How To Deal With Uveitis Patients?

During the past nine years, our center has grown into the largest uveitis referral center in China. To deal with this increasing stream of patients we have developed a management system to coordinate communication with our patients, their referring ophthalmologists, consultations with other medical specialties and worldrenowned foreign uveitis specialists. We have established the biggest database of uveitis patients records allowing continuous analysis of clinical features and response to treatment of patients with various uveitis entities as well as the evaluation of the relevance of various ancillary tests performed in this patient group. The establishment of a specimen biobank has been shown to be instrumental in the research on the complex immunopathological mechanisms involved in this disease. The close interaction between patient care and clinical research under one roof has led to a novel understanding of disease mechanisms and will undoubtedly lead to a tailored treatment for this disease.

Notch3 signaling activation in smooth muscle cells promotes extrauterine growth restriction-induced pulmonary hypertension

BACKGROUND AND AIMS

Early postnatal life is a critical developmental period that affects health of the whole life. Extrauterine growth restriction (EUGR) causes cardiovascular development problems and diseases, including pulmonary arterial hypertension (PAH). PAH is characterized by proliferation, migration, and anti-apoptosis of pulmonary artery smooth muscle cells (PASMCs). However, the role of PASMCs in EUGR has not been studied. Thus, we hypothesized that PASMCs dysfunction played a role in EUGR-induced pulmonary hypertension.

METHODS AND RESULTS

Here we identified that postnatal nutritional restriction-induced EUGR rats exhibited an elevated mean pulmonary arterial pressure and vascular remodeling at 12 weeks old. PASMCs of EUGR rats showed increased cell proliferation and migration features. In EUGR-induced PAH rats, Notch3 signaling was activated. Relative mRNA and protein expression levels of Notch3 intracellular domain (Notch3 ICD), and Notch target gene Hey1 in PASMCs were upregulated. We further demonstrated that pharmacological inhibition of Notch3 activity by using a γ-secretase inhibitor DAPT, which blocked the cleavage of Notch proteins to ICD peptides, could effectively inhibit PASMC proliferation. Specifically knocked down of Notch3 in rat PASMCs by shRNA restored the abnormal PASMC phenotype in vitro. We found that administration of Notch signaling inhibitor DAPT could successfully reduce mean pulmonary arterial pressure in EUGR rats.

CONCLUSIONS

The present study demonstrated that upregulation of Notch3 signaling in PASMCs was crucial for the development of EUGR-induced PAH. Blocking Notch3-Hey1 signaling pathway in PASMCs provides a potential therapeutic target for PAH.

Contribution of the polymorphism rs1800469 of transforming growth factor β in the development of myocardial infarction: meta-analysis of 5460 cases and 8413 controls (MOOSE-compliant article)

Studies investigating the association between transforming growth factor (TGF-β-509C/T, rs1800469) promoter polymorphism and myocardial infarction (MI) risk reported inconsistent results. The aim of our study was to assess the association between the 509C/T polymorphism of the TGF-β gene (rs1800469) and MI risk.A total of 5460 cases and 8413 controls in 7 case-control studies were incorporated in our current meta-analysis. The original studies were selected through searching the databases of the PubMed and EMBASE. The odds ratio (OR) and 95% confidence interval (95% CI) of TGF-β 509C/T (rs1800469) for MI risk were applied to estimate the strength of the association.Our results showed that T allele carriers had a 13% increased risk of MI, when compared with the C allele carriers (OR = 1.13, 95% CI: 1.00-1.27). In the subset analysis by the type of MI, significantly elevated risk of MI was associated with the homozygote TT and heterozygote C/T in no-AMI subjects, when compared with the CC homozygote carriers (OR = 1.12, 95% CI:1.02-1.23).Our meta-analysis shows that the polymorphism with homozygote TT and heterozygote C/T of TGF-β 509C/T (rs1800469) is significantly associated with the increased risk of MI.

