[Influence of guided bone regeneration on marginal bone loss of implants in the mandible posterior region: a 10-year retrospective cohort study]

Objective: To investigate the effect of guided bone regeneration (GBR) on marginal bone loss (MBL) in the region of the mandibular posterior tooth by using a retrospective cohort study, in order to provide reference for clinical practice. Methods: The research subjects were patients who received dental implants from October 2008 to June 2011 in the region of the mandibular posterior tooth at the Department of Oral Implantology, School of Stomatology, The Fourth Military Medical University. According to whether GBR was performed or not and the time of implant insertion, the patients were divided into the controls group (patients without bone grafting), simultaneous GBR implantation group, and delayed GBR implantation group. On this basis, the MBL was measured according to radiographs by comparing the marginal bone level from that of immediate postoperation 10 years ago. General data was collected and compared among groups, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and gingival papilla height. Results: The controls group (patients without bone grafting), implantation group, and delayed GBR implantation group followed 58, 76, 26 implants in 26, 32, 13 patients aging at (46.5±9.9), (45.5±10.7), (58.3±6.4) respectively. The duration of the follow-up was (11.2±0.7), (11.1±0.8), (11.1±0.9) years respectively. The 10-year implant survival rate was 100% (58/58), 100% (76/76), 100% (26/26). The MBL was (0.91±0.28), (0.84±0.27), (1.01±0.27) mm respectively. The MBL difference of patients with simultaneous GBR implantation and delayed GBR implantation showed statistical significance (P<0.05), but these two groups showed no statistical significance compared with the controls group (P>0.05). The mPI, mSBI, PD, and gingival papilla height of the three groups all had no significance on statistics (P>0.05). Conclusions: It can be concluded that there is no difference in long-term marginal bone resorption between simultaneous and delayed implantation with or without GBR (using autologous blood mixed with granular bone meal) in the posterior mandibular area.

Expression and immunogenicity study of a novel mhp183 gene fragment of Mycoplasma hyopneumoniae

A highly immunogenic nucleotide fragment (195bp) was selected from the Mhp183 gene of Mycoplasma hyopneumoniae using information software technology and was named Mhp183195bp. Three Mhp183195bp were linked to form a new nucleotide sequence called Mhp183615bp. Mhp183615bp was directly synthesized and cloned into a pET100 vector and expressed in Escherichia coli. After purification, the proteins were successfully validated using SDS-PAGE and Western blot. BALB/c mice were injected with purified proteins on the first, eighth, and fifteenth days of feeding, respectively; serum samples were collected from mice on the day of immunization and on the 22nd day after immunization. The antibody level in mouse serum was detected by Western blotting using purified expressed proteins as antigens. IL-2, TNF-α and IFN-γ were simultaneously detected in mouse serum by ELISA. The 30 kDa protein was successfully expressed and reacted specifically with the specific serum Mhp His-Tag mouse monoclonal antibody and pig antibody. The expressed recombinant protein was immunogenic. The expression levels of IFN-γ, IL-2 and TNF-α were found to be significantly higher on day 22 than in the control group. This study suggests that the expressed recombinant protein could be used as one of the novel vaccine candidates for Mhp.

[Effects of radical radiotherapy combined with different regimens of chemotherapy on radiation intestinal injury in patients with non-metastatic anal squamous cell carcinoma]

