P6347Wireless optogenetic inhibition of cardiac sympathetic nerve activity to improve cardiac function and remodeling in chronic post-infarction canines

Background

Our previous study has shown that optogenetic modulation of left stellate ganglion (LSG) nerve activity suppresses ventricular arrhythmia (VA) after acute myocardial infarction (MI).

Objective

This study introduced a fully implantable, battery-free wireless optogenetic neuromodulation system to investigate whether chronic optogenetic inhibition of LSG nerve activity could reduce myocardial infarct size and improve left ventricular (LV) function and remodeling in a post-MI canine model.

Methods

Eighteen beagles were randomized into the normal control group (saline injection without MI, n=6), the MI group (AAV2/9-CAG-GFP injection plus MI, n=6) and the optogenetics group (AAV2/9-CAG-ArchT-GFP injection plus MI, n=6). Four weeks after AAV/saline microinjection into LSG, MI was induced and LED device (Figure 1A) was implanted (Figure 1B, C) to perform illumination (565nm) for optogenetic modulation 1h per day for 4 weeks.

Results

Chronic optogenetic modulation significantly attenuated LSG function and neural activity as compared to the MI group. Chronic optogenetic modulation significantly reduced myocardial infarction size and improved LV function (LV ejection fraction: 53±1.3% vs. 45.9±1.8%, P<0.05) as compared to the MI group. Furthermore, chronic optogenetic modulation suppressed MI-induced LSG sympathetic remodeling and LV fibrosis.

Figure 1

Conclusion

Chronic optogenetic modulation using this fully implantable, battery-free wireless optogenetic system significantly inhibited LSG nerve activity, reduced myocardial infarction size, improved LV function and remodeling in a post-MI canine model (Figure 1D).

3055Interactions between metabolism regulator adiponectin and intrinsic cardiac autonomic nervous system: a potential treatment target for atrial fibrillation

Background

Previous studies indicated that inhibiting the cardiac autonomic nervous system (CANS) suppressed atrial fibrillation (AF). Clinical research revealed that high levels of serum adiponectin (APN) could exert a beneficial influence on sympathetic and vagal tone in patients with type 2 diabetes. The aim of this study was to elucidate whether APN could regulate CANS and subsequently suppress rapid atrial pacing (RAP)-induced AF.

Methods

Eighteen anesthetized male beagles were randomly divided into three groups: the control group (saline plus sham RAP, N=6), the RAP group (saline plus 3 h RAP, N=6) and the APN + RAP group (APN plus 3 h RAP, N=6). Multielectrode catheters were attached to all atria and pulmonary veins. After bilateral thoracotomy, APN (10 μg, 0.1 μg/μL) or saline was microinjected into 4 fat pads, each containing one of the major atrial ganglionated plexi (GP), prior to RAP. Electrophysiological parameters including atrial effective refractory period (ERP), cumulative window of vulnerability (ΣWOV), anterior right GP (ARGP) function and neural activity were measured at baseline and 3 h after pacing. The fat pads containing the GP were excised for molecular biological testing and pathological staining at the end of the protocol.

Results

Compared with the control treatment, RAP markedly shortened ERP values at all tested sites and increased ΣWOV, ARGP function and neural activity, whereas APN injection into the GP reversed these changes. Mechanistically, APN treatment ameliorated the increased inflammatory response induced by RAP. In addition, the APN receptors AdipoR1 and AdipoR2 were detected both in neurons and in non-neuronal cells. Downstream of the AdipoRs, AMPK signaling was significantly activated and NF-κB signaling was significantly inhibited. More importantly, binding between APN and AdipoRs promoted macrophage phenotype switching from proinflammatory to anti-inflammatory.

Figures

Conclusion

This study demonstrates that local administration of APN into atrial GP suppress RAP-induced AF by regulating the activity of the CANS. AMPK activation and macrophage phenotype switching may contribute to the attenuation of GP inflammation after APN injection. Therefore, APN signaling may provide a potential therapeutic target to AF.

[Epithelial-mesenchymal transition of small airway epithelium in patients receiving lung tumor surgery with normal lung function and chronic obstructive pulmonary disease]

Objective: To investigate the phenomenon of small airway epithelial-mesenchymal transition (EMT) in patients with normal pulmonary function and chronic obstructive pulmonary disease (COPD) who received surgical treatment for lung tumors. Methods: In this study, 52 patients undergoing surgical treatment for lung tumors admitted to the General Hospital of Ningxia Medical University were included from January 2018 to January 2019. According to the preoperative pulmonary function and smoking history, patients were divided into group A (non-smoking with normal pulmonary function group, 15 patients), group B (smoking with normal pulmonary function group, 21 patients), group C (COPD stable phase group, 16 patients). HE staining was performed to observe the pathological changes in small airway and lung tissue. Immunohistochemistry was used to detect the localization and expression of E-cadherin, α-smooth muscle actin (α-SMA) and Vimentin in small airway. Western blot was used to detect the levels of E-cadherin, α-SMA and Vimentin. Results: (1) There were no significant differences in age, gender, and the ratio of disease composition among the three groups (P>0.05), but forced expiratory volume in one second (FEV(1)) as percentage of predicted value (FEV(1)%pred) and FEV(1)/forced vital capacity (FEV(1)/FVC) in group C were lower than those in groups A and B (all P<0.01), while there was no significant difference between group A and group B (P>0.05); (2) the bronchial wall thickness in group B and group C were higher than that of group A [(32.4±2.4) and (54.6±4.9) vs (22.4±2.2) μm], and group C was significantly higher than group B (P=0.003); (3) the expression levels of E-cadherin in the epithelial cells of small airway in group B and group C were lower than those in group A (0.021±0.008 and 0.018±0.007 vs 0.062±0.010) (all P<0.05), while the levels of mesenchymal cell markers such as α-SMA and Vimentin in group B and group C were higher than group A, and group C was higher than group B (α-SMA: 0.641±0.113, 0.780±0.133 vs 0.404±0.123; Vimentin: 0.064±0.033, 0.083±0.022 vs 0.030±0.021) (P=0.002 and P=0.003). Conclusion: In patients undergoing surgical treatment of lung tumors, there is EMT in the small airways of patients with COPD, and EMT has occurred in the small airways of smokers with normal pulmonary function.

