[Fourth branchial cleft deformity with skin orifice: a series of 10 cases]

Objective: To report rare cases of congenital neck cutaneous sinus with an orifice near the sternoclavicular joint and to investigate their origins and managements. Methods: A total of ten patients with congenital neck cutaneous sinus having an orifice near the sternoclavicular joint treated in the Guangdong General Hospital from January 2010 to June 2015 were retrospectively analyzed. Results: There four boys and six girls, aging from 11 months to 96 months with an average of 33.4 months, and they had a common feature showing a congenital cutaneous sinus with an orifice near sternoclavicular joint. Discharge of pus from the orifice or abscess formation was commonly seen soon after infection. With bacteriological study, staphylococcus aureus was positive in five cases and klebsiella pneumonia in a case. Another orifice of fistula/sinus was not depicted in pyriform with barium swallow X-ray in five cases Ultrasound studies of three cases demonstrated anechoic (i.e., nearly black) and solid-cystic lesion near sternoclavicular joint with posterior acoustic enhancement. Magnetic resonance imaging (MRI) showed isointensity of the lesion on T1 and T2 weighted images with heterogeneous enhancement and a close relationship with sternoclavicular joint. All patients underwent laryngoscopic examination, which showed no orifice of sinus in pyriform at same side. Surgical resection of fistula/sinus was performed in all cases. The lengths of the fistula varied from 5 mm to 22 mm with an average of 11 mm. Postoperative pathological examination showed all specimens were accordance with fistula. No complications were noticed. Recurrence was not observed in the cases by following-up of 6 months to 70 months (median: 33 months). Conclusion: Congenital neck cutaneous sinus with orifice near the sternoclavicular joint maybe a special clinical phenotype of the fourth branchial cleft sinus with skin orifice in cervicothoracic junction. Differential diagnoses between low cervical diseases are required. The curative treatment is a complete excision during inflammatory quiescent period.

[The selective anterior neck dissection for treating children's recurrent thyroglossal duct cysts]

Objective:To evaluate the therapeutic effect of selective anterior neck dissection on the treatment of children's recurrent thyroglossal duct cysts. Method: The clinical data of 28 patients with recurrent thyroglossal duct cysts were retrospectively analyzed. In accordance with the embryologic and anatomic features of thyroglossal duct cysts, different types of selective neck dissection were applied. Enbloc resection principles were applied to extirpate thyroglossal duct cysts,scarrings and inflammatory granuloma during the operation. Result:All the wounds of 28 patients healed primarily without significant complications including dysphagia, paragammacism, injury of hypoglossal nerve and superior laryngeal nerve. No recurrences were found in all 28 cases with a follow-up period of 24 to 72 months(average 46 months). Conclusion:Selective anterior neck dissection is a safe and effective surgical procedure for the radical treatment of children's recurrent thyroglossal duct cysts.

[The selective anterior neck dissection for treating children's recurrent thyroglossal duct cysts]

Objective:To evaluate the therapeutic effect of selective anterior neck dissection on the treatment of children's recurrent thyroglossal duct cysts. Method: The clinical data of 28 patients with recurrent thyroglossal duct cysts were retrospectively analyzed. In accordance with the embryologic and anatomic features of thyroglossal duct cysts, different types of selective neck dissection were applied. Enbloc resection principles were applied to extirpate thyroglossal duct cysts,scarrings and inflammatory granuloma during the operation. Result:All the wounds of 28 patients healed primarily without significant complications including dysphagia, paragammacism, injury of hypoglossal nerve and superior laryngeal nerve. No recurrences were found in all 28 cases with a follow-up period of 24 to 72 months(average 46 months). Conclusion:Selective anterior neck dissection is a safe and effective surgical procedure for the radical treatment of children's recurrent thyroglossal duct cysts.

[Progress in surgery treatment of congenital pyriform sinus fistula]

Congenital pyriform sinus fistula(CPSF) is a rare brancial cleft deformity in neck, characterized by acute suppurative thyroiditis, recurrent cervical abscesses and cellulitis. At present, surgical treatment of CPSF include traditional surgery and endoscopic cauterization. In the past,en block resection of the fistula by surgery is the only cure method. The late 90, relatively safe and effective endoscopic and minimally invasive aesthetic surgery is applied in treatment of CPSF, and was recommended as the preferred treatment for congenital pyriform sinus fistula. From the long term efficacy, which method is more dominant, yet to be elegant. Through the analysis of embryo principles and anatomy of CPSF,we introduce and summarize the indications, complications and prevention in conventional surgical treatment and endoscopic cauterization, and briefly descript the factors influencing the efficacy of the treatment of CPSF.