Objective: To investigate the effects of radical radiotherapy combined with different chemotherapy regimens (fluorouracil-based versus docetaxel plus cisplatin) on the incidence of radiation intestinal injury and the prognosis in patients with non-metastatic anal squamous cell carcinoma. Methods: A retrospective cohort study was conducted to recruit non-metastatic anal squamous cell carcinoma patients who underwent chemoradiotherapy in the Sixth Affiliated Hospital of Sun Yat-sen University and Nanfang Hospital from July 2013 to January 2021. Inclusion criteria: (1) newly diagnosed anal and perianal squamous cell carcinoma; (2) completed radical radiotherapy combined with concurrent chemotherapy; (3) tumor could be evaluated before radiotherapy. Exclusion criteria: (1) no imaging evaluation before treatment, or the tumor stage could not be determined; (2) patients undergoing local or radical resection before radiotherapy; (3) distant metastasis occurred before or during treatment; (4) recurrent anal squamous cell carcinoma. A total of 55 patients (48 from the Sixth Affiliated Hospital of Sun Yat-sen University and 7 from Nanfang Hospital) were given fluorouracil (the 5-FU group, n=34) or docetaxel combined with the cisplatin (the TP group, n=21). The evaluation of radiation intestinal injury, hematological toxicity and 3-year disease-free survival (DFS) rate were compared between the two groups. The effects of chemotherapy regimen and other clinicopathological factors on the incidence and severity of acute and chronic radiation intestinal injury were analyzed. The assessment of radiation intestinal injury was based on the American Cancer Radiotherapy Cooperation Group (RTOG) criteria. Results: During radiotherapy and within 3 months after radiotherapy, a total of 45 patients developed acute radiation intestinal injury, including 18 cases of grade 1 (32.7%), 22 cases of grade 2 (40.0%) and 5 cases of grade 3 (9.1%). No patient developed chronic radiation intestinal injury. Among the 34 patients in the 5-FU group, 21 had grade 2-3 radiation intestinal injury (21/34, 61.8%), which was significantly higher than that in the TP group (6/21, 28.6%) (χ(2)=5.723, P=0.017). Multivariate analysis showed that 5-FU chemotherapy regimen was an independent risk factor for radiation intestinal injury (HR=4.038, 95% CI: 1.250-13.045, P=0.020). With a median follow-up period of 26 (5-94) months, the 3-year DFS rate of patients in TP group and 5-FU group was 66.8% and 77.9%, respectively, whose difference was not significant (P=0.478). Univariate analysis showed that the DFS rate was associated with sex, age, tumor location, T stage, N stage, and induction chemotherapy (all P<0.05), while the DFS rate was not associated with chemotherapy regimen or radiation intestinal injury (both P>0.05). Multivariate analysis revealed that age ≥ 50 years old was an independent risk factor affecting the prognosis of patients (HR=8.301, 95% CI: 1.130-60.996, P=0.038). Conclusions: For patients with non-metastatic anal squamous cell carcinoma, radical radiotherapy combined with TP chemotherapy regimen can significantly reduce the incidence of radiation intestinal injury as compared to 5-FU regimen. However, due to the short follow-up time, the effect of different chemotherapy regimens on the prognosis is not yet clear.

Identification and clinical validation of EMT-associated prognostic features based on hepatocellular carcinoma

BACKGROUND

The aim of this study was to construct a model based on the prognostic features associated with epithelial-mesenchymal transition (EMT) to explore the various mechanisms and therapeutic strategies available for the treatment of metastasis and invasion by hepatocellular carcinoma (HCC) cells.

METHODS

EMT-associated genes were identified, and their molecular subtypes were determined by consistent clustering analysis. The differentially expressed genes (DEGs) among the molecular subtypes were ascertained using the limma package and they were subjected to functional enrichment analysis. The immune cell scores of the molecular subtypes were evaluated using ESTIMATE, MCPcounter, and GSCA packages of R. A multi-gene prognostic model was constructed using lasso regression, and the immunotherapeutic effects of the model were analyzed using the Imvigor210 cohort. In addition, immunohistochemical analysis was performed on a cohort of HCC tissue to validate gene expression.

RESULTS

Based on the 59 EMT-associated genes identified, the 365-liver hepatocellular carcinoma (LIHC) samples were divided into two subtypes, C1 and C2. The C1 subtype mostly showed poor prognosis, had higher immune scores compared to the C2 subtype, and showed greater correlation with pathways of tumor progression. A four-gene signature construct was fabricated based on the 1130 DEGs among the subtypes. The construct was highly robust and showed stable predictive efficacy when validated using datasets from different platforms (HCCDB18 and GSE14520). Additionally, compared to currently existing models, our model demonstrated better performance. The results of the immunotherapy cohort showed that patients in the low-risk group have a better immune response, leading to a better patient's prognosis. Immunohistochemical analysis revealed that the expression levels of the FTCD, PON1, and TMEM45A were significantly over-expressed in 41 normal samples compared to HCC samples, while that of the G6PD was significantly over-expressed in cancerous tissues.

CONCLUSIONS

The four-gene signature construct fabricated based on the EMT-associated genes provides valuable information to further study the pathogenesis and clinical management of HCC.

Protein-DNA complex structure modeling based on structural template

DNA-binding is an important feature of proteins, and protein-DNA interaction involves in many life processes. Various computational methods have been developed to predict protein-DNA complex structures due to the difficulty of experimentally obtaining protein-DNA complex structures. However, prediction of protein-DNA complex is still a challenging problem compared with prediction of protein-RNA complex, this may be due to the large conformational changes between bound and unbound structure in both protein and DNA. We extend PRIME 2.0 to PRIME 2.0.1 to model protein-DNA complex structures. By comparing sequence and structure alignment methods, we found that structure-based methods can find more templates than sequence-based methods. The results of all-to-all structure alignments showed that DNA structure plays an important role in prediction of protein-DNA complex structure. By exploring the relationship of sequence and structure, we found that in protein-DNA interaction, numerous structures with dissimilar sequences have similar 3D structures and perform the similar function.