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

Background

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

Methods

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

Results

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

Conclusions

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

[Hybrid schwannoma/perineurioma: a clinicopathological analysis of 35 cases]

Objective: To investigate the clinical pathological features, pathological diagnosis and differential diagnosis of hybrid schwannoma/perineurioma. Methods: The clinicopathological data of 35 cases were collected at Fudan University Shanghai Cancer Center, from October 2010 to August 2017; morphological observation and immunohistochemical staining were performed, and the literatures were also reviewed. Results: There were 7 males and 28 females (male∶female=1∶4), patients with onset age ranging from 3 to 81 years(mean=36 years). Of 35 tumors, 11 cases occurred in the head and neck, 10 in the extremities, 9 in the trunk, 4 in the intestine, and 1 in the labiamajora, respectively. Clinically, most patients presented as a slowly growing dermal nodule, sometimes associated with pain. The duration of symptoms ranged from 1 month to 20 years before excision. Tumor size ranged from 0.8 cm to 6.0 cm (mean=2.6 cm). Microscopically, the tumors were usually well circumscribed but unencapsulated. At low power, most tumors were located in the dermis or subcutis, and several cases in the submucosal tissues. The tumors were composed of fascicular, storiform or whorled growth of closely intermixed plump spindle cells and slender spindle cells. The plump spindle cells had ill-defined eosinophilic cytoplasm with larger tapered or wavy nuclei, whereas the slender spindle cells had comparatively delicate nuclei with elongated cytoplasmic processes. Tumor cells had no obvious atypia, and mitoses were rare. Scattered large cells with degenerative nuclear atypia were seen in some cases. By immunohistochemistry, most of plump spindle cells showed strong staining of S-100 protein(35/35) and SOX10(8/9), whereas slender spindle cells stained variably for epithelial membrane antigen(31/35), CD34(32/33), Claudin-1 (15/15) and GLUT-1(8/8). Ki-67 proliferation index were all less than 5%. Follow-up data available in 16 patients (range 4 to 72 months; mean=46 months) were all free of disease, and one case developed local recurrence. Conclusions: Hybrid schwannoma/perineuriomaisa benign nerve sheath tumor that typically manifests as a dermaland subcutaneous tumor, less frequently may affect uncommon sites such as the nasal cavity, the gastro-intestinal tract, and the external genital areas. The tumors consisted of intimately admixed plump-spindled schwannian cells and slender-spindled perineurial cells showing dual differentiation of strong S-100 protein and SOX10 expression in the former component and variable immunoreactivity of epithelial membrane antigen, Claudin-1 and CD34 in the latter. It should be aware of the possibility of potentially misinterpretation of hybrid schwannoma/perineurioma as dermatofibrosarcoma protuberans and solitary fibrous tumor and so on.

[Ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes based on Robson classifications]

Objective: To investigate the ratio of transfer cesarean section after trial of labor and maternal-fetal outcomes based on Robson classifications. Methods: The delivery data by cesarean section in Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2009 to December 31st, 2015 (gestational age ≥28 weeks and newborn birth weight >1 000 g) were retrospectively collected. The ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes were analyzed by weighted adverse outcome score in different Robson classifications. Results: (1) The highest ratio of transfer cesarean section after trial of labor was classification 9 (all abnormal lies, including previous cesarean section and breech were excluded) reached 47.31% (431/911) , followed by classification 2 (nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced) accounted for 44.90%(409/911). (2)The tops of weighted adverse outcome score of transfer cesarean section after trial of labor were classification 10 (single cephalic pregnancy at <37 weeks gestation, including women with previous cesarean delivery) 24.55, classification 5 (single cephalic pregnancy multiparous women, with at least one previous cesarean delivery, ≥37weeks gestation) 3.64. Conclusion: Carefully evaluating the delivery mode and emphasizing the intrapartum management in nulliparous women with a single cephalic pregnancy, at ≥37 weeks gestation who had labour induced and trial of labor after cesarean section is essential to reduce the risk of adverse outcomes in transfer cesarean section after trial of labor.

[Expression of SMARCA4(BRG1) and SMARCB1(INI1) in dedifferentiated and undifferentiated endometrial carcinomas and their correlations with clinicopathological features]

Objective: To investigate the expression of SMARCA4 (BRG1) and SMARCB1 (INI-1) protein in endometrial dedifferentiated carcinoma (DDC) and undifferentiated carcinoma (UDC), and their correlation with clinicopathologic features. Methods: Clinicopathological information was gathered for 26 cases of DDC and UDC and consulting hospitals from January, 2006 to December, 2018 in Fudan University Shanghai Cancer Center, including 10 cases of DDC and 16 cases of UDC. Morphologic features and diagnosis were reviewed by two pathologists. Immunohistochemistry for expression of BRG1 and INI1 protein was performed. The correlations with clinicopathologic features were analyzed. Results: BRG1 and INI1 loss were present in 14 of 26 cases of DDC/UDC, including 12 BRG1-deficient cases and 2 INI1-deficient cases, respectively. Six cases demonstrated variable amounts of rhabdoid cells in 14 BRG1/INI1-deficient cases, and only 1 case showed rhabdoid cells in the 12 intact expression cases. However, there was no significantly statistical difference (P=0.060). Age, invasive depth, lymph node status and FIGO stage were not associated with the expression of the BRG1 and INI1 (P=0.437, P=0.672, P=0.242, P=0.348). Remarkably, the BGR1/INI1-deficient patients had worse survival than those with intact expression (4.7 vs. 22.9, P=0.033). Conclusion: BRG1/INI1-deficient is observed in approximately half of DDC and UDC. Identification of these tumors is clinically relevant due to their more aggressive behavior and poor prognosis. Hence, BRG1 and INI1 immunohistochemical stains should be performed for DDC and UDC in order to help the pathologists to distinguish these tumors from other carcinomas, and to predict the clinical prognosis.

[Clinicopathological study of BCOR rearrangement in high grade endometrial stromal sarcoma]

Objective: To investigate clinicopathological, cytogenetic features and differential diagnoses of high grade endometrial stromal sarcoma (HGESS) with BCOR gene rearrangement. Methods: Five cases of HGESS with BCOR rearrangement were collected from consultant files (2016-2018) at Fudan University Shanghai Cancer Center. Interphase FISH was performed using a dual color break-apart probe. The clinical data, histologic features and immunohistochemical findings were reviewed. Results: All 5 cases occurred in adult women with a median age of 48 (range, 45-55) years. Abdominal pain and abnormal vaginal bleeding were the most common symptoms. Microscopically, the tumors showed mainly tongue-like and/or intersecting myometrial invasion. Stromal myxoid matrix and/or collagen plaques were prominent in all the cases. Most tumors consisted of uniform, haphazard fascicles of short spindle cells with mild to moderate nuclear atypia. Mitotic figures and necrosis were easily identified. Significant nuclear pleomorphism was not seen. Most tumors were rich in thick-walled small vessels. Prominent perivascular tumor cell whorling seen in conventional low-grade endometrial stromal sarcoma was not seen. All tumors expressed CD10 with only focal or absent desmin, SMA and/or h-caldesmon staining. ER or PR expression was seen in 4 tumors and 1 tumor showed both marker expression. Diffuse cyclin D1 was present in 2 tumors. BCOR immunoreactivity was present with strong staining in 3 cases and moderate staining in 1 case respectively. Ki-67 index ranged from 10% to 30%. Fluorescence in situ hybridization confirmed chromosomal aberration of BCOR gene in all tumors, that were previously diagnosed as myxoid leiomyosarcoma (2 cases), spindle cell uterine sarcoma (2 cases) and low-grade endometrial stromal sarcoma (1 case). Limited follow-up information revealed that 3/5 patients developed tumor recurrence, metastasis or death within one year. Conclusion: BCOR rearranged HGESS has distinct morphological features and aggressive clinical behavior. In the presence of significant overlapping morphologic features between BCOR rearranged HGESS and other myxoid uterine mesenchymal tumors, especially myxoid leiomyosarcoma, molecular analysis is essential for accurate diagnoses.