[Manifestation of first branchial anomaly:56 cases reportrhinitis]

Objective:To sum up and conclude manifestation of congenital first branchial anomaly(CFBCA).Method:The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed.Result:Manifestation:mass without pain(26.8%),repeated sore and discharge(71.4%),otological symptom(external auditory discharge､hearing loss,28.6%).Eleven cases bacterial sample showed positive result,and most of them show pseudomonas aeruginosa and staphylococcus aureus.Auricular endoscopy typically performed stricture of external auditory canal,cholesteatoma samples accumulated in ear canal,fistula at the conjunction of the bone and cartilage and tympanic membranous attachment.Typical performance of CT(MRI)was that there were cystic,lobulated or tubular abnormal shadow related with ear canal in Pochet's triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT(MRI) scans,and part of that could be connected with skin.The statistical difference between type Oslen and Work and clinical characteristics(P<0.01),and the relationship between type Oslen and Work(P<0.01).Most of Work Ⅰ were cyst type,and these two type often had no infected symptom.Most of them were young patients.Most of Work Ⅱ were sinus and fistula type ,and these two type often had infected symptom.Most of them were teenagers.Part of patients of type Work Ⅱ showed tympanic membranous attachment.Conclusion:CFBCA was rare,and it is more common in young patients and often in left part.It always performed as mass without pain､repeated sore and discharge､external auditory discharge.Most of Work Ⅰ were cyst type,and these two type often had no infected symptom and most of them were young patients .Most of Work Ⅱ were sinus and fistula type,and these two type often had infected symptom and most of them were teenagers.Auricular endoscopy,CT,MRI could help make diagnose.Doctors clinical need to differentiate it with related diseases according to different manifestations.

Optofluidic restricted imaging, spectroscopy and counting of nanoparticles by evanescent wave using immiscible liquids

Conventional flow cytometry (FC) suffers from the diffraction limit for the detection of nanoparticles smaller than 100 nm, whereas traditional total internal reflection (TIR) microscopy can only detect few samples near the solid-liquid interface mostly in static states. Here we demonstrate a novel on-chip optofluidic technique using evanescent wave sensing for single nanoparticle real time detection by combining hydrodynamic focusing and TIR using immiscible flows. The immiscibility of the high-index sheath flow and the low-index core flow naturally generate a smooth, flat and step-index interface that is ideal for the TIR effect, whose evanescent field can penetrate the full width of the core flow. Hydrodynamic focusing can focus on all the nanoparticles in the extreme centre of the core flow with a width smaller than 1 μm. This technique enables us to illuminate every single sample in the running core flow by the evanescent field, leaving none unaffected. Moreover, it works well for samples much smaller than the diffraction limit. We have successfully demonstrated the scattering imaging and counting of 50 nm and 100 nm Au nanoparticles and also the fluorescence imaging and counting of 200 nm beads. The effective counting speeds are estimated as 1500, 2300 and 2000 particles per second for the three types of nanoparticles, respectively. The optical scattering spectra were also measured to determine the size of individual Au nanoparticles. This provides a new technique to detect nanoparticles and we foresee its application in the detection of molecules for biomedical analyses.

TLR3 and TLR4 But not TLR2 are Involved in Vogt-Koyanagi- Harada Disease by Triggering Proinflammatory Cytokines Production Through Promoting the Production of Mitochondrial Reactive Oxygen Species

Vogt-Koyanagi-Harada (VKH) disease is considered to be an autoimmune disease possibly triggered by an abnormal response to infection. Activation of TLRs signaling pathways by microbial products can drive inflammatory responses and adaptive immunity. In the present study, we investigated the role of TLRs in the pathogenesis of VKH disease. We showed that the expression of TLR3 and TLR4, but not TLR2, was significantly increased in monocyte-derived macrophages (MDMs) from VKH patients with active uveitis compared to controls. VKH patients with active uveitis showed an elevated level of IL-1β, IL-6, IL-8, TNF-α and reactive oxygen species (ROS) in MDMs. IL-1β, IL-6, IL-8 and TNF-α production could be significantly upregulated and downregulated by a ROS activator or inhibitor, respectively. Downregulation of the NLRP3 inflammasome significantly inhibited the production of IL-1β but not IL-6, IL-8 and TNF-α. The phosphorylation levels of p38 and ERK1/2 were significantly higher in MDMs from active VKH patients compared to controls. Inhibition of p38 or ERK1/2 significantly decreased IL-1β, IL-6, IL-8 and TNF-α expression. These results suggest that the increased expression of TLR3/4 in MDMs may be involved in the pathogenesis of VKH disease by the induction of inflammatory cytokines which is mediated by enhanced production of ROS.

