AB1328-HPR INCREASED BODY MASS INDEX AFFECTS SPINAL MOBILITY RATHER THAN DISEASE ACTIVITY IN ANKYLOSING SPONDYLITIS

Background:

Studies have reported the association between overweight or obesity and ankylosing spondylitis (AS), but their relation is still unclear in China.

Objectives:

To explore the prevalence of overweight or obesity and its effect on other indicators and their relationships in Chinese AS patients.

Methods:

Demographic and clinical variables were collected from 207 AS patients. Patients were categorized to normal BMI group (BMI < 23kg/m2) and overweight group (BMI ≥ 23kg/m2). We used Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Health Assessment Questionnaire (HAQ), Ankylosing Spondylitis Quality of Life (ASQoL) and Medical Outcomes Study Short Form 36 (SF-36) to evaluate disease activity, physical function, spinal mobility, functional limitation and health-related quality of life, respectively. Statistical analysis used independent t test, Mann-Whitney U test, Chi-square test and Spearman’s rank correlation test.

Results:

56.5% (117) AS patients were overweight or obese, among which 80.3% (94) were male. In the overweight group, patients were older, more being married, and have higher BMI, higher waist circumference, higher waist-to-hip ratio, longer disease duration, higher BASMI score, higher white blood cell count (WBC), higher lymphocyte and higher platelet count compared to the non-overweight group (P≤ 0.038). However, there was no distinct difference in BASDAI score between the two groups (P= 0.891). In the correlation analyses, gender and marital status (P≤ 0.036) were correlated negatively with BMI; while age, waist circumference, waist-to-hip ratio, WBC, lymphocyte count and red blood cell (P≤ 0.036) were correlated positively with BMI.

Conclusion:

Overweight or obesity is common in Chinese AS patients. Increased BMI affects not disease activity but spinal mobility, which indicates that patients with high BMI are more likely to have limitations in flexion, extension, lateral bending and torsion of spine.

References:

[1]Bowness P. Hla-B27. Annu Rev Immunol. 2015;33:29-48.

[2]de Araújo TA, Mota MC, Crispim CA. Obesity and sleepiness in women with fibromyalgia. Rheumatology International. 2014;35(2):281-7.

Acknowledgments:

This study was funded by Science and technology Project of Nantong City (Grant/Award Number: MSZ18217), Postgraduate Research & Practice Innovation Program of Jiangsu Province (Grant/Award number: KYCX19_2071 and KYCX18_2410), National Natural Science Foundation of China (Grant/Award number: 81671616 and 81871278), Science and technology Project of Jiangsu Province (Grant/Award number: BE2018671) and Clinical Research Center of Stem Cells, Affiliated Hospital of Nantong University, Nantong (Grant/Award number: HS2018001).

Disclosure of Interests:

None declared

0437 Characterizing the Impact of EEG Referencing on Sleep Spindle and Slow Oscillation Analyses

Introduction

The impact of EEG referencing on sleep oscillations, such as spindles and slow oscillations, is largely overlooked across studies. While it is recognized that a topographic head plot of EEG activity does not reflect the true location of the underlying cortical activity, spatial distributions, as well as spectral properties and morphology of EEG oscillations can change dramatically as a function of referencing scheme. It is therefore vital to understand the impact of referencing when drawing inferences about the nature of EEG sleep oscillations. In this study, we use MRI structural data to construct subject-specific forward models of EEG signals. Using these models, we can simulate cortical activity and observe its true representation on the scalp. In particular, we simulate spindles and slow wave oscillations and examine how referencing affects topography, spectral power, and phase of oscillations.

Methods

High-density EEG (Brain Vision, 64-channel) polysomnography was performed on 9 healthy young subjects. 3T structural MRI scans were acquired and forward models were built in MNE-Python using 3-shell Boundary Element Models (BEM) based on individual anatomical details processed with Freesurfer. Simulations of various sleep spindle and slow oscillation dynamics were projected to the sensor space. Different referencing schemes (common average, Laplacian, linked-mastoid) were then applied to the experimental and simulated data and analyzed for effects on time-frequency characteristics of sleep oscillations.