Prevalence of Piroplasma in Ticks Collected from Dogs and Cattle in Guangxi, South China Determined by Reverse Line Blot Hybridization Assay

Piroplasmosis is a disease of domestic and wild animals caused by tick-borne protozoa of the genera Theileria and Babesia. Piroplasmosis leads to substantial economic losses in the livestock industry. This disease has been frequently reported in subtropical and tropical regions worldwide. However, information regarding the prevalence of piroplasma in ticks collected from dogs and cattle is lacking in most areas. To assess the potential threat of piroplasmosis in South China, 671 ticks were collected in Guangxi Province. Deoxyribonucleic acid (DNA) was extracted from these ticks to evaluate the presence of piroplasma through a reverse line blot (RLB) hybridization assay using the hypervariable V4 region of the piroplasmic 18S ribosomal ribonucleic acid (r)RNA genes as probes to detect Theileria and Babesia species. The RLB results indicated that 144/671 (21.46%) ticks were infected with piroplasma species belonging to the genera Theileria or Babesia. Theileria buffeli, Babesia vogeli, Theileria annulata, and Theileria luwenshuni were present in the ticks at frequencies of 60/671 (8.94%), 21/671 (3.13%), 6/671 (0.89%), and 6/671 (0.89%), respectively. Mixed infections with 2 or more piroplasma species were present in 8/671 (1.19%) tick samples. The hypervariable V4 region of the piroplasmic 18S rRNA genes from 6 tick DNA samples with single infections was cloned, sequenced, and aligned to related sequences from GenBank. The Theileria and Babesia sequences were analyzed separately. 18S rRNA gene fragment sequences of T. annulata and T. buffeli were compared with previously reported homologous sequences. All 3 B. vogeli sequences examined in this study were grouped into the same cluster and belonged to the same genotype. The present study provides important epidemiological information regarding piroplasmosis occurrence in China. The existence of tick-borne piroplasma likely leads to high infection risks among the local animals in the studied areas.

Pressure effects on iron-based superconductor CaFe0.88Co0.12AsF

Systematic measurements of electrical resistivity and Hall coefficient under high pressure were performed on CaFe_0.88Co_0.12AsF single crystal samples. The superconductivity is suppressed quickly by pressure and can not be detected down to 2 K at above 12.7 GPa, while the magnitude of the Hall coefficient [Formula: see text] shows a very weak pressure and temperature dependence. A comprehensive analysis considering the pressure dependence of [Formula: see text], [Formula: see text], residual resistivity ratio, and the Fermi-liquid term of the resistivity indicates that the electron correlation is an important factor in superconductivity of iron-based superconductors.

Age-related neurochemical and behavioural changes in D409V/WT GBA1 mouse: Relevance to lewy body dementia

Heterozygous mutations in GBA1, the gene which encodes the lysosomal enzyme glucocerebrosidase (GCase), are a strong genetic risk factor for the development of Lewy body dementia (LBD). Until this point however, recapitulation of the symptoms and pathology of LBD has been limited to a homozygous GBA1 mouse model which genetically and enzymatically reflects the lysosomal storage disorder Gaucher's disease. This study reports for the first time cognitive impairment by two independent behavioural tests in heterozygous GBA1 mutant mice (D409V/WT) which demonstrate significant cognitive impairment by the age of 12 months. Furthermore, reductions in GBA1 GCase enzyme activity within the brain reflects levels seen in sporadic and GBA1 mutant LBD patients. While there is no overt deposition of Lewy bodies within the hippocampus, alterations to cholinergic machinery and glial proliferation are evident, both pathological features of LBD. Interestingly, we also describe the novel finding of significantly reduced GBA2 GCase enzyme activity specifically within the hippocampus. This suggests that reduced GBA1 GCase enzyme activity dis-equilibrates the finely balanced glycosphingolipid metabolism pathway and that reductions in GBA2 GCase enzyme could contribute to the pathological and behavioural effects seen. Overall, this study presents evidence to suggest that pathological hallmarks associated with LBD specifically affecting brain regions intrinsically linked with cognition are present in the D409V/WT mice. In the absence of Lewy body deposition, the D409V/WT mice could be considered an early pre-clinical model of LBD with potential for drug discovery. Since few robust pre-clinical models of LBD currently exist, with further characterization, the mouse model described here may contribute significantly to developments in the LBD field.

[CIC-rearranged sarcoma:a clinicopathological analysis of 10 cases]

Objective: To investigate the clinicopathologic features, immunophenotype and prognosis of CIC-rearranged sarcoma (CRS). Methods: The clinical and pathological data of 10 cases of CRS diagnosed between January 2017 and December 2018 at the Department of Pathology,Fudan University Shanghai Cancer Center were analyzed. Immunohistochemical study and fluorescence in situ hybridization (FISH) were performed. The literature was reviewed. Results: There were five males and five females with a mean age of 28 years (range, 5 to 63 years). Eight tumors developed in the somatic soft tissues, including trunk (n=3),head and neck (n=3),and extremities (n=2). One case each arose in the small intestine and the occipital lobe. The average size was 4.9 cm (range,1.5-8.0 cm). Microscopically,all cases were composed of small to medium-sized round, oval to short spindled cells, showing nodular or lobular architecture, or were arranged in sheets. Compared with Ewing sarcoma, tumor cells of CRS usually showed irregular nuclear outline, coarse chromatin with prominent nucleoli and brisk mitotic activity. Necrosis was present in four cases with one showing geographic necrosis. Immunohistochemically, tumor cells usually showed focal or patch staining of CD99 (9/10),diffuse and strong nuclear expression of WT1 in half cases (2/4),and a high Ki-67 index (median 70%). By FISH, nine cases demonstrated convincing break-apart signal of CIC gene. Follow-up data available in seven cases (mean 12.1 months); of these two patients died of disease (2/7), whereas one patient was alive with unresectable recurrent tumor,the remaining four patients were alive with no evidence of disease. Five patients (5/7) experienced local recurrence and two patients (2/7) developed metastasis. The mean and median intervals to recurrence/metastasis were eight months and four months, respectively. Conclusions: CRS is the most common type of EWSR1-negative small round cell sarcoma (SRCS). Although it has clinical and pathological overlapping features with Ewing sarcoma,the prognosis is comparatively poor. Focal or patch staining of CD99 but diffuse staining of WT1 in a case of small RCS should raise the possibility of CRS. FISH assay is required for the final diagnosis.