Impact of total splenectomy on peripheral lymphocytes and their subsets in patients with hypersplenism associated with cirrhotic portal hypertension

To study the impact of total splenectomy (TS) on peripheral lymphocytes and their subsets in patients with hypersplenism associated with cirrhotic portal hypertension (CPH). We studied 102 consecutive patients who received TS from January 2008 to January 2020 due to CPH-related hypersplenism. A similar number of healthy individuals are used as healthy controls (HC). The total lymphocyte counts and their percentages of B lymphocytes, total T lymphocytes (cluster of differentiation (CD)3⁺) and their subsets (CD4⁺, CD8⁺), and natural killer (NK) cells in preoperative peripheral blood samples in hypersplenism patients were significantly lower than that of the HCs (both P < 0.05). The total lymphocyte counts and percentages of B lymphocytes in peripheral blood were significantly increased 1 week and 1 month after TS when compared with the pre-TS values (P < 0.05). There was no significant difference in the percentages of NK cells before or after surgery (P > 0.05). However, the percentages of CD3⁺ cells was significantly higher 1 month after than before surgery (P < 0.001). The percentages of CD4⁺, and CD8⁺ T lymphocytes were significantly lower 1 week after surgery (P < 0.05), but they were significantly higher 1 month after surgery (P < 0.01). The CD4⁺:CD8⁺ ratio was not significantly different from those before surgery, and 1 week or 1 month after surgery (P > 0.05). Patients with hypersplenism associated with CPH were significantly immunosuppressed preoperatively. After TS, the total lymphocyte count and percentages of B lymphocytes, and total T lymphocytes and their subsets increased significantly, resulting in improved immune functions.

RR3DD: an RNA global structure-based RNA three-dimensional structural classification database

The three-dimensional (3D) structure of RNA usually plays an important role in the recognition with RNA-binding protein. Along with the discovering of RNAs, several RNA databases are developed to study the functions of RNA based on sequence, secondary structure, local 3D structural motif and global structure. Based on RNA function and structure, different RNAs are classified and stored in SCOR and DARTS, respectively. The classification of RNA structures is useful in RNA structure prediction and function annotation. However, the SCOR and DARTS are not updated any more. In this study, we present an RNA classification database RR3DD based on RNA fold with the global 3D structural similarity. The RR3DD includes 13,601 RNA chains from PDB and mmCIF format structures which are classified into 780 RNA folds. The RNA chains from PDB and mmCIF format structures are aligned and clustered into 675 and 220 RNA folds, respectively. By analysing the RNA structure in RR3DD, we find that there are 11 clusters with more than 50 members. These clusters include rRNAs, riboswitches, tRNAs and so on. By mapping RR3DD into Rfam, we found that some RNAs without annotation by Rfam can be annotated through structural alignment. For example, we analysed tRNAs and found that tRNA were successfully grouped in RR3DD for which Rfam did not classify them into one family. Finally, we provide a web interface of RR3DD offering functions of browsing RR3DD, annotating RNA 3D structure and finding templates for RNA homology modelling.

Systematic Characterization of Novel Immune Gene Signatures Predicts Prognostic Factors in Hepatocellular Carcinoma

Background: The prognosis of patients with hepatocellular carcinoma (HCC) is negatively affected by the lack of effective prognostic indicators. The change of tumor immune microenvironment promotes the development of HCC. This study explored new markers and predicted the prognosis of HCC patients by systematically analyzing immune characteristic genes. Methods: Immune-related genes were obtained, and the differentially expressed immune genes (DEIGs) between tumor and para-cancer samples were identified and analyzed using gene expression profiles from TCGA, HCCDB, and GEO databases. An immune prognosis model was also constructed to evaluate the predictive performance in different cohorts. The high and low groups were divided based on the risk score of the model, and different algorithms were used to evaluate the tumor immune infiltration cell (TIIC). The expression and prognosis of core genes in pan-cancer cohorts were analyzed, and gene enrichment analysis was performed using clusterProfiler. Finally, the expression of the hub genes of the model was validated by clinical samples. Results: Based on the analysis of 730 immune-related genes, we identified 64 common DEIGs. These genes were enriched in the tumor immunologic related signaling pathways. The first 15 genes were selected using RankAggreg analysis, and all the genes showed a consistent expression trend across multi-cohorts. Based on lasso cox regression analysis, a 5-gene signature risk model (ATG10, IL18RAP, PRKCD, SLC11A1, and SPP1) was constructed. The signature has strong robustness and can stabilize different cohorts (TCGA-LIHC, HCCDB18, and GSE14520). Compared with other existing models, our model has better performance. CIBERSORT was used to assess the landscape maps of 22 types of immune cells in TCGA, GSE14520, and HCCDB18 cohorts, and found a consistent trend in the distribution of TIIC. In the high-risk score group, scores of Macrophages M1, Mast cell resting, and T cells CD8 were significantly lower than those of the low-risk score group. Different immune expression characteristics, lead to the different prognosis. Western blot demonstrated that ATG10, PRKCD, and SPP1 were highly expressed in cancer tissues, while IL18RAP and SLC11A1 expression in cancer tissues was lower. In addition, IL18RAP has a highly positive correlation with B cell, macrophage, Neutrophil, Dendritic cell, CD8 cell, and CD4 cell. The SPP1, PRKCD, and SLC11A1 genes have the strongest correlation with macrophages. The expression of ATG10, IL18RAP, PRKCD, SLC11A1, and SPP1 genes varies among different immune subtypes and between different T stages. Conclusion: The 5-immu-gene signature constructed in this study could be utilized as a new prognostic marker for patients with HCC.