Upregulation of microRNA‑337 promotes the proliferation of endometrial carcinoma cells via targeting PTEN

Endometrial carcinoma (EC) is a common malignancy in females. MicroRNAs (miRs) are a class of non‑coding RNA that regulate a wide variety of cellular processes, and are important in the development of multiple types of malignancy. In the present study, cancerous and adjacent non‑cancerous normal tissue samples were collected from 24 patients diagnosed with EC. Reverse transcription quantitative polymerase chain reaction was performed on the tissue samples to determine the expression levels of six candidate miRs. These miRs have been previously reported to be differentially expressed in EC; however, the present study observed that only miR‑337 was differentially expressed. In addition, the current study identified phosphatase and tensin homolog (PTEN) as a target of miR‑337 using computational analysis and a luciferase assay. EC cells transfected with miR‑337 mimics and anti‑PTEN small interfering RNA demonstrated significantly decreased expression of PTEN, markedly increased proliferation and inhibition of cell apoptosis. The results indicate that miR‑337 is oncogenic in EC cells, as it suppresses PTEN expression. This may facilitate the development of miR‑based prevention or treatment strategies for EC.

Anisotropic Li intercalation in a Li(x)FePO4 nano-particle: a spectral smoothed boundary phase-field model

A spectral smoothed boundary phase-field model is implemented to study lithium (Li) intercalation in a LixFePO4 nano-particle immersed in a Li(+) rich electrolyte. It takes into account different physical processes on the particle surface, such as heterogeneous nucleation, Li flux and stress-free boundary conditions. We show the nucleation and growth of plate-like Li-rich crystallites along the (010) plane due to the high Li mobility along [001]. Since such plate-like crystallites, which are nucleated from (001) surfaces, align their phase boundaries along the (101) habit planes, a LixFePO4 nano-particle with prominent (010) and (001) surface facets and the longest axis length along [100] is proposed to exhibit great mechanical stability.

Utility of a molecular prescreening program in advanced colorectal cancer for enrollment on biomarker-selected clinical trials

BACKGROUND

Incorporation of multiple enrichment biomarkers into prospective clinical trials is an active area of investigation, but the factors that determine clinical trial enrollment following a molecular prescreening program have not been assessed.

PATIENTS AND METHODS

Patients with 5-fluorouracil-refractory metastatic colorectal cancer at the MD Anderson Cancer Center were offered screening in the Assessment of Targeted Therapies Against Colorectal Cancer (ATTACC) program to identify eligibility for companion phase I or II clinical trials with a therapy targeted to an aberration detected in the patient, based on testing by immunohistochemistry, targeted gene sequencing panels, and CpG island methylation phenotype assays.

RESULTS

Between August 2010 and December 2013, 484 patients were enrolled, 458 (95%) had a biomarker result, and 157 (32%) were enrolled on a clinical trial (92 on biomarker-selected and 65 on nonbiomarker selected). Of the 458 patients with a biomarker result, enrollment on biomarker-selected clinical trials was ninefold higher for predefined ATTACC-companion clinical trials as opposed to nonpredefined biomarker-selected clinical trials, 17.9% versus 2%, P < 0.001. Factors that correlated positively with trial enrollment in multivariate analysis were higher performance status, older age, lack of standard of care therapy, established patient at MD Anderson, and the presence of an eligible biomarker for an ATTACC-companion study. Early molecular screening did result in a higher rate of patients with remaining standard of care therapy enrolling on ATTACC-companion clinical trials, 45.1%, in contrast to nonpredefined clinical trials, 22.7%; odds ratio 3.1, P = 0.002.

CONCLUSIONS

Though early molecular prescreening for predefined clinical trials resulted in an increase rate of trial enrollment of nonrefractory patients, the majority of patients enrolled on clinical trials were refractory to standard of care therapy. Within molecular prescreening programs, tailoring screening for preidentified and open clinical trials, temporally linking screening to treatment and optimizing both patient and physician engagement are efforts likely to improve enrollment on biomarker-selected clinical trials.

CLINICAL TRIALS NUMBER

The study NCT number is NCT01196130.

