botulinum toxin A injections on vocal process granuloma. Method:Adult patients in our outpatient department (from December 2014 to June 2016) complaining of trachyphonia and/or abnormal pharyngeal sensations who were found to have contact granulomas (38 cases) were included. Patients were divided into two groups according to the treatment selected by themselves: esomeprazole with mosapride citrate (n=28) or botulinum toxin A injection (n=20). The reflux symptom index and reflux finding score determined by electronic fibrolaryngoscopy were utilized to assess efficacy. Result:There was no statistical difference on age, sex and reflux symptom index and reflux finding score before treatment between the two groups. Total effective rate in the esomeprazole with mosapride citrate group and the botulinum toxin A group were 96.43% and 45.00%, separately. The recorded symptoms after therapy resolved with a statistically significant improvement in the esomeprazole with mosapride citrate group. Conclusion:Combined proton pump inhibitor plus prokinetic drug therapy plays a significant role in the treatment of vocal process granulomas.

Gene expression analysis of isolated salmonid GALT leucocytes in response to PAMPs and recombinant cytokines

Increased knowledge of the immune response of the intestine, a physiologically critical organ involved in absorption, secretion and homeostasis in a non-sterile environment, is needed to better understand the mechanisms involved in the induction of long-lasting immunity and, subsequently, the development of efficacious gastrointestinal immunization approaches. To this end, analysis of isolated gut cells will give an insight into the cell types present and their immune capability. Hence, in this study we first optimised a method for salmonid gut leucocyte isolation and characterised the cells on the basis of their expression of a range of selected cell markers associated with T & B cells and dendritic cells. The GALT leucocytes were then stimulated with a variety of PAMPs, recombinant cytokines and PHA, as a means to help characterise the diversity of the immune repertoire present in such cells. The stimulants tested were designed to examine the nature of the antibacterial, antiviral and T cell type responses in the cells (at the transcript level) using a panel of genes relevant to innate and adaptive immunity. The results showed distinct responses to the stimulants, with a clear delineation seen between the stimulant used (eg viral or bacterial PAMP) and the pathway elicited. The changes in the expression patterns of the immune genes in these cells indicates that the salmonid intestine contains a good repertoire of competent immune cells able to respond to different pathogen types. Such information may aid the development of efficient priming by oral vaccination in salmonids.

The discovery and comparative expression analysis of three distinct type I interferons in the perciform fish, meagre (Argyrosomus regius)

Type I interferons (IFN) play an important role in anti-viral responses. In teleost fish multiple genes exist, that are classified by group/subgroup. That multiple subgroups are present in Acanthopterygian fish has only become apparent recently, and 3 subgroups are now known to be expressed, including a new subgroup termed IFNh. However, the potential to express multiple IFN subgroups and their interplay is not well defined. Hence this study aims to clarify the situation and undertook the first in-depth analysis into the nature and expression of IFNc, IFNd and IFNh in the perciform fish, meagre. Constitutive expression was analysed initially during larval development and in adult tissues (gills, mid-gut, head kidney, spleen). During early ontogeny IFNc was the highest expressed IFN, and this was also the case in adult tissues with the exception of gills where IFNd was highest. However, comparison between tissues for individual isoforms showed that spleen had high transcript levels of all three IFNs, IFNd/IFNh were also highly expressed in gills. The expression of each sub-group was increased significantly in the four tissues following injection of poly I:C, however, this increase was only seen in the mid-gut for IFNh. Following in vitro stimulation with poly I:C again all three isoforms were upregulated, although with differences in kinetics and the cell source used. For example, early induction was seen for IFNc/IFNh in gill cells, IFNd/IFNh in splenocytes and all three isoforms in head kidney cells. Induction was sustained in splenocytes and head kidney cells, but in gut cells only a late induction was seen. These results demonstrate a complex pattern of regulation between the different IFN isoforms present in meagre and highlights potential sub-functionalisation of these IFN subgroups during perciform anti-viral responses.

[Crouzon syndrome coupled with OSAHS and congenital heart disease: a case report]

A case of Crouzon syndrome coupled with OSAHS and congenital heart disease in our hospital was reported. The patient who was a 2 years and 7 months old boy, was admitted in our hospital for repetitive sore throat, snoring with mouth breathing during sleep for more than 2 years and been found with some typical defect of Crouzon syndrome during physical examination. Half a year ago the boy underwent ventricular septal defect closure surgery. PSG shows severe apnea hypopnea and low ventilation existed. Under general anesthesia, the patient accepted bilateral tonsillectomy and adenoidectomy but dyspnea occurred after post-operative extubation till 2 days later the boy can breathe by himself. The follow-up at 6 months and 1 year revealed that the patient did not have snoring or mouth breathing during sleep. For this kind of case, we should assess detailed pre-operation and observe carefully post-operation so as to reduce the perioperative period risks.