High precision machine learning-enabled ECG algorithm for predicting sites of idiopathic ventricular arrhythmia origin

Introduction

Radiofrequency catheter ablation (CA) is an efficient antiarrhythmic treatment with a class I indication for idiopathic ventricular arrhythmia (IVA). The accurate prediction of the origins of IVA can significantly increase the procedure success rate, reduce operation duration and decrease the risk of complications. The present work proposes an ECG analysis algorithm to estimate 21 possible origins of idiopathic ventricular arrhythmia at a clinical-grade level accuracy, which include left coronary cusp (LCC), right coronary cusp (RCC), aortomitral continuity (AMC), summit, LCC-RCC commissure, left His bundle, mitral valve (MV), left septal including left anterior fascicle (LAF), left posterior fascicle (LPF), left anterior papillary muscle (LAPM), left posterior papillary muscle (LPPM), anterior cusp (AC), left cusp (LC), right cusp (RC), RVOT septal, free wall, right His bundle, tricuspid valve (TV), and right anterior papillary muscle (RAPM).

Method

A total of 18,612 ECG recordings extracted from 545 patients who underwent successful CA to treat IVA were proportionally sampled into training, validation and testing cohorts. We designed four classification schemes responding to different hierarchical levels of the possible IVA origins. The first scheme will help the operators to figure out the origin from epicardium of left ventricular summit, right, and left ventricle. The second one can separate origins from left/right outflow tract and left/right non-out flow tract, respectively. The third one is able to predict 18 anatomical locations, and the fourth scheme can distinguish 21 possible sites. For every classification scheme, we compared 98 distinct machine learning models with optimized hyperparameter values obtained through extensive grid search and reported an optimal algorithm with the highest accuracy scores attained on the validation cohorts.

Results

In the first classification scheme used to predict right ventricular endocardium, left ventricular endocardium, and epicardium of left ventricular summit, the model achieved an accuracy of 99.79 (99.41–99.89) and a F1-score of 99.84 (99.6–99.96). For scheme 2, the proposed method reached an accuracy of 99.62 (99.09–99.78) and a F1-score of 99.42 (98.79–99.75). For scheme 3, the model achieved an accuracy of 97.78 (96.76–98.41), a F1-score of 97.74 (94.15–99.73), and an adjusted accuracy of 98.53 (98.33–99.15). For scheme 4 that can distinguish 21 origin sites, the proposed model attained an accuracy of 98.24 (97.36–98.71), a F1-score of 98.56 (97.88–99.12) and an adjusted accuracy of 98.75 (98.35–99.38).

Conclusion

The proposed machine learning model can be immediately and effortlessly deployed to electrophysiology labs allowing cardiologists to predict the exact origins of arrhythmia and provide an optimum treatment plan both before and during the CA procedure. This approach will significantly reduce the CA procedure duration and the risk of complications.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): 2020 Natural Science Foundation of Zhengjiang Province Confusion matrix for classification schemes

An arthroscopic technique for closure of perforations in temporomandibular joint retrodiscal tissues