Characterizing the activation of the Wnt signaling pathway in hilar cholangiocarcinoma using a tissue microarray approach

Hilar cholangiocarcinoma (HCCA) is an invasive hepatic malignancy that is difficult to biopsy; therefore, novel markers of HCCA prognosis are needed. Here, the level of canonical Wnt activation in patients with HCCA, intrahepatic cholangiocarcinoma (IHCC), and congenital choledochal cysts (CCC) was compared to understand the role of Wnt signaling in HCCA. Pathology specimens from HCCA (n=129), IHCC (n=31), and CCC (n=45) patients were used to construct tissue microarrays. Wnt2, Wnt3, β-catenin, TCF4, c-Myc, and cyclin D1 were detected by immunohistochemistry. Parallel correlation analysis was used to analyze differences in protein levels between the HCCA, IHCC, and CCC groups. Univariate and multivariate analyses were used to determine independent predictors of successful resection and prognosis in the HCCA group. The protein levels of Wnt2, β-catenin, TCF4, c-Myc, and cyclin D1 were significantly higher in HCCA compared to IHHC or CCC. Wnt signaling activation (Wnt2+, Wnt3+, nuclear β-catenin+, nuclear TCF4+) was significantly greater in HCCA tissues than CCC tissues. Univariable analyses indicated that expression of cyclin D1 as well as Wnt signaling activation, and partial Wnt activation (Wnt2+ or Wnt3+ and nuclear β-catenin+ or nuclear TCF4+) predicted successful resection, but only cyclin D1 expression remained significant in multivariable analyses. Only partial Wnt activation was an independent predictor of survival time. Proteins in the canonical Wnt signaling pathway were present at higher levels in HCCA and correlated with tumor resecility and patient prognosis. These results suggest that Wnt pathway analysis may be a useful marker for clinical outcome in HCCA.

Tunable self-imaging effect using hybrid optofluidic waveguides

Multimode interference (MMI) is a typical self-imaging phenomenon and has been widely exploited for optical devices like couplers and splitters. Usually, it utilizes solid waveguides only and thus has very limited tunability in self-imaging properties. This paper reports our original work on tunable MMI using a hybrid optofluidic waveguide. It is generated by the diffusion between miscible flows in a microchannel and consists of two parts: gradient-index liquid-liquid waveguide for light modulation and step-index liquid-solid waveguide for image formation. Simulation and experiments have shown successful realization of the real-time tuning of self-imaging properties. For detail, the image point (focal spot) width could be modulated from 7 μm to 16 μm, and the self-imaging period changes in the range of 500 μm by varying the fluid properties. It is foreseeable that such a hybrid optofluidic waveguide may find wider applications in lab-on-a-chip systems and optical devices.

Can tumor regression grade influence survival outcome in ypT3 rectal cancer?

PURPOSE

Locally advanced rectal cancer (LARC) patients achieving ypT3 status following neoadjuvant chemoradiation are considered to have poor response with minimal downstaging. However, residual cancer cell amounts vary in the subserosa/perirectal fat. Tumor regression grading (TRG) is an evaluation method based on the proportion of fibrosis and residual cancer cells. The aim of this study is to assess the influence of TRG in ypT3 rectal cancer patients who received neoadjuvant chemoradiation.

METHODS

We retrospectively reviewed 325 LARC patients who received neoadjuvant chemoradiation and surgery. TRG scores were recorded by two independent pathologists. Among these patients, 143 were staged as ypT3. We analyzed TRG and other clinicopathological factors and their relationship with survival outcome including overall survival (OS) and disease-free survival (DFS).

RESULTS

Among 143 ypT3 patients, 44 (30.8 %) were TRG1, 84 (58.7 %) were TRG2 and 15 (10.5 %) were TRG3. Seventy-nine (55.3 %) of these patients had metastatic lymph nodes. In univariate analysis, TRG was not associated with DFS (TRG2 vs TRG1, P = 0.852; TRG3 vs TRG1, P = 0.593) or OS (TRG2 vs TRG1, P = 0.977; TRG3 vs TRG1, P = 0.665). Palliative surgery (HR 3.845; 95 % CI 1.670-8.857; P = 0.002) and metastatic lymph nodes after surgery (HR 5.894; 95 % CI 1.142-3.48; P = 0.015) were significantly associated with decreased DFS, while palliative surgery was the only factor associated with worse OS (HR 6.011; 95 % CI 2.150-16.810; P = 0.001). Palliative surgery (HR 3.923; 95 % CI 1.696-9.073; P = 0.001) and metastatic lymph nodes (HR 2.011; 95 % CI 1.152-3.512; P = 0.014) also showed prognostic significance for DFS in multivariate analysis.

CONCLUSIONS

Residual cancer cells evaluated by TRG score after neoadjuvant chemoradiation do not influence survival outcome in ypT3 rectal cancer patients. However, lymph node status is a significant prognostic factor in ypT3 patients.

MicroRNA-206 functions as a tumor suppressor in colorectal cancer by targeting FMNL2

BACKGROUND

Colorectal cancer (CRC) is one of the most common cancers in the world. MicroRNAs play important roles in the progression of CRC. This study aimed to investigate the role of miR-206 and its novel mechanism in the invasion and metastasis of CRC.