[Neuroendocrine carcinoma of cervix: a clinicopathologic study of 82 cases]

Objective: To investigate the clinicopathological characteristics and prognostic factors of neuroendocrine carcinoma (NEC) of the cervix. Methods: Eight-two patients diagnosed as NEC of cervix from 2008 to 2016 at West China Second University Hospital were analyzed retrospectively including HE slide review, immunohistochemistry and HPV genotyping. Survival analysis was performed using Kaplan-Meier and Cox regression model. Results: The age of the patients ranged from 16 to 75 years with mean age of 43 years. According to International Federation of Gynecology and Obstetrics (FIGO) clinical stage, 52 cases were in stageⅠ, 10 cases in stageⅡ, 14 cases in stage Ⅲ and 6 cases in stage Ⅳ. The tumor size ranged from 0.5 to 6.5 cm, with an average of 3.6 cm. Upon histopathologic review, 74 tumors were classified as small cell carcinoma; 7 tumors as large cell NEC, and 1 as atypical carcinoid. Further evaluation showed 52 cases (63.4%) with deep stromal invasion, 73 cases (89.0%) with lymph-vascular invasion, and 28 cases (34.2%) with pelvic and (or) para-aortic lymph nodes involvement. Immunohistochemical staining showed neuroendocrine markers Syn, CD56, NSE, S-100 protein and CgA were positive in 93.9%, 84.2%, 74.4%, 64.6% and 51.2% of cases, respectively. The results of HPV-DNA detection were positive in 72 cases, high-risk HPV types were 70 cases and 49 cases were HPV18 positive. The median follow-up time was 37 months (range, 6-101 months). Twenty-nine cases were found recurrence or metastasis, including 23 cases of death. The univariate analysis demonstrated that the tumor size, lymph node metastasis, infiltration depth, FIGO stage and whether the lesion confined to the uterus were significant prognostic factors(P<0.05). Cox multivariate analysis showed that lymph node metastasis and FIGO stage were independent prognostic factors of NEC(P<0.05). Conclusions: NEC of the cervix is a highly aggressive malignancy with poor prognosis. The tumor is associated with HPV infection, especially type 18. Small cell NEC is the most common type of cervical NEC. Diagnosis is based on histological and immunohistochemical examination. Lymph node metastasis and FIGO stage are the independent factors affecting prognosis.

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

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

Abstract PD3-08: A randomized phase II trial of pyrotinib plus capecitabine versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer previously treated with taxanes, anthracyclines and/or trastuzumab

Background:Pyrotinib is an oral, irreversible pan-ErbB receptor tyrosine kinase inhibitor (TKI) with activity against epidermal growth factor receptor (EGFR) / HER1, HER2, and HER4. Lapatinib in combination with capecitabine is one of the standards of care for patients with HER2-positive metastatic breast cancer (MBC) who have received prior taxanes, anthracyclines and/or trastuzumab.

Methods: We conducted an open label, multicenter, randomized phase II trial to comparatively evaluate efficacy and safety of pyrotinib + capecitabine (PC) or lapatinib + capecitabine (LC) in women with HER2-positive MBC. Key eligibility criteria included prior treatment with taxanes, anthracyclines and/or trastuzumab, ≤2 prior chemotherapies for metastatic disease, no CNS metastases, and no prior treatment with HER2 targeted TKI. Eligible patients were randomized 1:1 to PC Arm (P 400 mg QD D1–21 + C 1000 mg/m2BID D1–14, 21-D cycle) or LC Arm (L 1250 mg QD D1–21 + C 1000 mg/m2BID D1–14, 21-D cycle). The primary endpoint was objective response rate (ORR) as assessed by investigator, and secondary endpoints included progression-free survival (PFS), time to progression (TTP), duration of response (DoR), overall survival (OS), and safety.

Results: Between May 2015 and Mar 2016, 128 patients (65 in PC arm and 63 in LC arm) were enrolled in this study. Median age was 48 years (range 25-70), ECOG performance status was 0 (53.9%) or 1 (46.1%), 62.5% had hormone receptor-positive disease, 76.6% had visceral disease and 53.9% had received prior trastuzumab in (neo)adjuvant and/or mestastatic setting. Baseline characteristics were well balanced in two arms. Median follow-up time was 15.0 months. ORR was 78.5% in PC arm and 57.1% in LC arm (p=0.01), Median PFS was 18.1 months in PC arm and 7.0 months in LC arm (hazard ratio 0.363; 95% CI 0.228, 0.579; p&lt;0.0001), PFS benefit in PC arm compared to LC arm was observed irrespective of prior trastuzumab or not. Treatment related Grade 3-4 toxicities occurred in &gt;2% patients in PC arm vs LC arm included hand-foot syndrome (21.5% vs 19.0%), diarrhea (13.8% vs 4.8%), decreased neutrophil (7.7% vs 1.6%), decreased WBC (6.2% vs 1.6%), vomiting (4.6% vs 0%), increased AST (3.1% vs 1.6%), decreased hemoglobin (3.1% vs 1.6%), increased total bilirubin (0% vs 4.8%) and increased conjugated bilirubin (0% vs 3.2%).