The objective of this retrospective study was to introduce and evaluate an arthroscopic discopexy for closure of retrodiscal tissue perforations. A total of 112 patients (135 joints) receiving an arthroscopic discopexy for management of retrodiscal tissue perforations between January 2016 and September 2019 were included. Pre- and postoperative visual analogue scale (VAS) pain scores and maximum inter-incisal opening (MIO), as well as magnetic resonance imaging (MRI) data, were collected and analysed. Success was recorded when the disc position was >11 o'clock, VAS pain score <3, and MIO>25 mm. For patients with a condyle deformity, postoperative bone remodelling was also recorded. The VAS pain score decreased from 3.04 ± 2.66 preoperatively to 0.88 ± 1.13 at 12 months postoperatively (P < 0.001) and MIO increased from 33.90 ± 7.39 mm to 35.19 ± 6.14 mm (P = 0.029). MRI evaluation revealed that 133 discs were successfully repositioned back on top of the condyle. Among these, 11 joints were associated with either VAS pain score ≥3 or MIO ≤25 mm. Therefore, a success rate of 90.4% (122/135) was achieved at 12 months postoperative. Bone remodelling was detected in 72 joints. Arthroscopic discopexy is a minimally invasive and effective treatment for retrodiscal tissue perforations that achieves the purpose of simultaneously restoring the intra-articular structures and relieving clinical symptoms.

[Anatomical study and clinical application of in situ reduction and fixation of anterior medial fenestration approach of femoral head fracture]

Objectives: To explore the feasibility of anterior medial fenestration approach in situ reduction and fixation in the treatment of PipkinⅠ and Ⅱ femoral head fractures,and to explore the clinical effect of this operation. Methods: Hips of two anti-corrosion adult specimens treated with formalin were dissected, then anatomical structures and directional characteristics of anterior medial main muscles,ligaments,blood vessels and nerves were observed.The anterior medial fenestration approach was performed on bilateral hips of four fresh frozen specimens to determine pulling direction of stripped muscles and ligaments required during operation,and to observe and analyze vascular and nerve traction protection directions exposed in the approach.Determine extent of exposure to the approach and assess feasibility of this approach.The clinical data of 12 patients with Pipkin Ⅰ and Ⅱ femoral head fractures who underwent in situ reduction and fixation of anterior medial fenestration at Department of Orthopaedics,Affiliated Hospital of Chengdu University from February 2016 to April 2018 were retrospectively analyzed.There were 3 males and 9 females with an age of 48.5 years(range:37 to 59 years).There were 8 cases of Pipkin type Ⅰ and 4 cases of Pipkin type Ⅱ.The operation time,blood loss,fracture healing time,last Thompson-Epstein evaluation and Harris score were observed. Results: Anterior medial fenestration approach to expose the femoral head in 4 bilateral hips with a total of 8 sides of fresh frozen specimens.The upper boundary of observation fenestration was pubic body (anterior acetabulum),and the outer upper boundary was iliacus and psoas muscle.The lateral boundary is rectus femoris and femoral vessels,the lower boundary was transverse branch of the medial femoral circumflex artery and vein.The medial boundary was pubis muscle,short adductor muscle and long adductor muscle.Pubofemoral and iliofemoral ligament were seen in fenestration. Four quadrants in front of femoral head in fenestration can be seen after cutting switch capsule active hip joint. In 12 patients with femoral head fracture,the operation time was 107.5 minutes(range:90 to 135 minutes),and the intraoperative bleeding volume was 115.0 ml(range:85 to 150 ml).The patients were followed up for 18.6 months(range:12 to 28 months).The fracture healing time of 12 patients was 144.2 days(range:120 to 180 days).The curative effect was evaluated according to Thompson-Epstein standard at the last follow-up:excellent in 6 cases,good in 4 cases and fair in 2 cases.At the last follow-up,the Harris score of hip joints was 85.1(range:75 to 93). Conclusions: Anterior medial fenestration in situ reduction and fixation surgery is feasible for the treatment of Pipkin Ⅰ and Ⅱ femoral head fractures. The short and midterm follow-up reveal satisfactory effect.

Study of PWR hot leg creep rupture and RCS depressurization strategy during an SBO accident

Preventing the leakage of radioactive materials is important to nuclear safety. During a station blackout accident in pressurized water reactors, the hot leg creep rupture caused by hot leg countercurrent flow occurs before the reactor pressure vessel failure that caused by lower head rupture. The secondary fission products barrier is lost after hot leg creep rupture. An analysis for this phenomenon was done using the Modular Accident Analysis Program version 4.0.4 code. A station blackout accident for CPR1000 is simulated and the occurrence and influence of hot leg creep rupture phenomenon are analyzed in detail. After that, a sensitivity analysis of the opening of different pressurizer pilot-operated relief valves at five minutes after entering severe accident management guideline (before the hot leg creep rupture occurs) is studied. The results show that reactor pressure vessel failure time can be extended by at least 4 h if at least one pilot-operated relief valve is opened and direct containment heating phenomenon can be eliminated if at least two pilot-operated relief valves are opened.