Urban agglomeration (Guangzhou-Foshan-Zhaoqing) ecosystem management under uncertainty: A factorial fuzzy chance-constrained programming method

In this study, a factorial fuzzy chance-constrained programming (FFCP) method is developed for planning urban agglomeration ecosystem under uncertainty. FFCP cannot only address uncertainties presented as possibility distributions and random variables, but also quantitatively evaluate the individual and the interactive effects of multiple eco-environmental factors on urban agglomeration ecosystem. The FFCP method is applied to planning the Guangzhou-Foshan-Zhaoqing (GFZ) urban agglomeration, one of the most important economic circles of the Pearl River Delta region. With rapid industrialization, urbanization and population growth, a number of eco-environmental issues (e.g., water contamination, air pollution, and ecological deterioration) are becoming more and more serious. Results reveal that (i) the main environmental problem of Guangzhou is water pollution due to excessive chemical oxygen demand (COD) discharge (with a contribution of 53.1%), (ii) Foshan would suffer air pollution due to sulfur dioxide (SO₂) emitted from industrial processing and production, and (iii) solid waste disposal would continue to be challenge faced by Zhaoqing. Results also disclose that multiple uncertainties in system components have sound effects on the urban agglomeration ecosystem management as well as eco-environmental constraints have individual and/or joint effects on the system benefit. Different probability levels would lead to changed land-use patterns. Decisions at a lower violation level would lead to an increased reliability in fulfilling ecosystem requirement but with a lower system benefit. The findings can help decision makers to gain insights into tradeoff between economic development and eco-environmental protection as well as generate synergetic development strategies of urban agglomeration in an economic-effective and ecological-harmonious way.

[Severe hematologic toxicity and its impact on treatment response in newly diagnosed patients with chronic myeloid leukemia receiving tyrosine kinase-inhibitor therapy]

目的

评估慢性髓性白血病（CML）初诊患者酪氨酸激酶抑制剂（TKI）一线治疗中严重的白细胞和（或）血小板减少的发生率、相关因素及其对治疗反应及生存的影响。

方法

回顾性分析2001年1月至2018年1月诊治的初诊CML慢性期（CP）或加速期（AP）连续病例资料。

结果

共收集855例患者的数据，其中523例（61.2%）为男性，中位年龄39（14~87）岁。CP患者744例（87.0%），AP患者111例（13.0%）。一线服用伊马替尼749例（87.6%），尼洛替尼93例（10.9%），达沙替尼13例（1.5%）。137例（16.0%）在中位1.0（0.1~7.0）个月时发生≥3级白细胞和（或）血小板减少，持续0.6（0.3~6.5）个月。多因素分析显示，女性（OR=1.5，95%CI 1.0~2.2，P=0.033）、诊断时WBC ≥100×10⁹/L（OR=1.9，95%CI 1.3~2.8，P=0.001）、CP-Sokal高危（OR=2.2，95%CI 1.2~3.9，P=0.005）和原始细胞增多型AP（OR=5.1，95%CI 1.9~13.3，P=0.001）与≥3级白细胞和（或）血小板减少的发生显著相关。与未发生≥3级白细胞和（或）血小板减少相比，发生≥3级白细胞和（或）血小板减少且停药>2周与较低的完全细胞遗传学反应率（OR=0.4，95%CI 0.3~0.6，P<0.001）显著相关；发生≥3级白细胞和（或）血小板减少，无论停药是否>2周，均与较低的主要分子学反应率（OR=0.3，95%CI 0.2~0.5，P<0.001；OR=0.7，95%CI 0.5~1.0，P=0.036）和MR4.5率（OR=0.2，95%CI 0.1~0.5，P=0.002；OR=0.7，95%CI 0.4~1.1，P=0.110）相关，但不影响疾病进展和生存。

结论

严重的白细胞和（或）血小板减少是TKI治疗中常见的不良反应，女性、诊断时WBC ≥100×10⁹/L和CP-Sokal高危、原始细胞增多型AP是严重的白细胞和（或）血小板减少发生的高危人群。发生严重的白细胞和（或）血小板减少降低了TKI治疗中的细胞遗传学和分子学反应率。

[In vitro fertilization-embryo transfer affects focal adhension kinase signaling pathway in early placenta]

OBJECTIVE

To study the effects of in vitro fertilization-embryo transfer (IVF-ET) technique on gene expression of focal adhension kinase (FAK) signaling pathway in early placental trophoblast cells, and to explore the effects of IVF-ET technology on the development and function of early placenta.

METHODS

We collected 7-8 weeks of gestation placenta tissue as a study group by ultrasound guided reduction of fetal from double embryo transfer under IVF-ET technology. In the control group, placenta tissues were obtained from the spontaneous abortion of natural pregnancy twin 7-8 weeks. Microarray hybridization analysis was performed on the placenta tissue of the two groups using the Affymetrix HG-U133 Plus 2.0 gene chip. Eight differentially expressed genes were identified by real-time quantitative polymerase chain reaction (qRT-PCR), and unsupervised clustering analysis and functional bioinformatics analysis were performed for the differentially expressed genes.

RESULTS

Twenty-eight cases of IVF-ET reduced fetal villi and 8 cases of spontaneous abortion villi were collected. A total of 8 placental villi were detected by the gene chip. Compared with the natural pregnancy control group, 32 differentially expressed genes in the placental FAK signaling pathway were expressed in IVF-ET. The differential expression was greater than or equal to 2 times, of which 12 genes were up-regulated and 20 were down-regulated. The qRT-PCR showed that the expression of the 8 genes in FAK signaling pathways of IVF-ET was significantly different from that in the placenta of natural pregnancy, which was consistent with the result of the gene chip detection. The FAK signal pathway gene localization showed that the FAK gene was mainly located in the upstream of the signal pathway in the placenta of IVF-ET. The placental trophoblast cells maintained the FAK signaling pathway function through gene expression compensation.

CONCLUSION

There are gene expression differences in the FAK signaling pathway between the IVF-ET derived early placenta and the natural pregnancy placenta. The differentially expressed genes are involved in many key functions of the FAK signaling pathway and affect the early development and function of the IVF-ET placenta, while the placental trophoblast cells change gene expression for interference to compensate for IVF-ET technology itself, maintain normal function of the FAK signaling pathway, and satisfy the need for placental and fetal development.

Epididymal small non-coding RNA studies: progress over the past decade

BACKGROUND

Small non-coding RNAs (sncRNAs) accomplish a huge variety of biological functions. Over the past decade, we have witnessed the substantial progress in the epididymal sncRNA studies. In the Epididymis 7, we had the true privilege of having a whole session to share our findings and exchange ideas on the epididymal sncRNA studies.

OBJECTIVES

This mini-review attempts to provide an overview of what is known about the sncRNAs in the mammalian epididymis and discuss the future directions in this field.

METHODS

We surveyed literature regarding the sncRNA studies in the mammalian epididymis, and integrated some of our unpublished findings as well. We focus on the progress in methodology and the advances in our understanding of the expression and functions of epididymal sncRNAs.

RESULTS AND DISCUSSION

The applications of high-throughput approaches have made great contributions in the discovery of new sncRNA species and profiling their dynamics in the epithelial cells, the passing spermatozoa, and the luminal environment. The diverse classes of epididymal sncRNAs exert important biological functions from the in situ regulation of epididymal gene expression to the epigenetic inheritance in the offspring.

CONCLUSION

Although still in its infancy, we believe that the research on epididymal sncRNAs will not only lead to a better understanding of their physiological and pathological functions, but also contribute to the whole landscape of the RNA field.