Identification of susceptibility SNPs in CTLA-4 and PTPN22 for scleritis in Han Chinese

The aim of this study was to determine the association between 13 single nucleotide polymorphisms (SNPs) in the cytotoxic T lymphocyte-associated antigen-4 (CTLA4) and protein tyrosine phosphatase non-receptor type 22 (PTPN22) genes with scleritis in a Chinese Han population. We recruited 432 scleritis patients and 710 healthy controls. Four tag SNPs of CTLA4 and nine tag SNPs of PTPN22 were selected using Haploview. Genotyping was performed with the Sequenom MassArray® iPLEX GOLD Assay. Genotype and allele frequency differences were analyzed by χ² test and Bonferroni correction. Haplotype analysis was performed to further evaluate the association of these two genes with scleritis. In this study, CTLA4/rs3087243 G allele frequency and GG genotype frequency were significantly increased in scleritis patients compared to healthy controls [corrected P-value (Pc) = 0·02, odds ratio (OR) = 1·475, 95% confidence interval (CI) = 1·175-1·851; Pc = 0·04, OR = 1·546, 95% CI = 1·190-2·008, respectively]. None of the tested SNPs in the PTPN22 gene showed an association with scleritis. Haplotype analysis revealed a lower frequency of a CTLA4 TCAA haplotype (order of SNPs: rs733618, rs5742909, rs231775, rs3087243) (Pc = 4·26 × 10^-3 , OR = 0·618, 95% CI = 0·540-0·858) and a higher frequency of a PTPN22 TTATACGCG haplotype (order of SNPs: rs3789604, rs150426536, rs1746853, rs1217403, rs1217406, rs3789609, rs1217414, rs3789612, rs2488457) (Pc = 2·83 × 10^-4 , OR = 1·457, 95% CI = 1·210-1·754) in scleritis patients when compared to healthy controls. In conclusion, our findings indicate that CTLA4 and PTPN22 might confer genetic susceptibility to scleritis in a Chinese Han population.

[Dynamic analysis of the academic influence in Chinese Journal of Hepatology from 2010 to 2016]

Objective: To dynamically analyze the discipline status, influence factors and key issues of Chinese Journal of Hepatology from 2010 to 2016 and explore the development rules of citation indexes. Methods: We collected information published by the China Institute of Scientific and Technological Information [China Science and Technology Journal Citation Report (Core Edition)] and Wanfang Database Periodicals statistical analysis platform from 2010 to 2016. A bibliometric analyses on article volume, citation frequency, citation rate, h-index, ratio of fund-aided papers, periodical influence, key number published period, number of relevant articles, and so on were analyzed for annual's impact factor. Results: According to the data released by the China Institute of Science and Technology Information, from 2010 to 2011, the impact factor of Chinese Journal of Hepatology was at leading level in the field of internal medicine and ranked sixth in the Journal of Internal Medicine. From 2012 to 2016, the overall comprehensive assessment score and citation frequency score of Chinese Journal of Hepatology were ranked first in the Journal of Gastroenterology. Core impact factors kept the discipline ahead. Indexes such as immediacy index, h- index, cited half-life and all other indicators were increased. Citation rate was >90% and cited issue number had greatly increased. Conclusion: Chinese Journal of Hepatology has a leading position in the Journal of Gastroenterology and credited by inland readers and authors of digestive and infectious fields. It has played a positive role in promoting the development of the discipline.

Protecting books from mould damage by decreasing paper bioreceptivity to fungal attack using decoloured cell-free supernatant of Lysobacter enzymogenes C3

AIMS

To evaluate whether decoloured cell-free supernatant of Lysobacter enzymogenes C3 can decrease paper bioreceptivity to fungal attack.

METHODS AND RESULTS

To prepare colourless C3 supernatant, single-factor design and uniform design were applied. The optimum conditions with high decolouration degree and low antifungal activity loss were achieved as follows: carbon granule content 1·6% (M/V), temperature 27°C, decolouring time 1·2 h and pH 8·0. An agar plate bioassay was used to assess the antifungal activity of the decoloured supernatant against the fungal isolates obtained from contaminated books, and strong suppression was observed. Small-sacle laboratory test was further introduced, in which common book papers were artificially inoculated with the fungal isolates, and then sprayed uniformly with decoloured supernatant or water. The results showed that, after treatment, the paper showed a significantly low extent of fungal colonization and high tensile strength, and maintained the same colour before and after treatment.