Results

Analyses of experimental data showed distinct reference-based differences in topographical distribution of spectral power and phase of oscillations. Simulated data revealed many scenarios in which the spatial distribution of activity the EEG sensor space poorly represented the true location of the underlying source activity. Moreover, there were alterations to the spatial spread and envelope form of sleep spindle events under different referencing schemes despite from identical source activities.

Conclusion

This study shows that spindle and slow oscillation activity is highly variable across referencing schemes and that EEG topographical plots on the scalp may poorly represent cortical activity locations. It is thus vital to consider the choice of referencing when quantifying characteristics of sleep EEG oscillations.

Support

This work was supported by R01 NS-096177.

0449 Characterizing Spindle Activity as a Time-Frequency Phenomenon

Introduction

Spindles are currently defined clinically based on observed patterns in the EEG waveform trace, with automated methods seeking to replicate visual scoring by experts. Recent work suggests that sleep spindles may be more readily observed as time-frequency peaks in the EEG spectrogram. This study compares spectral peaks in the multitaper spectrogram to expert and automatic detection scoring, characterizes the variability of spindles across a night, and investigates topographical and temporal clustering of spindles within individual EEG records.

Methods

We compared spectral peaks, expert scoring, and automatic detection in two datasets (DREAMS, and a high-density control study). Peaks were identified using multitaper spectral estimation and the peak prominence of the normalized power spectrum for each channel. Spatiotemporal variability analysis was performed using cluster and pattern recognition algorithms including penalized sorting of channel activation order, 2D-cross correlation, PCA and UMAP cluster analysis, and the seqNMF method.

Results

Spectral peaks were shown to be highly robust to and easily differentiated from broadband noise, occuring at rates (10-16 per min) far exceeding spindle rates reported in literature (~2.5 per min). Expert scoring and automated scoring failed to capture clear spectral peaks in the time-frequency domain, indicating an underreporting of the phenomenology. No apparent clustering or patterns of sleep spindle-like activity was observed using the proposed methods, suggesting high variability of spatiotemporal evolution of spindles.

Conclusion

These results suggest that the difficulty of time-domain visual scoring of spindles causes an artificially low estimate of the underlying phenomenology, which is mirrored in the assumptions implicit in the thresholds of automated scorers. This work shows that spindles are highly variable in their spatiotemporal evolution, suggesting that there is no optimal single electrode for analysis and casting doubt on the presence of a single cortical generation mechanism. We must therefore revisit the concept of the spindle using the time-frequency domain to more robustly characterize underlying phenomenology.

Support

National Institute Of Neurological Disorders And Stroke Grant R01 NS-096177

Therapeutic effects of chimeric antigen receptor T cells (CAR-T) on relapse/refractory diffuse large B-cell lymphoma (R/R DLBCL): a meta-analysis

OBJECTIVE

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL). This study aimed to systematically evaluate the efficacy of chimeric antigen receptor T cells (CAR-T) in treating relapse/refractory DLBCL (R/R DLBCL) and associated complete-remission rate (CR).

MATERIALS AND METHODS

PubMed, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases were searched, and literature was collected up to January 2019. According to inclusion criteria and exclusion criteria, two researchers independently reviewed and screened literature, extracted required data and crossly checked them. This meta-analysis was conducted using RevMan 5.3 software.

RESULTS

This study finally included 13 English literatures and 263 cases. There was no heterogeneity among all these studies, therefore, fixed effect model was used. Meta-analysis findings showed that total CR rate of R/R DLBCL treated with CAR-T was 46.8% (95% CI: 0.408-0.533). Subgroup analysis showed that CR rate of CD28 group was slightly higher [52.5%, with 95% confidence interval (CI): 0.441-0.602] compared to that of 4-1BB group (41.5%, with 95% CI: 0.324-0.510). CR rate of CD19 group was slightly higher (49.2%, with 95% CI: 0.429-0.556) compared to that of CD20 group (42.2%, with 95% CI: 0.231-0.639). Funnel chart of total CR rate, co-stimulatory factor, and target antigen demonstrated fundamental symmetry. Moreover, age, HSCT administration, CAR-T cell counts, and drug pre-treatment also affected immunotherapy on CAR-T on R/R DLBCL.

