The Combined Effect of Hearing Impairment and Cognitive Impairment with Health-Related Outcomes in Chinese Older People

OBJECTIVES

To determine the risk of poor health-related outcomes in older adults with cooccurring hearing impairment and cognitive impairment, and to compare the risk of hearing impairment only, cognitive impairment only, and multiple morbidities.

DESIGN

Cross-sectional study.

SETTING

Community-dwelling older adults aged 60 years and older were included.

PARTICIPANTS

The data of missing hearing and cognitive status were excluded, and 3770 older people participated in the study.

MEASUREMENTS

The hearing function evaluation was conducted by questionnaire survey. Assessment of cognitive function was completed using the SPMSQ scale. The subjects were divided into hearing impairment and cognitive impairment group, hearing impairment only group, cognitive impairment only group and neither group. Multiple logistic regression was used to analyze the risks of hearing and cognitive impairment and health-related condition.

RESULTS

The prevalence of hearing impairment and cognitive impairment, hearing impairment only, cognitive impairment only, and neither were 9.4%, 8.3%, 29.9% and 52.4%, respectively. Compared with the control group, the individuals with hearing impairment and cognitive impairment were associated with depression (OR=3.48, 95% CI=2.66, 4.56), anxiety (OR=2.35, 95% CI=1.92, 3.33), frailty (OR=4.30, 95% CI=2.89, 6.40), and ADL impairment (OR=2.77, 95% CI=2.03, 3.77).

CONCLUSION

The studies shows that hearing impairment combined with cognitive impairment is significantly associated with anxiety, depression, frailty, and ADL impairment. Comprehensive management and intervention should be provided for older people to reduce the occurrence of adverse health consequences.

[Endemic situation of schistosomiasis in national surveillance sites of Hubei Province from 2015 to 2019]

OBJECTIVE

To analyze the changing tendency in the endemic situation of schistosomiasis in the national surveillance sites of Hubei Province, so as to provide the scientific evidence for facilitating the progress towards the elimination of schistosomiasis in the province.

METHODS

According to the National Schistosomiasis Surveillance Scheme (2014 version), a total of 65 national schistosomiasis surveillance sites were assigned in Hubei Province, and the Schistosoma japonicum infections in humans, domestic animals, snails and wild feces were monitored in these national surveillance sites from 2015 to 2019. All data pertaining to the surveillance results were descriptively analyzed.

RESULTS

There were 151 159 person-time local residents and 70 928 person-time mobile populations screened for S. japonicum infections in the 65 national surveillance sites of Hubei Province from 2015 to 2019, and the seroprevalance of S. japonicum infections reduced from 3.45% (1 077/31 197) in 2015 to 1.57% (431/27 371) in 2019 among local residents and from 1.06% (98/9 249) in 2015 to 0.81% (116/14 318) in 2019 among mobile populations. During the period from 2015 through 2019, there were 22 egg-positive local residents and 2 egg-positive mobile populations identified in 2015, with 0.07% and 0.02% prevalence rates of S. japonicum infections, respectively. During the 5-year period, a total of 7 025 herd-time domestic animals examined for S. japonicum infections, with no infections detected, and a total of 2 035 wild feces were tested, with no egg-positives identified in the 65 national surveillance sites of Hubei Province. Snail survey was conducted covering 28 767.35 hm² during the 5-year period, and the area of snail habitats ranged from 1 609.82 to 2 119.81 hm². The mean density of living snails and occurrence of frames with snails reduced from 0.360 5 snails/0.1 m² and 11.26% in 2015 to 0.175 9 snails/0.1 m² and 8.43% in 2019, respectively, and no S. japonicum infection was found in snails during the 5-year period. In addition, no snails were found in the potential schistosomiasis transmission foci in the two national surveillance sites in the Three Gorges Dam.

CONCLUSIONS

The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hubei Province during the period from 2015 through 2019; however, the schistosomiasis transmission risk remains. Improving the surveillance system of schistosomiasis and increasing the sensitivity and performance of the surveillance system are required to provide insights into the implementation of precision control strategy and interventions in Hubei Province.

Effects of lncRNA MALAT1-mediated β-catenin signaling pathway on myocardial cell apoptosis in rats with myocardial ischemia/reperfusion injury

OBJECTIVE

To investigate the effects of long non-coding ribonucleic acid (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) on myocardial ischemia/reperfusion (I/R) injury in rats and its mechanism, and to provide a certain reference for the clinical prevention and treatment of myocardial infarction.