[Current status of national free antiretroviral therapy in interprovincial migrating people living with HIV/AIDS and influencing factors, China, 2011-2015]

Objective: To understand the current status of national free antiretroviral therapy in interprovincial migrating people living with HIV/AIDS (PLWHA) and influencing factors in China. Methods: Descriptive and trend test analyses were performed to evaluate the historical characteristics and trends of main descriptive indicators on national free antiretroviral therapy for the interprovincial migrating PLWHA by using the data collected from National Comprehensive HIV/AIDS Information System from 2011 to 2015. Logistic regression model was used to explore the main factors that influencing the coverage of national free antiretroviral therapy among the interprovincial migrating PLWHA in China. Results: The proportion of interprovincial migrating PLWHA gradually increased in last 5 years from 7.1% (17 784/250 645) in 2011 to 10.3% (54 596/528 226) in 2015 (Z=51.38, P<0.000 1) in China. The coverage rate of free antiretroviral therapy in interprovincial migrating PLWHA increased from 37.3% (6 641/17 784) in 2011 to 71.0% (38 783/54 596) in 2015, showing a significant rising tendency (Z=96.23, P<0.000 1), but it was slightly lower than that in non-interprovincial migrating PLWHA in 2015 (71.5%, 338 654/473 630). Multivariate logistic regression analysis showed that the PLWHA who were females, aged ≥50 years, of Han ethnic group, married or had spouse, had the educational level of high school or above, infected through homosexual intercourse, with CD(4)(+)T cells counts ≤500 cells/μl at the first visit, identified to be infected with HIV in medical setting, living in urban areas et al, were more likely to receive free antiretroviral therapy. Conclusions: The coverage rate of free antiretroviral therapy varied among the interprovincial migrating PLWHA with different characteristics. It is still necessary to take effective measures to further increase the coverage of free antiretroviral therapy in interprovincial migrating PLWHA and to include the free antiretroviral therapy in interprovincial migrating PLWHA into standardized management system as soon as possible.

[A multicenter study of reference intervals for 15 laboratory parameters in Chinese children]

Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion: This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.

[Clinical study on blocking mother-to-child transmission of hepatitis B virus with high viral load and HBeAg positivity during pregnancy in Guizhou province]

Objective: To observe the efficacy and safety related measures by blocking mother-to-child transmission of hepatitis B virus with high viral load and HBeAg positivity during pregnancy in Guizhou province. Methods: Outpatient and inpatient cases of the Department of Infectious Diseases and Obstetrics of Guizhou Medical University Affiliated Hospitals from May 2016 to July 2017 were retrospectively divided into intervention group, non-intervention group and non- hepatitis B pregnant women group; with 75 cases in each group. HBsAg and HBeAg were positive in the intervention group. Pregnant women with HBV DNA ≥10(6) IU/ml were treated with anti-HBV therapy for 24 to 28 weeks of gestation until delivery. According to oral drugs, they were divided into tenofovir (TDF) group or telbivudine (LDT) group, non-intervention group (HBsAg and HBeAg positive), HBV DNA positive pregnant women, pregnant women with no anti-HBV drugs, non-hepatitis B pregnant women (normal pregnant women without HBV infection). Infants and young children born to the three groups of women were immunized with the national viral hepatitis B action plan. The gestational weeks and Apgar scores at birth, delivery mode, feeding mode, sex and 7-months-old age were observed and counted. Serum hepatitis B markers (HBVM) and HBV DNA were quantitatively detected. HBVM was detected by time-resolved fluorescence immunoassay (TRFIA), and HBV DNA was detected by real-time PCR (FQ-PCR). The changes of liver parameters, HBsAg, HBeAg, HBV DNA, adverse drug reactions and treatment response of pregnant intervention group before medication (12-24 weeks of gestation), 4 weeks of medication (28-32 weeks of gestation), 36-40 weeks of gestation (36-40 weeks of gestation) were statistically calculated. A t-test was used to compare the data between the measurements. Data measurements within the groups were analyzed using rank -sum test. Results: In the intervention group, therapeutic medications showed no differences in demographic and clinical characteristics between TDF group and LDT group, including liver parameters, HBsAg, HBeAg and log10HBV DNA level. Compared with pre-treatment (TDF group: 4.84 ± 2.01; LDT group: 5.08 ± 1.99), TDF and LDT were significantly lower at the end of pregnancy (TDF group: 3.06 ± 0.66; LDT group: 3.51 ± 1.20). P < 0.05); and the treatment response rate was 100%. There were no serious adverse events in the intervention group. Infants and young children (7-months-old) in the intervention group had negative HBsAg, HBeAg and HBV DNA. The mother-to-child transmission rate of HBV was zero, with blocking rate of 100%. In addition, both infants and young children had different degrees of hepatitis B protective antibodies (anti-HBs, M: 144.33), and their antibody titers were higher than that of non-intervention group (anti-HBs, M: 65.91) and non-hepatitis B pregnant women (anti-HBs, M: 58.43). The difference was statistically significant (P < 0.05), and there was no significant correlation between the use of antiviral and the way of delivery and feeding. Outcomes of mother-to-child transmission of HBV infection in infants and young children (7-months-old) delivered by three groups of pregnant women in the non-intervention groups had 20.0% (15/75)/ 17.3% (13/75) HBsAg/HBeAg positivity rate, and 17.3% (13/75) HBV DNA positivity rate. Overall, mother-to-child transmission rate of HBV infection was 20% (15/75). Furthermore, the relationship between mother's HBV DNA load and infant HBV infection in the non-intervention group showed mother's HBV DNA ≥10(6) IU/ml. Conclusion: In the non-intervention group, mother-to-child transmission of HBV occurred, and infected mothers HBV DNA was ≥106 IU/ml before delivery. This suggests that HBeAg positive and high load HBV DNA replication were independent risk factors for mother-to-child transmission of hepatitis B. Therefore, prenatal drug intervention and postpartum standard immune blockade are necessary for high-risk pregnant women with hepatitis B to achieve zero mother-to-child transmission of hepatitis B in real- clinical practice.

[Clinical outcomes of peripheral blood stem cell transplantation for aggressive peripheral T-cell lymphoma]

目的

研究外周血造血干细胞移植治疗外周T细胞淋巴瘤（PTCL）的疗效。

方法

回顾性分析解放军总医院血液科2007年6月至2017年6月接受外周血造血干细胞移植PTCL患者的临床资料。

结果

共有41例PTCL患者纳入研究，男30例，女11例，中位年龄38（13~57）岁。17例行自体外周血造血干细胞移植（auto-PBSCT），24例行异基因外周血造血干细胞移植（allo-PBSCT）。auto-PBSCT组ALK阳性间变大细胞淋巴瘤占47.1%（8/17），allo-PBSCT组NK/T细胞淋巴瘤和外周T细胞淋巴瘤-非特指型占66.7%（16/24）。auto-PBSCT组患者移植前疾病处于完全缓解（CR）状态者占58.8%（10/17），疾病进展（PD）状态者占11.8%（2/17）；allo-PBSCT组移植前疾病状态为CR者8.3%（2/24），PD者45.8%（11/24）。auto-PBSCT组和allo-PBSCT组移植后2年总生存率、无病生存率差异均无统计学意义[（64.0±10.8）%对（53.5±9.7）%，P=0.543；（57.1±12.4）%对（53.5±10.6）%，P=0.701]。auto-PBSCT组6例死亡，5例死于复发；allo-PBSCT组12例死亡，其中5例死于复发，7例为移植相关死亡。

结论

auto-PBSCT和allo-PBSCT均是PTCL的有效治疗方法。

Elevated urinary lipocalin-2, interleukin-6 and monocyte chemoattractant protein-1 levels in children with congenital ureteropelvic junction obstruction

INTRODUCTION

In children with congenital ureteropelvic junction obstruction (UPJO), urinary biomarkers could assist in the diagnosis of renal damage or kidneys at risk for damage. Urinary levels of interleukin-6 (IL6), neutrophil gelatinase-associated lipocalin (LCN2), monocyte chemoattractant protein-1 (MCP1), and transforming growth factor-β1 (TGFB1) proteins have been correlated with renal damage in several contexts. Whether they might be useful non-invasive biomarkers of obstructive nephropathy due to unilateral and bilateral congenital UPJO was tested.