CONCLUSION

These results suggest that the decoloured C3 supernatant inhibits fungal growth on types of paper commonly used in books.

SIGNIFICANCE AND IMPACT OF THE STUDY

Decoloured C3 supernatant could be used as a preventive agent to protect books and other paper-based items against fungal growth.

Abstract P4-08-20: Pre-analytical effects of FFPE extraction methods on targeted and whole transcriptome sequencing assays for endocrine sensitivity in metastatic breast cancer

Background: The clinical management of patients with metastatic HR-positive breast cancer is often uncertain due to decreased sensitivity to anti-estrogen therapy over time. Recently, we developed a targeted RNAseq based 18-transcript SET ER/PR assay of endocrine sensitivity from biopsies of metastatic cancer. In this work we assess the effect of pre-analytical factors, specifically RNA extraction methods for FFPE tissue samples, on the reliability of the targeted RNAseq assay.

Methods: FFPE blocks and matched fresh frozen (FF) sections from 12 tumors were collected at MD Anderson Cancer Center. RNA from FFPE slides was extracted in duplicate using three kits (Norgen, Qiagen, Roche), and RNAseq libraries from all samples were prepared using Kapa Total RNAseq kit. Targeted RNA libraries were prepared using droplet-based PCR (RainDance), and also by transcriptome-wide RNAseq for comparison. Reads were mapped to genomic sequence using STAR and expression was quantified using RSEM. Expression data were normalized based on expression of 10 reference genes. The effect of FFPE RNA extraction kit on the reliability of the SET index was assessed using linear mixed effects model (LME) analysis, and agreement with FF was assessed using the concordance correlation coefficient (CCC).

Results: Analysis of the whole transcriptome RNAseq data confirmed minimal 3'-end transcript bias from FFPE samples, irrespective of transcript size or FFPE kit. All 18 genes included in the SET index had high overall concordance between FFPE and FF (median CCC percentile=98.8, range 57.2-99.9 for Norgen; similar for the other two kits) and relatively consistent bias across genes, as estimated by the random effects of the LME model. Furthermore, compared to random 18-gene indices, concordance in the SET index values between FF and FFPE was higher than 99.8% of the random samples, verifying the analytical reliability of the selected genes. For the targeted RNAseq assay, RNA from FFPE extracted with the Norgen kit showed the highest concordance compared to FF (CCC=0.956, 95%CI 0.871-0.985). In general, the analytical variation of SET from FFPE samples was greater than that from FF (1.71-2.71 fold greater), with the lowest variation associated with the Norgen kit. The SET index values from targeted RNAseq for both FF and FFPE samples were consistently lower compared to transcriptome-wide RNAseq but were highly correlated, with the Norgen kit having the highest correlation between targeted and transcriptome-wide RNAseq (rho=0.915).

Conclusions: All three FFPE RNA extraction kits have excellent analytical performance compared to FF samples. The Norgen kit may be marginally better yielding higher concordance with FF and lower analytical variation between replicates. All genes in the SET ER/PR showed very good analytical performance in comparison to random indices and individual genes. Targeted gene RNA sequencing appears very promising as a platform for clinical deployment of quantitative assays, showing only a small (fixable) bias compared to RNAseq.

Citation Format: Marczyk M, Fu C, Lau R, Du L, Trevarton AJ, Sinn BV, Gould RE, Symmans WF, Hatzis C. Pre-analytical effects of FFPE extraction methods on targeted and whole transcriptome sequencing assays for endocrine sensitivity in metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-20.

Electrospun composite nanofibre fabrics containing green reduced Ag nanoparticles as an innovative type of antimicrobial insole

In this study, polyvinyl alcohol (PVA) nanofibrous membranes containing silver nanoparticles (Ag NPs) were successfully fabricated by the combination of electrospinning and a green reduction approach. Through the electrospinning technique, uniform and smooth nanofibres can be obtained, and the Ag NPs with a narrow size distributions are well dispersed in PVA nanofibres. The investigation indicates that the mass ratio of reductant tea polyphenols and AgNO₃ play a crucial role in controlling the size of the Ag NPs. More importantly, multi-layered fabrics with a layer of PVA/Ag NP nanofibrous membrane layered onto cotton substrates were developed and applied to shoe insoles. The fabricated shoe insoles with functionalized PVA nanofibres exhibit remarkable antimicrobial activity against both E. coli and S. aureus (i.e. antibacterial rate > 99%). The creation of such an encouraging fabric could establish a new optimization methodology for producing nanoengineered functional textiles.