METHODOLOGY

Real-time RT-PCR or Western blotting was used to detect the expressions of miR-206, FMNL2 and c-MET in CRC cell lines and tissues. Luciferase reporter assays were conducted to detect the associations between miR-206 and 3'UTRs of FMNL2 and c-MET. A series of loss-of-function and gain-of-function assays were performed to evaluate the effect of miR-206 on the proliferation, invasion and metastasis of CRC cells.

RESULTS

miR-206 was significantly down-regulated in CRC tissues and correlated closely with differentiation, lymphatic metastasis and serosal invasion. miR-206 suppressed CRC cell proliferation by arresting CRC cells in the G1/G0 phase and accelerating apoptosis. miR-206 also inhibited cell invasion and lung metastasis in CRC cells. Mechanically, FMNL2 and c-MET were identified as direct targets of miR-206. And FMNL2 rescued the suppression of miR-206 in the proliferation and invasion of CRC cells.

CONCLUSIONS

This study revealed functional and mechanistic links between miR-206 and oncogene FMNL2 and c-MET in the progression of CRC. miR-206 functioned as a tumor suppressor in the progression of CRC by targeting FMNL2 and c-MET. Restoration of miR-206 expression may represent a promising therapeutic approach for targeting malignant CRC.

Conservation and population genetic diversity of Curcuma wenyujin (Zingiberaceae), a multifunctional medicinal herb

Curcuma wenyujin is an important multifunctional medicinal herb in China. Currently, populations of C. wenyujin are decreasing, and wild individuals have almost disappeared from their natural habitats. Moreover, little is known regarding the molecular characteristics of this plant. In this study, we investigated the genetic diversity and variation of five populations of C. wenyujin, using ran-dom amplified polymorphic DNA (RAPD) and inter-simple sequence repeat (ISSR) markers. We found that the percentages of polymorphic loci (PPL) at the species level (98.25% by RAPD and 100% by ISSR) were significantly higher than those at the population level (66.32% by RAPD and 67.14% by ISSR). The highest values of PPL, expected heterozygosity, and Shannon's information index were in Pop1, while the lowest values were in Pop2. Both DNA markers revealed a short genetic distance between Pop1 and Pop2 (0.1424 by RAPD and 0.1904 by ISSR). Phylogenetic trees produced similar results, with Pop1, Pop2, and Pop5 in one group and Pop3 and Pop4 in another. There were no significant correlations between their genetic distances and their geographical distances. The highest genetic diversity was in Pop1 and the lowest was in Pop2, and genetic diversity at the species level was relatively low, but much higher than that at the population level. We recommended the establishment of a germplasm bank, in situ con-servation, and propagation of wild individuals. The present study will improve the evaluation, protection, and utilization of the population resources of C. wenyujin.

Somatic gene copy number alterations in colorectal cancer: new quest for cancer drivers and biomarkers

Colorectal cancer (CRC) results from the accumulation of genetic alterations, and somatic copy number alterations (CNAs) are crucial for the development of CRC. Genome-wide survey of CNAs provides opportunities for identifying cancer driver genes in an unbiased manner. The detection of aberrant CNAs may provide novel markers for the early diagnosis and personalized treatment of CRC. A major challenge in array-based profiling of CNAs is to distinguish the alterations that play causative roles from the random alterations that accumulate during colorectal carcinogenesis. In this view, we systematically discuss the frequent CNAs in CRC, focusing on functional genes that have potential diagnostic, prognostic and therapeutic significance.

Imported case of MERS-CoV infection identified in China, May 2015: detection and lesson learned

At the end of May 2015, an imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was confirmed in China. The patient is in a stable condition and is still undergoing treatment. In this report, we summarise the preliminary findings for this imported case and the results of contact tracing. We identified 78 close contacts and after 14 days of monitoring and isolation, none of the contacts presented symptoms and all tested negative for MERS-CoV.

PhIN: A Protein Pharmacology Interaction Network Database

Network pharmacology is a new and hot concept in drug discovery for its ability to investigate the complexity of polypharmacology, and becomes more and more important in drug development. Here we report a protein pharmacology interaction network database (PhIN), aiming to assist multitarget drug discovery by providing comprehensive and flexible network pharmacology analysis. Overall, PhIN contains 1,126,060 target–target interaction pairs in terms of shared compounds and 3,428,020 pairs in terms of shared scaffolds, which involve 12,419,700 activity data, 9,414 targets, 314 viral targets, 652 pathways, 1,359,400 compounds, and 309,556 scaffolds. Using PhIN, users can obtain interacting target networks within or across human pathways, between human and virus, by defining the number of shared compounds or scaffolds under an activity cutoff. We expect PhIN to be a useful tool for multitarget drug development. PhIN is freely available at http://cadd.pharmacy.nankai.edu.cn/phin/.