PATIENTS AND METHODS

A cohort study was performed at People's Hospital of Xinjiang Uygur Autonomous Region in China. Bladder urine samples from 17 patients with UPJO were obtained before surgical intervention and from 17 healthy age-matched controls. Levels of IL6, LCN2, MCP1, and TGFB1 were determined by enzyme-linked immunosorbent assay and normalized to urinary creatinine levels.

RESULTS

Levels of urinary LCN2, MCP1, and IL6 were significantly elevated in the urine from individuals with UPJO compared with controls (P = 0.0003, P = 0.0003, and P = 0.0073, respectively). Children with bilateral UPJO (n = 5) showed significantly higher levels of IL6, LCN2, and MCP1 protein in their urine compared with controls or those with unilateral UPJO (n = 12; P = 0.007, P < 0.0001, and P = 0.0002, respectively). Combining LCN2 and MCP1 slightly improved biomarker performance.

DISCUSSION

Urinary biomarkers could be used in obstructed patients to monitor for renal damage and might find particular utility on patients with bilateral UPJO. Monitoring urinary biomarkers and imaging features in untreated patients could provide insights into the natural history of renal damage due to obstruction and will be necessary to test their performance characteristics as biomarkers.

CONCLUSIONS

Urinary levels of LCN2 and MCP1 protein are promising biomarkers monitoring children with UPJO, particularly in those with bilateral disease.

The combination of apolipoprotein E4, age and Alzheimer's Disease Assessment Scale - Cognitive Subscale improves the prediction of amyloid positron emission tomography status in clinically diagnosed mild cognitive impairment

BACKGROUND AND PURPOSE

Randomized clinical trials involving anti-amyloid interventions focus on the early stages of Alzheimer's disease (AD) with proven amyloid pathology, using amyloid positron emission tomography (amyloid-PET) imaging or cerebrospinal fluid analysis. However, these investigations are either expensive or invasive and are not readily available in resource-limited centres. Hence, the identification of cost-effective clinical alternatives to amyloid-PET is highly desirable. This study aimed to investigate the accuracy of combined clinical markers in predicting amyloid-PET status in mild cognitive impairment (MCI) individuals.

METHODS

In all, 406 MCI participants from the Alzheimer's Disease Neuroimaging Initiative database were dichotomized into amyloid-PET(+) and amyloid-PET(-) using a cut-off of >1.11. The accuracies of single clinical markers [apolipoprotein E4 (ApoE4) genotype, demographics, cognitive measures and cerebrospinal fluid analysis] in predicting amyloid-PET status were evaluated using receiver operating characteristic curve analysis. A logistic regression model was then used to determine the optimal model with combined clinical markers to predict amyloid-PET status.

RESULTS

Cerebrospinal fluid amyloid-β (Aβ) showed the best predictive accuracy of amyloid-PET status [area under the curve (AUC) = 0.927]. Whilst ApoE4 genotype (AUC = 0.737) and Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) 13 (AUC = 0.724) independently discriminated amyloid-PET(+) and amyloid-PET(-) MCI individuals, the combination of clinical markers (ApoE4 carrier, age >60 years and ADAS-Cog 13 > 13.5) improved the predictive accuracy of amyloid-PET status (AUC = 0.827, P < 0.001).

CONCLUSIONS

Cerebrospinal fluid Aβ, which is an invasive procedure, is most accurate in predicting amyloid-PET status in MCI individuals. The combination of ApoE4, age and ADAS-Cog 13 also accurately predicts amyloid-PET status. As this combination of clinical markers is cheap, non-invasive and readily available, it offers an attractive surrogate assessment for amyloid status amongst MCI individuals in resource-limited settings.

[Patient reported outcome of tyrosine kinase inhibitor related side effects and their impact on daily life in Chinese patients with chronic myeloid leukemia in the chronic phase]

目的

评估中国慢性髓性白血病（CML）慢性期（CP）患者报告的酪氨酸激酶抑制剂（TKI）相关不良反应及其对日常生活的影响。

方法

2014年5月至11月在全国范围内向正在接受TKI治疗的成年CML患者发放无记名调查问卷。TKI不良反应对患者日常生活的影响程度采用自我报告的形式，以1分（没有影响）至5分（严重影响）进行评估。

结果

731例CML-CP受访者报告了TKI相关不良反应影响其日常生活评分，中位年龄41 (18~88）岁，男性407例（56%），560例（77%）确诊至TKI治疗时间< 1年。中位TKI治疗时间为3（<1~13）年，549例（75%）获得完全细胞遗传学反应，301例（41%）获得完全分子学反应。TKI最多见的不良反应依次为水肿（44%）、乏力（38%）、胃肠道不适（32%）、面部颜色改变（19%）、肌肉痉挛（19%）、皮疹（14%）、肝功能异常（12%）、体重增加（12%）和血细胞计数降低（8%）。多因素分析显示，TKI服药时间<4年是乏力的独立影响因素；女性、年龄≥40岁、服用一代TKI者容易发生水肿；服用一代TKI容易发生胃肠道不适；服用二代TKI容易出现皮疹及肝功能异常；女性容易出现体重增加；确诊至TKI治疗时间≥1年、服用一代TKI者较易出现肌肉痉挛；服用仿制品是血细胞计数降低的独立影响因素。患者自我报告TKI相关不良反应影响日常生活的评分显示218例（30%）没有影响（1分），375例（51%）受轻中度影响（2~3分），138例（19%）受严重影响（4~5分）。多因素分析显示，仅将人口学特征纳入分析时，女性、年龄≥40岁、服用仿制品、TKI服药时间<4年与受访者较高的日常生活受影响程度显著相关；将不良反应也纳入多因素分析后，未接受高等教育、TKI服药时间<4年、服用仿制品以及以下不良反应：水肿、乏力、胃肠道不适、面部颜色改变、皮疹和肝功能异常与较高的日常生活受影响程度相关。

结论

服用TKI的中国CML-CP患者中，水肿、乏力、胃肠道不适、皮疹、面部颜色改变和肝功能异常是最常见的、影响其日常生活的药物不良反应。女性、年龄≥40岁、未接受高等教育、服用仿制品和TKI治疗时间较短与患者日常生活受影响显著相关。

Dominance of Tensor Correlations in High-Momentum Nucleon Pairs Studied by (p,pd) Reaction

The isospin character of p-n pairs at large relative momentum has been observed for the first time in the ^{16}O ground state. A strong population of the J,T=1,0 state and a very weak population of the J,T=0,1 state were observed in the neutron pickup domain of ^{16}O(p,pd) at 392 MeV. This strong isospin dependence at large momentum transfer is not reproduced by the distorted-wave impulse approximation calculations with known spectroscopic amplitudes. The results indicate the presence of high-momentum protons and neutrons induced by the tensor interactions in the ground state of ^{16}O.