CONCLUSIONS

CAR-T treatment for R/R DLBCL demonstrated evident curative effect and high complete remission rate. CAR-T cell immunotherapy would be expected to become mainstream therapy for hematolymph system tumors.

All in one plasma process: From the preparation of S-C composite cathode to alleviation of polysulfide shuttle in Li-S batteries

Tremendous efforts have been made to improve the electrochemical performance of the lithium-sulfur batteries. However, challenges remain in achieving fast electronic and ionic transport while accommodate the significant cathode volumetric change. On the other hand, the severe capacity decay mainly attributed to polysulfide shuttle also hampers the practical applications. Here, we report a simple, low-cost, and eco-friendly method for the one-step preparation of a binder-free S-C composite cathode by plasma dissociation of CS₂ containing gases at room-temperature. The key issue of polysulfide shuttle effect in Li-S batteries is also effectively resolved just by the introduction of N₂ into the precursor gases. The electrode exhibits a high reversible capacity of ~600 mAh/g of the total hybrid of S + C at 100 mA/g after 100 cycles with an excellent initial coulombic efficiency of nearly 100%. The cells also demonstrate along cycle life and an extremely high capacity of ~306 mAh/g even after 300 cycles at 1 A/g with a high coulombic efficiency of about 100%. The proposed method will open the way for the plasma applications in facile preparation of Li-S batteries and the improvement of its electrochemical performance.

[Clinical efficacy and pregnancy outcomes of fertility-preserving re-treatment after recurrence of the patient with atypical endometrial hyperplasia and early stage endometrial carcinoma]

Objective: To analyze the clinical efficacy and pregnancy outcomes of fertility- preserving re-treatment in patients with recurrent atypical endometrial hyperplasia (AEH) and early stage endometrial carcinoma (EEC) after achieved complete remission (CR) of primary fertility-preserving therapy. Methods: There were 104 cases of AEH and EEC collected from 9 hospitals in the multi-center research network platform of fertility-preserving therapy of endometrial carcinoma in China from January 2005 to May 2019. Thirth-one cases of them relapsed from four hospitals mentioned above,who achieved CR after primary fertility-preserving therapy,was analyzed retrospectively. Of the 31 cases, 27 cases chose fertility-preserving re-treatment. The demographic characteristics, re-treatment effect, clinical factors and pregnancy outcomes were observed. Results: (1) There were 16 AEH cases and 11 ECC cases among 27 recurrent patients who chose fertility-preserving therapy again. After re-treatment, CR was found in 13 out of 16 cases of AEH and 9 out of 11 cases of EEC. The overall CR rate was 81% (22/27). (2) After CR of recurrence, 5 cases (23%, 5/22) of re-recurrence were found after with a median time of 33 months (range 21-80 months). There were 4 cases underwent comprehensive surgical staging, and 1 patient chose the third round of fertility preservation therapy with fully informed consent, and CR was reached after 15 months. (3) There were 16 cases with pregnancy intention, with a total of 12 pregnancies, including 5 cases were natural pregnancy and 7 cases were assisted reproductive technology pregnancy. There were 5 live births. The follow-up time was up to May 2019, and the median follow-up time was 73 months (range 0-123 months). All 27 patients had disease free survival. Conclusions: Recurrent patients with AEH and EEC after achieving successful fertility-preserving therapy could choose fertility-preserving therapy again with comprehensive assessment and fully informed consent. After re-treatment, there is a certain tumor CR rate and pregnancy rate, while the close follow-up is required during treatment.