An evaluation comparing Californium252 neutron brachytherapy with neoadjuvant intra-arterial embolism chemotherapy assisted surgery effect for treating advanced cervical carcinoma patients

PURPOSE OF INVESTIGATION

To compare the therapeutic and side effects of using Californium252 (252Cf) neutron brachytherapy with neoadjuvant intra-arterial embolism chemotherapy in combination with surgery for treating Stage Ib2-IIb cervical cancers (CCs).

MATERIALS AND METHODS

Thirty-two Stage Ib2-IIb CC patients were enrolled and randomly divided into two groups from January 2007 to April 2010 in the present Hospital. Prior to surgery within four weeks, a total of 17 cases were treated with 252Cf neutron brachytherapy (700-800 cGy doses at point A) once a week (Group A), and 15 cases were treated by neoadjuvant intra-arterial embolism chemotherapy using a combination of bleomycin, carboplatin, and cyclophosphamide twice (Group B). The clinical symptoms and signs, side effects, and relapse condition follow up until July 2013 were compared between the two groups for the perioperation.

RESULTS

Reductions in tumor mass and CR+PR were not significantly different between the groups before the surgery (p > 0.05). Abdominal pain and pelvic adhesions were significantly more severe in Group B (p < 0.05). There were no significant differences in surgical time, blood loss or the other side effects between Groups A and B (p > 0.05). The percentage of pelvic tumor recurrences in Group A was lower than that of the patients in Group B (11.8% vs 20.0%) although with no significant difference at present. No distant metastasis has been found in both two groups.

CONCLUSION

Except for less abdominal pain and pelvic adhesions, 252Cf neutron brachytherapy has perioperative effects similar to those of neoadjuvant intra-arterial embolism chemotherapy.

Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor

BACKGROUND

Obesity and anxiety are often linked but the direction of effects is not clear.

METHOD

Using genetic instrumental variable (IV) analyses in 5911 female participants from the Nurses' Health Study (NHS, initiated 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated 1986), we aimed to determine whether obesity increases symptoms of phobic anxiety. As instrumental variables we used the fat mass and obesity-associated (FTO) gene, the melanocortin 4 receptor (MC4R) gene and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms (SNPs) that significantly predict body mass index (BMI). 'Functional' GRSs corresponding with specific biological pathways that shape BMI (adipogenesis, appetite and cardiopulmonary) were considered. The main outcome was phobic anxiety measured by the Crown Crisp Index (CCI) in 2004 in the NHS and in 2000 in the HPFS.

RESULTS

In observational analysis, a 1-unit higher BMI was associated with higher phobic anxiety symptoms [women: β = 0.05, 95% confidence interval (CI) 0.030-0.068; men: β = 0.04, 95% CI 0.016-0.071). IV analyses showed that BMI was associated with higher phobic anxiety symptoms in the FTO-instrumented analysis (p = 0.005) but not in the GRS-instrumented analysis (p = 0.256). Functional GRSs showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms.

CONCLUSIONS

Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, and hence that obesity and phobic anxiety may share common genetic determinants.

FOXC2 promotes colorectal cancer metastasis by directly targeting MET

Metastasis is the major cause of death in colorectal cancer (CRC). Although multiple genes have been identified to be responsible for the development of CRC, the molecular changes that enable CRC cells to undergo early local invasion and to form distant metastatic colonies still remain largely unknown. Herein, we investigated the role of Forkhead box protein C2 (FOXC2) and explored the underlying mechanisms in invasion and metastasis of CRC. We show that both high FOXC2 expression and nuclear localization of FOXC2 are significantly correlated with advanced TNM (T=primary tumor; N=regional lymph nodes; M=distant metastasis) stages. FOXC2 enhanced the invasive abilities of CRC cells in vitro and promoted local invasion and distant metastasis in an orthotopic mouse metastatic model of CRC. Microarray analysis revealed that overexpression of FOXC2 increased the proto-oncogene MET tyrosine kinase expression and activated the hepatocyte growth factor (HGF)-MET signaling pathway. Furthermore, luciferase reporter assays and chromatin immunoprecipitation assays revealed that FOXC2 directly associated with MET promoter to increase the transcriptional activity of MET. Inhibition of MET attenuates the invasive phenotype and metastatic potential of FOXC2-overexpressing CRC cells, indicating that MET is a major mediator of FOXC2-promoted metastasis. In addition, FOXC2 expression was positively correlated with MET expression in CRC tissue samples. Our findings suggest that FOXC2 has a crucial role in CRC metastasis by regulating HGF-MET signaling via inducing MET expression, highlighting FOXC2 as a potential therapeutic target for preventing or reducing metastasis in CRC.