AB0011 EXPRESSION PROFILE AND POTENTIAL FUNCTION OF CIRCRNAS IN PERIPHERAL BLOOD MONONUCLEAR CELLS FROM PATIENTS WITH PRIMARY GOUT

Background:

Autophagy is a phenomenon of “self-phagocytosis” in eukaryotic cells, which maintains cell homeostasis by transporting intracellular materials to lysosomes for degradation and recycling. In recent years, studies have shown that autophagy may be involved in the pathogenesis of rheumatoid arthritis(RA)[1], but its specific mechanism is still unclear.

Objectives:

The expression levels of autophagy-related genes(ATG) unc-51-like kinase 1(ULK1), ATG13, ATG17, microtubule associated protein 1 light chain 3 (LC3), and P62 in peripheral blood mononuclear cells (PBMC) of patients with RA were detected, and their role and clinical significance in the pathogenesis of RA were explored.

Methods:

Real-time fluorescent quantitative PCR was performed to detect the expression levels of ULK1, ATG13, ATG17, LC3, and P62 in PBMCs of 50 RA patients, 50 healthy controls (HC), and 25 moderate to severe RA patients before and after treatment. Then, t test, χ2 test, Mann-Whitney U test, Pearson test were used for statistical analysis.

Results:

1.The levels of hsCRP, white blood cell(WBC), neutrophils(GR), platelet(PLT) and plateletcrit(PCT) in RA group were higher than those in HC group (P <0.05). Lymphocytes (LY), red blood cell(RBC), hemoglobin(HGB), hematocrit(HCT), mean corpuscular hemoglobin(MCH), mean red blood cell volume(MCV) and mean red blood cell hemoglobin concentration(MCHC) in RA group were lower than those in HC group (P <0.05). 2.The expressions of ULK1, ATG17, and LC3 in RA group were higher than those in HC group, while the expressions of P62 was lower than those in HC group(P<0.05) (Figure 1). The correlation analysis suggested that ATG17 was positively correlated with tender joint count (TJC), swollen joint count (SJC), and health assessment questionnaire (HAQ) (P<0.05); ULK1 and HAQ were negatively correlated (P<0.05).3. Compared with before treatment with TNFi, ATG17, HAQ, DAS-28, ESR, hsCRP, WBC, GR, PLT and PCT were significantly reduced after treatment (P<0.05); the expressions of RBC, HCT, MCV and MCH were significantly increased after treatment,(P<0.05); ULK1, ATG13, LC3, P62 and other related clinical and laboratory indicators were not significantly different before and after treatment with TNFi (P>0.05).

Figure 1.

The expression levels of ATGs in HC and RA groups.

Conclusion:

There is abnormal expression of autophagy genes in the peripheral blood of RA patients. ULK1, ATG17, LC3 and P62 may be related to the pathogenesis of RA, among them, ATG17 may regulate the pathogenesis of RA by participating in the TNF-α pathway.

References:

[1]Rockel Jason S,Kapoor Mohit,Autophagy: controlling cell fate in rheumatic diseases.[J].Nat Rev Rheumatol, 2016, 12: 517-31.

Disclosure of Interests:

Yu-Feng Qing Grant/research support from: Science and Technology Project of Nanchong City (no.18SXHZ0522), Fei Dai: None declared, Quan-Bo Zhang Grant/research support from: the National Natural Science Foundation of China(General Program) (no.81974250), and Science and Technology Plan Project of Sichuan Province (no.2018JY0257), Yi-Ping Tang: None declared, Zeng-Rong Dong: None declared, Yi-Xi He: None declared, Yi Jiang: None declared, Yu-Qin Huang: None declared, Jianxiong Zheng: None declared

AB0075 HSA_CIRC_0012732, HSA_CIRC_0008961, HSA_CIRC_0405239 AND HSA_CIRC_0068784 MIGHT BE INVOLVED IN THE PATHOGENESIS AND DEVELOPMENT OF ANKYLOSING SPONDYLITIS

Background:

CircRNAs have been found to be involved in the occurrence and development of many rheumatic diseases[1-2]. Are circRNAs involved in the pathogenesis of ankylosing spondylitis (AS)? How do these circRNAs participate in the pathogenesis of AS? This all needs further study.

Objectives:

This study is to clarify the expression levels of hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 in the peripheral blood of AS patients, and to explore whether these circRNAs are involved in the pathogenesis of AS.