This study aims to develop an antimicrobial insole with an electrospun nanofibre mat which contains green reduced Ag NPs by a facile fabrication method.

Comparing the vascular thromboembolic events following arteriovenous fistula in Chinese population with end-stage renal diseases receiving Clopidogrel versus Beraprost sodium therapy: a retrospective cohort study

BACKGROUND

To assess the time to first on-study vascular thromboembolic events (VTEs) of clopidogrel (CL) or beraprost sodium (BPS) in Chinese population with end-stage renal disease (ESRD) treated with arteriovenous fistula (AVF) surgery.

METHODS

From Jan 2009 to May 2015, 346 ESRD cases suffering an AVF surgery and undergoing oral administration of 75 mg CL (initial dose of 300 mg), 1 time/day, for 4 weeks or 40 μg BPS, 3 times/day, for 4 weeks were retrospectively assessed. The primary outcome was time to first on-study VTE.

RESULTS

In total, 222 ESRD cases (CL, n = 112; BPS, n = 110) were assessed, with a median follow-up time of 38.1 months (range, 37-40 months). The mean time to first on-study VTE was 1.2 weeks (0.5-2.3) and 1.8 weeks (1.2-3.8) for CL and BPS, respectively (HR 0.27, 95% CI 0.16-1.45; P = 0.00). An increased incidence of VTEs was found during the 1th-month follow-up, with rates of 14.2 and 5.5% for CL and BPS, respectively (P = 0.03). The difference persisted over time, with rates of 24.1 and 11.8% at final follow-up, respectively (P = 0.02).

CONCLUSION

CL with an increased risk of VTEs tended to have a VTE within the 1st month after cessation compared with BPS.

Enhanced gross primary production and evapotranspiration in juniper-encroached grasslands

Woody plant encroachment (WPE) into grasslands has been occurring globally and may be accelerated by climate change in the future. This land cover change is expected to alter the carbon and water cycles, but it remains uncertain how and to what extent the carbon and water cycles may change with WPE into grasslands under current climate. In this study, we examined the difference of vegetation indices (VIs), evapotranspiration (ET), gross primary production (GPP), and solar-induced chlorophyll fluorescence (SIF) during 2000-2010 between grasslands and juniper-encroached grasslands. We also quantitatively assessed the changes of GPP and ET for grasslands with different proportions of juniper encroachment (JWPE). Our results suggested that JWPE increased the GPP, ET, greenness-related VIs, and SIF of grasslands. Mean annual GPP and ET were, respectively, ~55% and ~45% higher when grasslands were completely converted into juniper forests under contemporary climate during 2000-2010. The enhancement of annual GPP and ET for grasslands with JWPE varied over years ranging from about +20% GPP (~+30% for ET) in the wettest year (2007) to about twice as much GPP (~+55% for ET) in the severe drought year (2006) relative to grasslands without encroachment. Additionally, the differences in GPP and ET showed significant seasonal dynamics. During the peak growing season (May-August), GPP and ET for grasslands with JWPE were ~30% and ~40% higher on average. This analysis provided insights into how and to what degree carbon and water cycles were impacted by JWPE, which is vital to understanding how JWPE and ecological succession will affect the regional and global carbon and water budgets in the future.

[Analysis of copy number variation by CMA in fetus with increased nuchal translucency]