Millennial-scale ocean acidification and late Quaternary decline of cryptic bacterial crusts in tropical reefs

Ocean acidification by atmospheric carbon dioxide has increased almost continuously since the last glacial maximum (LGM), 21,000 years ago. It is expected to impair tropical reef development, but effects on reefs at the present day and in the recent past have proved difficult to evaluate. We present evidence that acidification has already significantly reduced the formation of calcified bacterial crusts in tropical reefs. Unlike major reef builders such as coralline algae and corals that more closely control their calcification, bacterial calcification is very sensitive to ambient changes in carbonate chemistry. Bacterial crusts in reef cavities have declined in thickness over the past 14,000 years with largest reduction occurring 12,000-10,000 years ago. We interpret this as an early effect of deglacial ocean acidification on reef calcification and infer that similar crusts were likely to have been thicker when seawater carbonate saturation was increased during earlier glacial intervals, and thinner during interglacials. These changes in crust thickness could have substantially affected reef development over glacial cycles, as rigid crusts significantly strengthen framework and their reduction would have increased the susceptibility of reefs to biological and physical erosion. Bacterial crust decline reveals previously unrecognized millennial-scale acidification effects on tropical reefs. This directs attention to the role of crusts in reef formation and the ability of bioinduced calcification to reflect changes in seawater chemistry. It also provides a long-term context for assessing anticipated anthropogenic effects.

MicroRNA-922 promotes tau phosphorylation by downregulating ubiquitin carboxy-terminal hydrolase L1 (UCHL1) expression in the pathogenesis of Alzheimer's disease

Decreased levels of soluble ubiquitin carboxy-terminal hydrolase L1 (UCHL1) have been reported in the brains of sporadic Alzheimer's disease (AD) patients, and the introduction of UCHL1 rescued the synaptic and cognitive function of AD model mice. Obviously, a reduction in the levels of UCHL1 may play a role in the pathogenesis of AD. However, the mechanisms underlying the regulation of UCHL1 levels in AD have not been fully elucidated. MicroRNAs (miRs) have been shown to participate in the process of AD. In our study, we discovered that microRNA-922 decreased the levels of UCHL1. Neurofibrillary tangles (NFTs) mainly consisting of the hyperphosphorylated microtubule-associated protein tau are the defining pathological features of AD. In the present study, we found the levels of UCHL1 affected the levels of phosphorylated tau: the phosphorylated tau levels increased after knockdown of UCHL1 expression, and the phosphorylated tau levels decreased when UCHL1 was overexpressed. Furthermore, overexpression of microRNA-922 increased the phosphorylated tau levels. In conclusion, miR-922 increasing the levels of phosphorylated tau by regulating UCHL1 levels contributed to the pathogenesis of AD. Our study partly explained one of the mechanisms underlying the downregulation of UCHL1 levels in AD patients and could enrich the content of tau pathology in the pathogenesis of AD.

PKM2 and ACVR 1C are prognostic markers for poor prognosis of gallbladder cancer

PURPOSE

To identify biological markers related to the progression and prognosis of GBC.

METHODS

The expressions of pyruvate kinase isoenzyme type M2 (PKM2) and activin A receptor type IC (ACVR 1C) in 46 squamous cell/adenosquamous carcinomas (SC/ASC) and 80 adenocarcinomas (AC) were examined using immunohistochemistry.

RESULTS

Positive PKM2 and negative ACVR 1C expressions were significantly associated with lymph node metastasis, invasion and TNM stage of SC/ASCs and ACs. Univariate Kaplan-Meier analysis showed that either elevated PKM2 or loss of ACVR 1C expression significantly correlated with shorter average survival times in both SC/ASC and AC patients. Multivariate Cox regression analysis showed that positive PKM2 expression and loss of ACVR 1C expression were poor prognosis biomarkers in both SC/ASC and AC patients.

CONCLUSIONS

Our study suggested that PKM2 overexpression is a marker of metastasis, invasion and poor prognosis of GBC. ACVR 1C is a tumor suppressor, and lowered ACVR 1C expression is an important marker for the metastasis, invasion, and prognosis of GBC.