Methods:

To collected 60 cases of AS (30 cases of active AS (ASA): BASDA> 6 or 6> BASDAI> 4, ESR> 22mm / h or 6> BASDAI> 4, hsCRP> 9mg / L; 30 cases of stable AS (ASS): BASDAI <4) and 30 health control (HC) peripheral blood samples, related clinical and laboratory indicators. The relative expression levels of hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 in each group were detected by real-time quantitative polymerase chain reaction (qPCR). The relationships between the 4 circRNAs and clinical and laboratory indicators were explored by correlation analysis.

Results:

1. The qPCR results suggested that the expression of hsa_circ_0012732 between the ASA and ASS groups was statistically significant (p<0.05), and the expression of hsa_circ_0008961 was statistically significant between the ASA and HC groups (p<0.05). Howeverthere was no statistical significance among other groups (p>0.05)Figure 1. Similarly, the expression level of hsa_circ_0405239 was not statistically significant among the groups (p>0.05), and the same was true for hsa_circ_0068784 (p>0.05).

2. Correlation analysis results (Figure 2) showed that hsa_circ_0012732 is positively correlated with lymphocyte count (LY), mean corpusular volume (MCV), albumin (ALB), and negatively correlated with Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), high sensitivity C-reactive protein (hsCRP), Globulin (GLOB) (p<0.05); hsa_circ_0008961 is negatively correlated with platelet (PLT) (p<0.05); hsa_circ_0405239 is negatively correlated with BASDAI and BASFI; hsa_circ_0068784 was negatively correlated with BASDAI (p<0.05); and there was no statistically significant (p>0.05) between these 4 circRNAs and other indicators.

Conclusion:

Hsa_circ_0012732, hsa_circ_0008961, hsa_circ_0405239 and hsa_circ_0068784 may be related to the pathogenesis of AS. Among them, hsa_circ_0012732 may be involved in AS inflammation and has the potential to participate in the judgment of disease activity.

References:

[1]LS, K., et al., The biogenesis, biology and characterization of circular RNAs. 2019. 20(11): p. 675-691.

[2]J, W., et al., Non-coding RNAs in Rheumatoid Arthritis: From Bench to Bedside. 2019. 10: p. 3129.

Disclosure of Interests:

Yi-Ping Tang Grant/research support from: Science and Technology Project of Nanchong City (18SXHZ0522)., Yu-Feng Qing: None declared, Zeng-Rong Dong: None declared, Fei Dai: None declared, Jianxiong Zheng: None declared, Yi Jiang: None declared, Yi-Xi He: None declared, Quan-Bo Zhang Grant/research support from: National Natural Science Foundation of China(General Program) (81974250); Science and Technology Plan Project of Sichuan Province (2018JY0257)

AB0449 CLINICAL CHARACTERISTICS AND RISK FACTORS OF SYSTEMIC SCLEROSIS WITH HEMATOLOGIC SYSTEM DAMAGES

Background:

SSc characterized by varying degrees of fibrosis of the skin and internal organs, clinicians pay more attention to skin and viscera conditions, tend to ignore hematologic system damage. Studies have shown that rheumatic disease such as SLE, RA, pSS often accompanied with hematologic system damages, and hematologic system damages is multiple organ involvement and risk factor of poor prognosis[1-2].

Objectives:

To investigate the the clinical features, laboratory characteristics and risk factors of Systemic Sclerosis (SSc) patient with hematologic system damages.

Methods:

The clinical data of 180 patients were collected from January 2010 to April 2020, at the Affiliated Hospital of North Sichuan Medical College. The demographic information, laboratory tests, and clinical symptoms were analyzed retrospectively.

Results:

Among 180 SSc patients, 70(38.9%) cases were complicated with hematologic system damages. 51(72.9%) cases had anemia, 24 cases (34.3%) had leukopenia, 24 cases (34.3%) had thrombocytopenia, and 22 cases had hematologic system damages associated with more than two cell line involvement. Clinical symptoms: arthritis was significantly higher in the hematologic system damages group than patient without (P<0.05), however, there was no significantly difference in gender, age, disease course, respiratory symptoms, gastrointestinal symptoms, Raynaud’s phenomenon, interstitial lung disease and pulmonary hypertension (all P>0.05). Laboratory tests: ESR and hsCRP were increased in the hematologic system damages group, while the albumin decreased (all P<0.05). The positive rates of resistance to anti-dsDNA antibody and anti-ribosomal P protein antibody was higher in the hematologic system damages group (all P<0.05). Prognosis: During follow-up, leukopenia was more likely to recover, while the thrombocytopenia was more difficult to recover. Logistics regression analysis showed that positive of anti-ribosomal P protein antibody maght be a risk factor for SSc complicated with hematologic system damages [OR = 3.930(P<0.05)] (Table 1).