Comparing the Cell Dynamics of Tree-Ring Formation Observed in Microcores and as Predicted by the Vaganov-Shashkin Model

New insights into the intra-annual dynamics of tree-ring formation can improve our understanding of tree-growth response to environmental conditions at high-resolution time scales. Obtaining this information requires, however, a weekly monitoring of wood formation, sampling that is extremely time-intensive and scarcely feasible over vast areas. Estimating the timing of cambial and xylem differentiation by modeling thus represents an interesting alternative for obtaining this important information by other means. Temporal dynamics of cambial divisions can be extracted from the daily tree-ring growth rate computed by the Vaganov-Shashkin (VS) simulation model, assuming that cell production is tightly linked to tree-ring growth. Nonetheless, these predictions have yet to be compared with direct observations of wood development, i.e., via microcoring, over a long time span. We tested the performance of the VS model by comparing the observed and predicted timing of wood formation in black spruce [Picea mariana (Mill.)]. We obtained microcores over 15 years at 5 sites along a latitudinal gradient in Quebec (Canada). The measured variables included cell size and the timing of cell production and differentiation. We calibrated the VS model using daily temperature and precipitation recorded by weather stations located on each site. The predicted and observed timing of cambial and enlarging cells were highly correlated (R ² = 0.8); nonetheless, we detected a systematic overestimation in the predicted timing of cambial cells, with predictions delayed by 1-20 days compared with observations. The growth rate of cell diameter was correlated with the predicted growth rate assigned to each cambial cell, confirming that cell diameter developmental dynamics have the potential to be inferred by the tree-ring growth curve of the VS model. Model performances decrease substantially in estimating the end of wood formation. The systematic errors suggest that the actual relationships implemented in the model are unable to explain the phenological events in autumn. The mismatch between the observed and predicted timing of wood formation in black spruce within our study area can be reduced by better adapting the VS model to wet sites, a context for which this model has been rarely used.

The Initiation of Swallowing Can Indicate the Prognosis of Disorders of Consciousness: A Self-Controlled Study

Objective: To detect the initiation of swallowing in patients with disorders of consciousness (DOC) as well as the relationship between the initiation of swallowing and the prognosis of DOC patients. Methods: Nineteen DOC patients were included in this study, and a self-controlled trial compared five different stimuli. The five different stimuli were as follows: (1) one command, as recommended by the Coma Recovery Scale-Revised (CRS-R), which was "open your mouth"; (2) placing a spoon in front of the patient's mouth without a command; (3) placing a spoon filled with water in front of the patient's mouth without a command; (4) one command-"there is a spoon; open your mouth"-with a spoon in front of the patient's mouth; (5) one command, "there is a spoon with water; open your mouth," with a spoon filled with water in front of the patient's mouth. All 19 patients were given these five stimuli randomly, and any one of the commands was presented four times to a patient, one at a time, at 15-s intervals. The sensitivity and specificity of the initiation of swallowing in detecting conscious awareness were determined. Results: None of the patients responded to the first four stimuli. However, six patients showed initiated swallowing toward the fifth stimulus. Among those six, five patients showed improvement in their consciousness state 6 months later. The sensitivity and specificity of the initiation of swallowing for DOC patients was 83.33% [95% CIs (36%, 100%)] and 92.31% [95% CIs (64%, 100%)], respectively. Conclusions: The initiation of swallowing can be an early indication of conscious behavior and can likely provide evidence of conscious awareness. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03508336; Date of registration: 2018/4/16.

P6420Can machine learning help us improve risk stratification of diabetic patients with acute coronary syndromes? The answer will blow your mind

Background

Risk stratification following an acute coronary syndrome (ACS) is of utmost importance, in order to identify patients at higher risk of subsequent cardiovascular events. Diabetic patients have a significantly worse prognosis, so new risk prediction tools are important to better identify and risk stratify high risk patients within this important ACS subpopulation.

Aim

The aim of this study was to identify the best predictors of a new ACS, in a single-center database of ACS, resorting to machine learning and artificial intelligence, and to compare the Global Registry of Acute Coronary Events (GRACE) risk score's relevance for risk discrimination in a general ACS population versus a subpopulation of diabetic patients.