Abstract P4-01-20: Explore the differences and relationships between normal, ADH tissues and DCIS, IDC in breast by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS)

Background: The mechanism that ADH changes to DCIS and even IDC is still not clear now. Raman spectroscopy is a powerful, non-invasive analytical tool which can provide detailed and meaningful information about biochemical composition of tissues at molecular level. Our aim was to find the differences and relationships between normal, ADH tissues and DCIS, IDC in breast based on their various biochemical characteristics by Raman spectroscopy.

Methods: The frozen sections were collected from 39 patients (all female; ages 27-74) who underwent surgical resection or mammotome biopsy at the Department of Breast Surgery, the First Hospital of Jilin University. After operation the samples were immediately frozen at -20∼-25°C and two contiguous sections (6 μm thickness) were cut from a sample by freezing microtome. One was stained with haematoxylin and eosin for routine histopathological analysis; the other was detected by Microscopic confocal Raman spectrometer (HORIBA JY Lab800, 633nm) with its mirror image (the H&E section). After the spectra we needed had been obtained, the Au@SiO2 shell-isolated nanoparticles (SHINs) were added to the surface of frozen sections immediately and then the spectra with SHINs were collected.

Results: A total of 475 Raman spectra and 470 SHINERS spectra were obtained from 9 normal breast tissues, 7 ADH, 8 DCIS, and 15 IDC breast tissues. The Raman signals were significantly enhanced by SHINs. The main spectral features of normal tissues at around 1301, 1442, 1654, and 1743 cm−1 are attributed to lipids. Meanwhile, no strong protein peaks emerged. The peaks of ADH, DCIS and IDC tissues located at 1004, 1033, 1610 and 1658 cm−1 from vibrational modes of proteins shows more stronger. 830, 880, 970, 1090 and 1157cm−1, representing DNA feature peaks, hold the same rules.

Table 1: Peak assignments of the Raman spectra of Breast tissues (wavenumbers in cm-1)NBADHDCISIDCMajor Assignments 880878880O-P-O stretch, DNA1003100410041003phenylalanine1092109210911090O-P-O stretch, DNA1301,14421302,14421303,14431303,1442CH2 twist and CH2 deformation, lipids  15261527C = C stretch of carotene 165816581658Amide I, α-helix1743174717451747C = O stretch, lipids

These show that diseased tissues contained more proteins and nucleic acids. The spectra of DCIS and IDC tissues contained 1527 cm−1, stemming from C = C stretching of carotene. The spectral features between ADH, DCIS and IDC tissues are described as followings: firstly, the concentrations of proteins, nucleic acids and carotene increased gradually but lipids content reduced from ADH to IDC. Secondly, ADH and DCIS tissues have extraordinary strong band of amide I, but in IDC tissues the peak almost cannot observed. Additionally, DCIS tissues have the red shifted and broad peak of CH2, which explains acyl backbone of lipids and proteins has fractured.

Conclusion: The changes including content and molecular structure of lipids, carotene, proteins and nucleic acids accompany with deterioration, indicating the Raman spectroscopy can be used to explore the differences and relationships between normal, ADH tissues and DCIS, IDC in breast. Simultaneously, it might be used to discover the mechanism that ADH convert to DCIS.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-20.

Combination of endobronchial ultrasound-guided transbronchial needle aspiration with standard bronchoscopic techniques enhanced the diagnosis yields of pulmonary tuberculosis patients with lymphadenopathy

AIM

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was reported to be useful for diagnosis of tuberculosis (TB) lymphadenitis, although its indication remains unclear for suspicious pulmonary TB patients. To clarify the role of EBUS-TBNA for the diagnosis of immunocompetent TB patients with intrathoracic lymphadenopathy, we compared two diagnostic modalities: traditional bronchoscopy alone and EBUS-TBNA combined with bronchoscopy.

METHODS

We retrospectively studied 175 patients of suspicious pulmonary TB with intrathoracic lymphadenopathy in a single institute (Tongji University, Shanghai, China) from January 2010 to May 2011.

RESULTS

Ninety-seven patients underwent traditional bronchoscopy alone while 78 received the combined diagnostic techniques. Sensitivity and specificity were 18.1% and 100%, respectively, in the bronchoscopy group alone, and 80% and 92.3%, respectively, in the EBUS-TBNA combination group (absolute increase in sensitivity, 61.9%; P<0.001; 95% CI, 48.7-75.1%). In the combination group, EBUS-TBNA alone was diagnostic of TB in 42 patients (64.6%, 95% CI, 53-76.2%). Bleeding without hemodynamic instability developed in two patients during the procedure of EBUS-TBNA and no hospitalization prolongation happened in the both arms.

CONCLUSION

Combination of EBUS-TBNA with standard bronchoscopic technique is safe and significantly increases the diagnostic yield in patients of suspicious pulmonary TB with lymphadenopathy.