A functional macrophage migration inhibitory factor promoter polymorphism is associated with reduced diffusing capacity

Cigarette smoke exposure is the leading modifiable risk factor for chronic obstructive pulmonary disease (COPD); however, the clinical and pathologic consequences of chronic cigarette smoke exposure are variable among smokers. Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine implicated in the pathogenesis of COPD. Within the promoter of the MIF gene is a functional polymorphism that regulates MIF expression (-794 CATT_5-8 microsatellite repeat) ( rs5844572 ). The role of this polymorphim in mediating disease susceptibility to COPD-related traits remains unknown. We performed a cross-sectional analysis of DNA samples from 641 subjects to analyze MIF-794 CATT_5-8 ( rs5844572 ) polymorphism by standard methods. We generated multivariable logistic regression models to determine the risk of low expressing MIF alleles for airflow obstruction [defined by forced expiratory volume in 1 s (FEV₁)/forced vital capacity ratio <0.70] and an abnormal diffusion capacity [defined by a diffusion capacity for carbon monoxide (DL_CO) percent predicted <80%]. We then used generalized linear models to determine the association of MIF genotypes with FEV₁ percent predicted and DL_CO percent predicted. The MIF-794 CATT₅ allele was associated with an abnormal diffusion capacity in two cohorts [odds ratio (OR): 9.31, 95% confidence interval (CI): 1.97-4.06; and OR: 2.21, 95% CI: 1.03-4.75]. Similarly, the MIF-794 CATT₅ allele was associated with a reduced DL_CO percentage predicted in these two cohorts: 63.5 vs. 70.0 ( P = 0.0023) and 60.1 vs. 65.4 ( P = 0.059). This study suggests an association between a common genetic polymorphism of an endogenous innate immune gene, MIF, with reduced DL_CO, an important measurement of COPD severity.

Nitric oxide inhibits the transcription of E6 gene of human papillomavirus

High-risk human papillomavirus (HPV) is an important pathogenic factor for cervical cancer and understanding the mechanism of HPV gene transcription is important for the prevention and therapy of HPV related cervical cancer. This study aimed to investigate the role of nitric oxide (NO) in the regulation of HPV gene transcription. SiHa cells containing integrated HPV16 were treated with NO donor DETA-NO and cell proliferation and cytotoxicity were determined. HPV gene transcription was detected by real-time PCR. We found no significant cytotoxic effects on SiHa cells when the concentration of DETA-NO was less than 0.5 mmol/l. The transcription of HPV E6 gene was inhibited by DETA-NO in a dose-dependent manner and the best inhibitory effect was observed at 0.5 mmol/l DETA-NO. In addition, ERK inhibitor U0126 decreased the transcription of HPV E6 gene at the concentration of 30 μmol/l. In conclusion, NO inhibits the transcription of HPV E6 gene and probably involves MAPK signaling pathway. Keywords: SiHa cells; nitric oxide; MAPK pathway; HPV transcription.

Evaluation of the readout electronics based on the center of gravity method for position sensitive radiation detection

In the application of position sensitive radiation detection, the center of gravity method is often used to obtain better spatial resolution. In order to obtain the resolution degradation caused by the readout electronics, an evaluation method is put forward in this paper. The principle of the method is to simulate the signal distribution on sense wires of the MWPC (Multiwire Proportional Chamber) detector. The evaluation software quantizes the simulated data and drives the digital to analog converter to generate test signals. The readout electronics is evaluated with these stimulus signals according to the readout scale. An evaluation board based on this method is implemented. Tests are carried out in the laboratory to evaluate a readout circuit for the MWPC detector. The position resolution contributed by the electronics is better than 15 μm when the swtiching frenquency of the switch array is 12.5 MHz. The test results proved that the evaluation method is correct and practical. It can greatly simplify the evaluation of the readout electronics.

[Hepatic adverse events associated with tyrosine kinase inhibitors in patients with chronic myeloid leukemia]

Objective: To explore the incidence and severity of hepatic adverse events (AEs) and identify factors associated with hepatic AEs in patients with chronic myeloid leukemia (CML) in chronic phase (CP) treated with tyrosine kinase inhibitors (TKIs). Methods: Liver biochemistry parameters [including ALT(alanine aminotransferase), AST(aspartate aminotransferase), ALP(alkaline phosphatase), and TBil(total bilirubin)] during the first 6 months on imatinib (Gleevec(®)), dasatinib (Sprycel(®)) or nilotinib (Tasigna(®)) in CML-CP patients were collected and analyzed retrospectively. Results: A total of 436 patients were enrolled in this study, including 271 with imatinib, 58 with dasatinib, and 107 with nilotinib. The incidences of any abnormality of liver injury were 21.8%(59/271), 15.5%(9/58) and 32.7%(35/107) in the imatinib, dasatinib and nilotinib groups, respectively. Most of the hepatic AEs were CTCAE grade 1 or 2 and mild or moderate liver injury except 1.9% of TBil CTCAE grade 3 in the nilotinib group. Multivariate analyses showed nilotinib [OR=2.9(1.3-6.6), P=0.012; OR=4.4(1.2-15.6), P=0.023] and male gender [OR=2.3(1.4-3.9), P=0.002; OR=3.0(1.2-7.6), P=0.018] were significantly associated with moderate liver impairment. Conclusions: TKIs including imatinib, dasatinib and nilotinib were well tolerated with mild to moderate hepatic AEs in CML-CP patients. Nilotinib and male sex were associated with occurrence of liver biochemistry abnormalities and moderate hepatic injury.