Conclusions: In women with HER2-positive MBC previously treated with taxanes, anthracyclines and/or trastuzumab, pyrotinib + capecitabine yield statistically significant better PFS and ORR than lapatinib + capecitabine in this randomized phase II trial. Phase III study is ongoing to validate this finding.

Citation Format: Xu B, Ma F, Ouyang Q, Li W, Jiang Z, Tong Z, Liu Y, Li H, Yu S, Feng J, Wang S, Hu X, Zhu X, Zou J. A randomized phase II trial of pyrotinib plus capecitabine versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer previously treated with taxanes, anthracyclines and/or trastuzumab [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 PD3-08.

Development of a 10 kHz high harmonic source up to 140 eV photon energy for ultrafast time-, angle-, and phase-resolved photoelectron emission spectroscopy on solid targets

We present a newly developed high harmonic beamline for time-, angle-, and carrier-envelope phase-resolved extreme ultraviolet photoemission spectroscopy on solid targets for the investigation of ultrafast band structure dynamics in the low-fs to sub-fs time regime. The source operates at a repetition rate of 10 kHz and is driven by 5 fs few-cycle near-infrared laser pulses generating high harmonic radiation with photon energies up to 120 eV at a feasible flux. The experimental end station consists of a complementary combination of photoelectron detectors which are able to spectroscopically address electron dynamics both in real and in k-space. The versatility of the source is completed by a phase-meter which allows for tracking the carrier-envelope phase for each pulse and which is synchronized to the photoelectron detectors, thus enabling phase sensitive measurements on the one hand and the selection of single attosecond pulses for ultimate time resolution in pump-probe experiments on the other hand. We demonstrate the applicability of the source by an angle- and carrier-envelope phase-resolved photoemission measurement on a tungsten (110) surface with 95 eV extreme ultraviolet radiation.

[Effects of voice therapy and psychological intervention on anxious and depressive in patients with voice disorders]

Objective:To investigatethe effect of voice therapy on anxious and depressive in patients with voice disorders.Method:The patients who received voicee therapy in our department from May 2014 to July 2016 were enrolled in our study and evaluated by self-rating anxiety scale (SAS) and self rating depression scale (SDS), before and after voice therapy.result:Before voicee therapy, the score of SAS and SDS were 47.52±11.15 and 48.63±8.70 respectively, which were higher than domestic norm (37.23±12.59 and 41.88±10.57 for SAS and SDS, respecative) with P< 0.05. After voice therapy, the score of SAS and SDS were 38.03±6.95 and 42.21±7.71, which were lower than the score of before voice therapy (P< 0.05). And compared with the domestic norm, the difference was not statistically significant (P> 0.05).Conclusion:The anxiety and depression scores of patients with voice disorders are higher than those of ordinary people. The voice therapy can effectively relieve anxiety and depression of patients with voice disease.

Phylogeny and expression analysis of C-reactive protein (CRP) and serum amyloid-P (SAP) like genes reveal two distinct groups in fish

The acute phase response (APR) is an early innate immune function that is initiated by inflammatory signals, leading to the release of acute phase proteins to the bloodstream to re-establish homeostasis following microbial infection. In this study we analysed the Atlantic salmon (Salmo salar) whole-genome database and identified five C-reactive protein (CRP)/serum amyloid P component (SAP) like molecules namely CRP/SAP-1a, CRP/SAP-1b, CRP/SAP-1c, CRP/SAP-2 and CRP/SAP-3. These CRP/SAP genes formed two distinct sub-families, a universal group (group I) present in all vertebrates and a fish/amphibian specific group (group II). Salmon CRP/SAP-1a, CRP/SAP-1b and CRP/SAP-1c and CRP/SAP-2 belong to the group I family whilst salmon CRP/SAP-3 is a member of group II. Gene expression analysis showed that the salmon CRP/SAP-1a as well as serum amyloid A-5 (SAA-5), one of the major acute phase proteins, were significantly up-regulated by recombinant cytokines (rIL-1β and rIFNγ) in primary head kidney cells whilst the other four CRP/SAPs remained refractory. Furthermore, SAA-5 was produced as the main acute phase protein (APP) in Atlantic salmon challenged with Aeromonas salmonicida (aroA(-) strain) whilst salmon CRP/SAPs remained unaltered. Overall, these data illustrate the potential different functions of expanded salmon CRP/SAPs to their mammalian homologues.