Methods

In a single center, 5977 patients admitted due to ACS between 2004 and 2017 and alive at discharge were studied. In the subpopulation of diabetic patients (n=3429), each covariate present in the database was analyzed separately with a Cox proportional hazard model with three terms – subpopulation belonging indicator, covariate, interaction term. The p-value of the interaction term was used to rank variables. The more significant the interaction term, the stronger the change in relationship between patients in the subpopulation and the risk of a new ACS, compared to the one in the general population.

Results

During long term follow-up, 13% of patients (n=771) experienced a second event. Kaplan-Meier curve represents how ACS free-survival depends on the GRACE risk score and group of interest. In the general population and in the subpopulation of diabetic patients, the GRACE score was used to further divide patients into 3 terciles, of which only the lower and upper tercile are shown (GRACE ≤113 and GRACE >144, respectively). The solid lines represent Kaplan-Meier curves for diabetic patients, and the dotted lines in the general population. Pink or grey colour of the curves represent the stratification level of the covariate.

Conclusions

In our model, the GRACE risk score was found to be a better discriminator of risk of futher ACS in diabetic patients than in the general ACS population. Strikingly, a higher GRACE score predicts a lower rate of readmission, probably because many patients will die in the index hospitalization or out of hospital. This finding reinforces the usefulness of the GRACE score in high risk patients and may improve risk stratisfication in diabetic post-ACS patients, making sure that they are closely followed and submitted to optimal risk factor management, in order to improve their post-ACS prognosis.

Extraction of the ^{235}U and ^{239}Pu Antineutrino Spectra at Daya Bay

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

Phenylethynyl-terminated oligoimides based on bis(p-aminophenoxy)dimethyl silane: Effect of siloxane structure on processability and thermal stability

A series of phenylethynyl-terminated oligoimides based on 2,3,3′,4′-biphenyltetracarboxylic dianhydride (a-BPDA), 2,2′-bis(trifluoromethyl)benzidine (TFDB), and bis( p-aminophenoxy)dimethyl silane (APDS) with different siloxane content and various calculated molecular weights were synthesized. The effect of siloxane structure on the processability of oligoimides and the thermal stability of cured polyimides (PIs) was investigated. The results indicated that the oligoimides have lower melt viscosity and broader processing window with the incorporation of flexible siloxane segment. The thermal stability of the cured PIs can be significantly enhanced by high-temperature postcuring due to the oxidative cross-linking of siloxane. The polyimide PI-s1-15 exhibited good balance between processability and thermal stability with the minimum melt viscosity of 0.4 Pa·s at 325°C and glass transition temperature as high as 470°C after postcuring at 450°C. The carbon fiber-reinforced composite T800/PI-s1-15 displayed excellent high-temperature performance, which gave the flexural strength and interlaminar shear strength of 703 and 33 MPa, respectively, when tested at the temperature as high as 450°C.

Correlations of ultrasound and pathological features of thyroid carcinoma with TC-1 mRNA and protein expression

OBJECTIVE

To investigate the correlations of ultrasound and pathological characteristics of thyroid carcinoma through evaluating the messenger ribonucleic acid (mRNA) level and protein expression of thyroid cancer-1 (TC-1).

PATIENTS AND METHODS

The patients with papillary thyroid carcinoma (PTC) hospitalized in our hospital were enrolled. Then, real-time fluorescence quantitative polymerase chain reaction (qPCR) and immunohistochemistry (IHC) streptavidin-peroxidase (SP) technique were applied to measure the mRNA and protein expression levels of TC-1 in PTC and corresponding adjacent tissues (NCE) of 50 patients. The relations with clinicopathological and ultrasound characteristics were analyzed.

RESULTS

The expression of TC-1 mRNA in PTC tissues was statistically higher than that in corresponding adjacent tissues and significantly correlated with tumor-node-metastasis (TNM) stage, pathological grade, and lymph node metastasis of PTC (p<0.05). According to IHC, TC-1 positive expression was mainly found in the cytoplasm in PTC samples, which was statistically increased compared to adjacent tissues (p<0.05). Western blotting results revealed that the relative protein expression of TC-1 in PTC tissues was 2.646±195, which was significantly higher than that in corresponding adjacent tissues (892±76) (p<0.05). The TC-1 protein expression also showed significant associations with TNM stage, pathological grade, and lymph node metastasis of patients (p<0.05). The level of TC-1 mRNA in PTC tissues with micro-calcification detected by ultrasound (87.46±49.55) was higher than that in those without micro-calcification (38.46±29.15) (p<0.05).