[Angiofibroma of soft tissue: a clinicopathologic analysis of 24 cases]

Objective: To investigate the clinicopathologic and genetic features, pathologic diagnosis and differential diagnosis of angiofibroma of soft tissue(AFST). Methods: The clinicopathologic characteristics of 24 cases diagnosed at Fudan University Shanghai Cancer Center from 2011 to 2017 were analyzed; immunohistochemical staining and interphase fluorescence in situ hybridization (FISH) were performed, and the literatures were also reviewed. Results: There were 15 male and 9 female (male∶female=1.7∶1.0) patients with age of onset ranging from 8 to 68 years (mean, 45 years). Fourteen cases occurred in extremities, including upper limbs (n=3) and lower limbs (n=11); seven cases were in the trunk, and 1 case each was in the temporal region, retroperitoneum and liver, respectively. Clinically, the tumors usually presented as a slowly growing painless mass. Tumor sizes ranged from 0.8 to 14 cm (mean 4.6 cm). Microscopically, most lesions were well-circumscribed, with fibrous capsules. Few cases infiltrated the surrounding fibrofatty tissue focally. The tumors were mainly composed of sparse short spindle cells and numerous small, branching, thin-walled blood vessels distributed in amyxoid, fibromyxoid or collagenous matrix, often accompanied by medium-sized, round or irregular and ecstatic vessels at the tumor periphery.By immunohistochemistry, all tested cases expressed vimentin (5/5), and showed variable positivity for EMA (2/4), ER (1/2), PR (2/3), α-SMA (1/18)and desmin (1/10). Ki-67 proliferation index were all less than 5%. CD34, CD31 and ERG staining clearly outlined the contours of blood vessels in the stroma. Four cases were tested for NCOA2 gene rearrangement by FISH, of which three were positive. Follow-up data was available in 17 patients (range, 3 to 69 months; mean, 30 months) were all free of disease. Conclusions: Soft tissue angiofibroma is a benign fibroblastic neoplasm characterized by a prominent and complex vasculature set in a myxoid-to-collagenous stroma, and cytogenetically a distinctive NCOA2 gene rearrangement. Caution should be exercised for the possibility of potentially misinterpretation of AFST as vascular tumors and other myxoid soft tissue tumors.

Comparison of imaging features and diagnostic values of MRI, CT and contrast-enhanced ultrasonography in the diagnosis of cervical carcinoma staging

OBJECTIVE

This study aimed at exploring and contrasting the clinical significances and values of MRI, CT and contrast-enhanced ultrasonography in FIGO staging of cervical carcinoma.

PATIENTS AND METHODS

The contrast-enhanced ultrasonography, CT and MRI imaging data of 348 patients with cervical carcinoma confirmed by clinical pathology were analyzed retrospectively and contrasted with pathological findings.

RESULTS

The total accuracy of MRI in cervical carcinoma staging was 79.89% (278/348), and the diagnostic accuracy of MRI in stage IB, stage II, stage III and stage IV of cervical carcinoma was 74.29% (26/35), 75.74% (153/202), 85.25% (52/61), 94.00% (47/50), respectively. The total accuracy of CT in cervical carcinoma staging was 73.28% (255/348), and the diagnostic accuracy of CT in stage IB, stage II, stage III and stage IV of cervical carcinoma was 60.00% (21/35), 69.80% (141/202), 78.69% (48/61), 94.00% (45/50), respectively. The total accuracy of contrast-enhanced ultrasonography in cervical carcinoma staging was 57.47% (200/348), and the diagnostic accuracy of contrast-enhanced ultrasonography in stage IB, stage II, stage III and stage IV of cervical carcinoma was 37.14% (13/35), 50.99% (103/202), 70.49% (43/61), 82.00% (41/50), respectively. The accuracy of MRI in the diagnosis of stage IB, stage II of cervical carcinoma was higher than that of CT and contrast-enhanced ultrasonography (p<0.05), and the diagnostic accuracy of CT was higher than that of contrast-enhanced ultrasonography (p<0.05). The differences among the three methods were statistically significant.

CONCLUSIONS

According to the results of pathological sections, there were statistically significant differences among the sensitivity and specificity of MRI, CT and contrast-enhanced ultrasonography in the diagnosis of stage IB and stage II (p<0.05). MRI has high diagnostic values in the differentiation and diagnosis of cervical carcinoma staging.

Host-location behavior of the tea green leafhopper Empoasca vitis Göthe (Hemiptera: Cicadellidae): olfactory and visual effects on their orientation

The tea green leafhopper, Empoasca vitis Göthe, is one of the most serious pests in tea growing areas. This study investigated the roles played by olfaction and vision in host orientation behavior. The compound eye of E. vitis was found to be a photopic eye; few olfactory sensilla were found on the antennae, while abundant gustatory sensilla were recorded on the mouthparts. Three opsin genes (EV_LWop, EV_UVop, EV_Bop) were isolated and found to be mainly expressed in the compound eye compared with other parts of the body. Immunolocalization indicated that the opsins mainly located in the different regions of rhabdom. The transcription levels of EV_LWop, EV_Bop and EV_UVop were reduced by 77.3, 70.0 and 40.0%, respectively, by RNA interference induced by being fed a special RNA-rich diet for 6 days. The rate of tropism to host color was effectively impaired by 67.6 and 29.5% in the dsEV_LWop and dsEV_Bop treatment groups, but there was no significant change in the dsEV_UVop group. The determination of the cause of the tropism indicated that odors from the host over long distances were unable to attract E. vitis and were only detected when the insects were close to the host. The developed compound eye of E. vitis plays a leading role in host location, and the long-wavelength opsin significantly affects the tropism to host color; the lack of olfactory sensilla results in long-distance odors not being able to be detected until the insect is near to the host-plant. The understanding of these behavioral mechanisms, especially the importance of opsin genes is expected to be useful for pest management.

[Polymorphisms of mTORC1 genes and risk of primary colorectal adenocarcinoma in Chinese populations]

Objective: To study the associations between variants of mTORC1 of PI3K/AKT/mTOR pathway and colorectal cancer. Methods: In this hospital-based case-control study, at the First Affiliated Hospital, Xinjiang Medical University from 2000 to 2013, 665 primary colorectal cancer cases and 695 cancer-free controls were genotyped at 10 potentially functional single nucleotide polymorphism (SNPs) loci of mTORC1 (mTOR: rs1034528, rs2295080; Raptor: rs1062935, rs3751934; mLST8: rs3160, rs26865; DEPTOR: rs2271900, rs4871827; AKT1S1: rs2290774, rs2353005) to assess their associations with risk of colorectal cancer by Logistic regression analysis. Results: In single-locus analysis, found a significantly decreased risk of colorectal cancer associated with mLST8 rs26865 by recessive genetic model, especially in populations of ≤68 years of age (OR=0.64; 95%CI=0.43-0.96, P=0.031), female (OR=0.61; 95%CI=0.38-0.99, P=0.046), non-smoking (OR=0.55; 95%CI=0.35-0.87, P=0.010). mTOR rs1034528 CC genotypes were associated with higher risk of colorectal cancer in >68-year-old populations (OR=3.34; 95%CI=1.12-9.91, P=0.030). Raptor rs3751934 CA/AA genotypes were associated with lower colorectal cancer risk in population of body mass index(BMI)>25 kg/m(2) (OR=0.68; 95%CI=0.47-0.98, P=0.038); and AKT1S1 rs2290774 CC genotypes were associated with lower colorectal cancer risk in non-smoking population (OR=0.67; 95%CI=0.45-0.99, P=0.048). Furthermore, found that populations carrying more than two low-risk genotypes were associated with lower colorectal cancer risk, compared with that of populations carrying less than two low-risk genotypes (OR=0.74, 95%CI=0.58-0.95, P=0.017), especially in population of ≤68 years of age, male and BMI>25 kg/m(2,) and non-smoking. Conclusions: SNPs of mTORC1-related genes individually or jointly contribute to colorectal cancer susceptibility in Chinese. Further studies of larger cohorts are needed to validate the findings.