Conclusion:

SSc complicated with hematologic system damages is common, and patients with hematologic system damages have more serious clinical symptoms, some of whom have difficulty in recovey. Anti-ribosomal P protein antibody may be a risk factor of SSc hematologic system damages.

Table 1.

Bivariate logistics regression analysis on risk factors associated with hematologic damages in SSc.

FactorBSEWaldOR(95%CI)P valuearthritis0.6540.3473.5431.922(0.973-3.797)0.060ESR-0.0810.4870.0280.922(0.355-2.393)0.868hsCRP-0.0070.4920.0000.993(0.379-2.607)0.989anti-dsDNA0.8680.6731.6642.393(0.637-8.916)0.197anti-Rib-P1.3690.6364.6333.930(1.130-13.666)0.031

References:

[1]González-Naranjo L A, Betancur O M, Alarcón G S, et al. Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort[J]. Seminars in Arthritis and Rheumatism, 2016,45(6):675-683.DOI:10.1016/j.semarthrit.2015.11.003.

[2]Skare T, Damin R, Hofius R. Prevalence of the American College of Rheumatology hematological classification criteria and associations with serological and clinical variables in 460 systemic lupus erythematosus patients[J]. Revista Brasileira de Hematologia e Hemoterapia, 2015,37(2):115-119.DOI:10.1016/j.bjhh.2015.01.006

Disclosure of Interests:

None declared.

POS0430 EXPRESSION AND CLINICAL SIGNIFICANCE OF AUTOPHAGY-RELATED GENES IN PERIPHERAL BLOOD MONONUCLEAR CELLS OF SYSTEMIC SCLEROSIS

Background:

Growing evidences have demonstrated that autophagy is a powerful regulators in the pathogenesis of fibrosis and autoimmune diseases. Autophagy abnormalities in SSc involve abnormal autophagy-related protein and autophagy-related gene polymorphism[1-2], however there is a few reports on the expression and clinical significance of autophagy-related genes.

Objectives:

To investigate the expression and clinical significance of autophagy-related genes LC-3 mRNA, Becline-1 mRNA, Agt-3 mRNA, Agt-5 mRNA, Agt-12 mRNA and Agt-16L1 mRNA in peripheral blood mononuclear cells (PBMC) of systemic sclerosis (SSc).

Methods:

51 cases of SSc and 60 cases of normal control were received from the Affiliated Hospital of North Sichuan Medical College, and autophagy-related genes were detected by RT-PCR. SPSS19.0 statistical software was used to compare the expression of autophagy-related genes between groups and analyze the relationship between autophagy-related genes and clinical data, P<0.05 was considered statistically significant

Results:

LC-3, Becline-1, and Agt-3 were highly expressed in SSc compared with normal control [LC-3: 0.78(0.60) ×10-3 vs. 0.52(0.54) ×10-3; Beclin-1: 6.68(3.56)×10-3 vs. 5.22(3.54)×10-3; Agt-3: 17.58(12.33)×10-3 vs. 11.00(4.56)×10-3, P<0.05], however Agt-5, Agt-12 and Agt-16L1 of autophagy-related genes were not statistically significant [AGT-5: 6.67(3.58) ×10-3 vs. 6.67(2.64) ×10-3; AGT-12: 8.64(5.56)×10-3 vs. 8.57(4.66)×10-3; Agt-16L1: 2.69(2.19)×10-3 vs. 2.52(2.26)×10-3] (Figure 1). Beclin-1 and Agt-5 high expressed in SSc with the positive of anti-SSA/Ro antibody. LC-3 was positively correlated with Age(r=0.662) and ESR(r=0.355) (all P<0.05).

Conclusion:

Autophagy-related genes were increased in PBMC of SSc, and were correlated with Age, ESR and autoantibody, suggested that autophagy is a key feature in the pathogenesis of systemic sclerosis.

Figure 1.

The relative expression of autophagy-related genes

References:

[1]LIU C, ZHOU X, LU J, et al. Autophagy mediates 2-methoxyestradiol-inhibited scleroderma collagen synthesis and endothelial-to-mesenchymal transition induced by hypoxia[J]. Rheumatology, 2019;58(11):1966–1975.

[2]Mayes M D, Bossini-Castillo L, Gorlova O, et al. Immunochip Analysis Identifies Multiple Susceptibility Loci for Systemic Sclerosis[J]. The American Journal of Human Genetics, 2014,94(1):47-61.DOI:10.1016/j.ajhg.2013.12.002.

Disclosure of Interests:

None declared