CONCLUSIONS

The expression of TC-1 plays an important role in the occurrence and development of PTC. Ultrasound characteristics reflect the expression of TC-1 in PTC tissues to some extent, providing a certain value in evaluating the prognosis of PTC.

Abstract P4-13-10: The outcome of lung metastasis treated with fulvestrant is superior to that of liver metastasis for metastatic breast cancer

Background: Endocrine therapy is the preferred option in patients presenting with hormone receptor (HR)-positive metastatic breast cancer (MBC). While visceral metastasis is a negative prognostic factor, few studies have distinguished between the prognosis of different visceral sites.

Patients and methods: 505 HR-positive MBC patients administered with fulvestrant at Fudan University Shanghai Cancer Center during a 6-year period were enrolled, 398 patients receiving fulvestrant 500mg were included in final analysis. Logistic regression models were used to identify prognostic factors associated with progression-free survival (PFS). Kaplan-Meier analysis was utilized to compare PFS of lung and liver metastases.

Results: Median follow-up time was 26 months. 233 patients presented with baseline visceral metastases, including 138 lungw/o liver metastases (lung metastasis without liver involvement), 51 liverw/o lung metastases (liver metastasis without lung involvement), and 41 with both lung and liver metastases. Median PFS was 6.8 months (5.6 months for visceral metastases, 9.2 months for non-visceral metastases, P = 0.028). Lungw/o liver metastases had longer median PFS compared to liverw/o lung metastases or both lung and liver metastases (9.6 months, 3.7 months and 3.2 months, respectively, P &lt; 0.001). In addition, patients with liver metastases experienced a significantly worse PFS when compared with those without liver involvement (3.7 versus 9.2 months, P &lt; 0.001). In multivariate analyses, PFS benefits of fulvestrant were observed in patients with longer disease-free interval, absence of liver metastases, and no previous chemotherapy for MBC.

Table 1.Univariate and multivariate analysis of progression-free-survival by prespecified stratification factors.VariablesN Univariate  Multivariate   Mediana95% CIPHR95% CIPMenopausal status       Premenopausal8411.06.4-15.7 ---Postmenopausal3145.94.7-7.10.052---Disease-free interval       &gt; 5 y1818.65.8-11.5 1  ≤ 5 y1714.83.6-6.00.0031.421.01-1.990.043PgR status       Positive2856.95.3-8.6 ---Negative + UK1135.54.6-6.30.107---Bone-only metastasis       Yes6110.92.7-19.0 1  No3375.84.8-6.80.0021.690.91-2.800.06Metastatic sites       Non-visceral1659.26.7-11.7 1  Lungw/o liver1389.65.3-13.90.860---Liver923.72.9-4.5&lt;0.0011.511.05-2.180.027ET naïve       Yes3226.8NE-59.3 1  No3666.04.9-7.20.012.120.99-4.540.052Prior ET for metastatic disease       014511.05.5-16.6 1  ≥12535.64.9-6.30.0020.910.62-1.340.645Sensitivity to prior ET       Primary resistance714.02.9-5.0 ---Secondary resistance2957.05.6-8.30.05---Prior chemotherapy for metastatic disease       02039.96.5-13.2 1  ≥11954.73.9-5.5&lt;0.0011.931.32-2.820.001Abbreviations: PgR, progesterone receptor; UK, unknown; HR, hazard ratio; 95% CI, 95% confidence interval; ET, endocrine therapy; NE, not estimable. Lungw/o liver, lung metastasis without liver involvement. aMedian PFS in months. P &lt; 0.05 was considered significant, significant values was presented in bold.