[Clinical and pathological analyses of 154 patients with white lesion of vocal cord]

Objective: To investigate the clinical and pathological features and prognosis of white lesion of vocal cord. Methods: One hundred and fifty-four cases of white lesion of vocal cord from January 2009 to February 2016 were retrospectively analysed. All the patients had undergone the resection of white lesion of vocal cord resection through retaining laryngoscope under general anesthesia with the specimens pathologically examined. Results: There were 148 males and 6 females in this study. The ages ranged from 36 to 83 years, and the median age was 54.5.There were 103(66.88%) long-term smokers, and 64(41.56%) long-term drinkers. Postoperative pathology showed that chronic mucosal inflammation in 19 cases (12.34%), squamous epithelial hyperplasia in 56 cases(36.36%), mild dysplasia in 25 cases(16.23%), moderate dysplasia in 34 cases(22.08%), severe dysplasia in 12 cases(7.79%), carcinoma in situ in 6 cases(3.90%), and invasive carcinoma in 2 cases(1.30%). The recurrence rate and canceration rate of chronic mucosal inflammation were 0. The recurrence rate of squamous epithelial hyperplasia was 10.71%, the canceration rate was 0.The recurrence rate of mild dysplasia was 8.00%, the canceration rate was 0. The recurrence rate of moderate dysplasia was 20.59%, the canceration rate was 8.82%. The recurrence rate of severe dysplasia was 25.00%, the canceration rate was 16.67%. Conclusions: White lesion of vocal cord is a predominantly male disease. Long-term smokering and drinking are one of common causes. The final diagnosis of white lesion of vocal cord relies on the pathology. Closed observation is necessary for theses dysplasia cases. The majority of which are benign, the operation effect is good.

Magnitude of and gender differences in cardiovascular risk profiles among community residents in Shenzhen, China

OBJECTIVES

Understanding the prevalence of cardiovascular disease (CVD) risk factors has an impact on the public policy for initiating CVD prevention. This study aimed to examine the prevalence of current smoking, overweight/obesity, hypertension, diabetes mellitus (DM), and dyslipidemia among Shenzhen residents and to investigate gender differences in CVD risk profiles to identify the subgroups at higher risk.

STUDY DESIGN

A large cross-sectional study was conducted between April and May 2015.

METHODS

Using multistage cluster random sampling methods, a total of 1784 residents finished the face-toface interview survey. Physical examinations and blood tests were performed by qualified professionals.

RESULTS

The prevalence of current smoking, overweight/obesity, hypertension, DM, and dyslipidemia were 21.8%, 40.6%, 17.6%, 4.8%, and 35.7%, respectively. Clustering of two or more or three or more of CVD risk factors was noted in 35.7% and 14.1% of participants. The prevalence of current smoking (45.0% vs 1.1%, P < 0.001), overweight/obesity (48.5% vs 33.4%, P < 0.001), hypertension (19.7% vs 15.7%, P < 0.05), and dyslipidemia (46.5% vs 20.5%, P < 0.001) was found higher among male than among female participants.

CONCLUSIONS

This study adds to the evidence suggesting high prevalence rates of CVD risk factors and composite measures among Shenzhen residents. The higher level of CVD risk factors in male than in female residents is suggested. Effective population-based intervention programs such as smoking cessation, early detection, management, and treatment of hypertension, DM, and dyslipidemia should be initiated and enhanced especially among the males.

Molecular dynamics investigation of desorption and ion separation following picosecond infrared laser (PIRL) ablation of an ionic aqueous protein solution

Molecular dynamics simulations were performed to characterize the ablation process induced by a picosecond infrared laser (PIRL) operating in the regime of desorption by impulsive vibrational excitation (DIVE) of a model peptide (lysozyme)/counter-ion system in aqueous solution. The simulations were performed for ablation under typical experimental conditions found within a time-of-flight mass spectrometer (TOF-MS), that is in vacuum with an applied electric field (E = ± 10⁷ V/m), for up to 2 ns post-ablation and compared to the standard PIRL-DIVE ablation condition (E = 0 V/m). Further, a simulation of ablation under an extreme field condition (E = 10¹⁰ V/m) was performed for comparison to extend the effective dynamic range of the effect of the field on charge separation. The results show that the plume dynamics were retained under a typical TOF-MS condition within the first 1 ns of ablation. Efficient desorption was observed with more than 90% of water molecules interacting with lysozyme stripped off within 1 ns post-ablation. The processes of ablation and desolvation of analytes were shown to be independent of the applied electric field and thus decoupled from the ion separation process. Unlike under the extreme field conditions, the electric field inside a typical TOF-MS was shown to modify the ions' motion over a longer time and in a soft manner with no enhancement to fragmentation observed as compared to the standard PIRL-DIVE. The study indicates that the PIRL-DIVE ablation mechanism could be used as a new, intrinsically versatile, and highly sensitive ion source for quantitative mass spectrometry.