Objective: To investigated the clinical value of chromosomal microarray analysis (CMA) in fetuses with increased nuchal translucency (NT) . Methods: Totally 101 cases out of 19 261 singleton fetuses who underwent the first trimester (11-13⁺⁶ weeks) ultrasound examination from January 2015 to June 2017 at First Affiliated Hospital of Sun Yat-sen University were diagnosed with NT ≥2.5 mm and underwent invasive prenatal test for fetal karyotype and CMA. According to the combination of other ultrasound abnormalities, the cases were divided into isolated group (67.3%, 68/101) and complicated group (32.7%, 33/101) . In addition, the cases were divided into 5 groups according to the thickness of NT, 2.5-2.9 mm (borderline thickening; 16.8%, 17/101) , 3.0-3.4 mm (33.7%, 34/101) , 3.5-4.4 mm (16.8%, 17/101) , 4.5-5.4 mm (15.8%, 16/101) , and ≥5.5 mm (16.8%, 17/101) . Chi square test was used to detect the different rates of other combined ultrasound abnormalities and abnormal chromosome between 5 groups. Results: The median thickness of NT was 3.4 mm (2.5-8.5 mm) . And 32 cases (31.7%, 32/101) had abnormal karyotype. There was a significant difference in the frequency of abnormal karyotype between the isolated and the complicated group (20.6% vs 54.5%, P<0.01) . Among 69 cases (68.3%, 69/101) of normal karyotype, 3 cases (4.3%, 3/69) were detected with pathogenic copy number variation (CNV) by CMA. Thirty-five cases with chromosomal abnormalities (include abnormal karyotype and pathogenic CNV) , there was a significant difference in the frequency of chromosomal abnormalities between the isolated and the complicated group (23.5% vs 57.6%, P=0.001) . The median age of pregnant women in 5 groups was 35 years (24-39 years) , 33 years (23-46 years) , 31 years (21-46 years) , 33 years (21-41 years) and 35 years (21-43 years) . The rates of chromosomal abnormalities increased with the increase of NT thickness. There was significant difference in the incidence of associated chromosomal abnormalities among 5 groups (P<0.05) . Comparative analysis within the 5 groups, the incidence of associated chromosomal abnormalities between NT 2.5-2.9 mm and ≥5.5 mm was significantly different (P=0.005) , while the differences between the other groups were not significant (P>0.05) . Conclusions: There is a high risk of fetal chromosomal abnormalities in borderline NT thickening (2.5-2.9 mm) at advanced maternal age, but the pathogenic CNV is not detected. Chromosomal microdeletion or microduplication could be further detected in the NT thickening (≥3.0 mm) fetuses with normal karyotype by chromosome microarray analysis, while the positive rate is relatively low, and the variants of unknown significance might be detected.

Cardiac Shock Wave Therapy Attenuates Cardiomyocyte Apoptosis after Acute Myocardial Infarction in Rats

Background/Aims: Researches have showed that cardiac shock wave therapy (CSWT) could improve left ventricular function and attenuate LV remodeling of the ischemic heart. Apoptosis plays an important role in myocardial infarction and determines heart function and prognosis. However, it is still not clear whether CSWT is sufficient to attenuate acute myocardial infarction (AMI) induced cardiomyocyte apoptosis in vivo. In this study, we used a rat model to examine whether CSWT could attenuate cardiomyocyte apoptosis after AMI and to explore potential mechanisms. Methods: We generated an AMI rat model to investigate the function and possible regulatory mechanisms of CSWT. All rats were randomly divided into four groups: the sham-operated only group, sham-operated with SW treatment group, AMI only group, and AMI treated with SW treatment group.The rats were treated with a left anterior descending coronary artery ligation for 12h and then treated with or without CSWT (800 shots at 0.1 mJ/ mm2). Cytochrome c release was measured to analyze mitochondrial function and integrity. The apoptotic cell rate was determined by TUNEL assay. Western blot was used to analyze the cell apoptosis-, inflammation-, and survival-related signaling pathways. Results: First, the methodology of CSWT in the rat model of AMI was established. Second, CSWT attenuated the cardiomyocyte apoptosis rate in the infarct border zone. Third, CSWT suppressed the expression of apoptosis and inflammation molecules after AMI. Fourth, CSWT inhibited activation of the JNK pathway, which indicated inhibition of the cell inflammatory pathways and promotion of cardiomyocyte survival after AMI. Conclusion: These results indicate that CSWT exerts a protective effect against AMI-induced cardiomyocyte apoptosis, potentially by attenuating cytochrome c release from the mitochondria and inhibiting of the mitochondrial-dependent intrinsic apoptotic pathway. We also demonstrate that CSWT suppresses the JNK pathway and cardiomyocyte inflammation, which may also decrease cardiomyocyte apoptosis in vivo.