Conclusion: Patients with lungw/o liver metastases benefit as well as those with non-visceral metastases from fulvestrant. Visceral metastases should distinguish between liver or lung when treating HR-positive/HER2-negative MBC with endocrine therapy.

Citation Format: He M, Li J-J, Zuo W-J, Ji L, Hu X-C, Wang Z-H, Shao Z-M. The outcome of lung metastasis treated with fulvestrant is superior to that of liver metastasis for 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 P4-13-10.

Electronic structure of multiferroic BiFeO3: Electron energy-loss spectroscopy and first-principles study

The electronic structure of BiFeO₃ has been investigated by using electron energy loss spectrum and first-principle calculations. Assignments of the individual interband transitions have been accomplished by comparing the interband transition energy with the calculated PDOS. The DOS is mainly divided into two regions, the hybridized region of O 2p with Fe 3p in the valence band and that of O 2p hybridized with Bi 6p in the conduction band. From the simulation of high energy-loss near-edge structure, the core-hole effect is believed to be more significant. The feature groups for the experimental spectra of O K-edge and Fe L_2,3-edge are consistent with simulation results.

[Impact factor of postoperative prognosis of esophageal cancer patients with stage pT2N0~1M0]

Objective: To investigate the postoperative prognosis and the related factors of patients with stage pT2N0-1M0 of thoracic esophageal carcinoma(EC). Methods: From 2008 to 2011, clinical data of 275 cases with stage pT2N0-1M0 of thoracic EC treated by esophagectomy were enrolled. These cases includ 180 male and 95 female. Among them, 32 cases were upper thoracic EC, 186 cases were middle thoracic EC and 57 cases were lower thoracic EC. Alternatively, 205 cases were stage pN0, 70 cases were stage pN1. 155 cases received esophagectomy alone and 120 cases received esophagectomy and postoperative adjuvant therapy. Results: The end of follow-up time was on September 30th, 2014. The 1-, 3-, 5-year overall survival (OS) rates were 91.6%, 70.2% and 63.7%, respectively. The 1- 3-, 5-year progression-free survival (PFS) rates were 83.9%, 64.0% and 60.0%, respectively. The result of univariate analysis showed that the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with OS (all of P<0.05). Moreover, the gender, the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with PFS (all of P<0.05). Cox multivariate analysis showed that the location of primary tumor and pN stage were the independent factors of OS (both P<0.05). The gender, pN stage and postoperative adjuvant therapy were the independent factors of PFS (all of P<0.05). Conclusion: Among the patients with pT2N0~1M0 stage of thoracic EC, patients with upper thoracic EC or pN1 stage have poorer postoperative prognosis compared with others, and postoperative adjuvant treatment is recommended for these patients.

Validation of the Chinese version of the Coma Recovery Scale-Revised (CRS-R)

PRIMARY OBJECTIVE

This study aims to validate the Chinese version of the Coma Recovery Scale-Revised (CRS-R).

METHODS

One hundred sixty-nine patients were assessed with both the CRS-R and the Glasgow Coma Scale (GCS), diagnosed as being in unresponsive wakefulness syndrome (UWS, formerly known as vegetative state), minimally conscious state (MCS), or emergence from MCS (EMCS). A subgroup of 50 patients has been assessed twice by the same rater, within 24 h. Patient outcome was documented six months after assessment.

RESULTS

The internal consistency for the CRS-R total score was excellent (Cronbach's α = 0.84). Good test-retest reliability was obtained for CRS-R total score and subscale scores (intra-class correlation coefficient [ICC] = 0.87 and ICC = 0.66-0.84, respectively). Inter-rater reliability was high (ICC = 0.719; p < 0.01). Concurrent validity was good between CRS-R total scale and GCS total scale. Diagnostic validity was excellent compared with GCS (emerged from UWS: 24%; emerged from MCS: 28%). When considering patient outcome, diagnostic validity was good. In addition, false-positive rates have been detected for both diagnoses.

CONCLUSION

The Chinese version of the CRS-R is a reliable and sensitive tool and can discriminate patients in UWS, MCS, and EMCS successfully.