MATERIALS AND METHODS

A total of 60 male Sprague-Dawley rats were divided into 3 groups using a random number table, including the Sham group (n=20), I/R group (n=20) and I/R + MALAT1 small interfering RNA (siRNA) group (n=20). An I/R model was established by means of recanalization after ligation of the left anterior descending coronary artery of the rats. The rats in the I/R + MALAT1 siRNA group were used to establish a model of MALAT1 knockdown by injecting MALAT1 siRNA from the tail vein. The myocardial infarction area in each group was detected via 2,3,5-triphenyl tetrazolium chloride (TTC) staining. The ejection fraction% (EF%) and fractional shortening% (FS%) of the heart in each group were measured through echocardiography. Hematoxylin and eosin (H&E) staining was adopted to determine the morphological changes in myocardial cells in each group. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining was performed to detect the apoptosis levels of myocardial cells and fibroblasts in the cardiac tissues in each group, and Western blotting assay was conducted to measure the expression levels of apoptosis-related proteins [B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax)]. In addition, the content of β-catenin in the three groups of rats was determined via immunohistochemical staining. Finally, the impacts of MALAT1 siRNA on the expression level of β-catenin protein were detected using Western blotting assay.

RESULTS

MALAT1 siRNA could prominently ameliorate the I/R-induced cardiac insufficiency in the rats and improve the EF% and FS% of the heart (p<0.05). Moreover, MALAT1 siRNA was able to remarkably inhibit the I/R injury-induced myocardial infarction, reducing the infarction area from (59.54±3.45) to (24.85±1.30; p<0.05). The results of the H&E staining indicated that compared with those in the I/R group, the myofilaments of the myocardial cells were well-arranged, the degrees of degradation and necrosis of the myofilaments declined, and the cellular edema was relieved markedly in the I/R + MALAT1 siRNA group. It was shown in the results of immunohistochemistry and Western blotting that MALAT1 siRNA could notably reverse the I/R-induced up-regulation of β-catenin expression (p<0.05).

CONCLUSIONS

MALAT1 knockdown can significantly ameliorate the I/R-induced myocardial injury and improve the cardiac function of the rats, whose mechanism is probably correlated with the inhibition of MALAT1 siRNA on β-catenin. Therefore, MALAT1 siRNA is expected to become a new target for the treatment of myocardial infarction.

The single nucleotide polymorphism rs11643718 in SLC12A3 is associated with the development of diabetic kidney disease in Chinese people with type 2 diabetes

AIMS

To examine the association between 24 literature-based single nucleotide polymorphisms and diabetic kidney disease in Chinese people with type 2 diabetes.

METHODS AND RESULTS

Twenty-four candidate diabetic kidney disease-susceptible single nucleotide polymorphisms were genotyped in 208 participants with type 2 diabetes and diabetic kidney disease and 200 participants with type 2 diabetes without diabetic kidney disease (case and control groups, respectively), together with 206 healthy participants using MassARRAY. Rs11643718 in the SLC12A3 gene was associated with diabetic kidney disease in the recessive model after adjusting for confounding factors, such as age and gender (adjusted odds ratio 2.056, 95% CI 1.120-3.776; P = 0.020). Meta-analyses further confirmed the association (P = 0.002). In addition, participants with the GG genotype had worse renal function and more albuminuria than those with the AA+AG genotype (P < 0.05). Renal section immunohistochemistry was conducted in participants with type 2 diabetes, diabetic kidney disease and AA+AG or GG genotypes and in participants with glomerular minor lesions. Together with data from the Nephroseq database, it was shown that the abundance of SLC12A3 was reduced in patients with the GG genotype, while elevated expression of SLC12A3 was associated with better renal function. In addition, rs10951509 and rs1345365 in ELMO1, which were determined to be in high linkage disequilibrium by SHEsis software, were also associated with diabetic kidney disease (adjusted P = 0.010 and 0.015, respectively).

CONCLUSIONS

The G allele and GG genotype of SLC12A3 rs11643718 are associated with the development of diabetic kidney disease in a Chinese population with type 2 diabetes.

[Correlation between compassion fatigue and workplace violence in emergency department nurses]

Objective: To investigate the workplace violence and compassion fatigue of nurses in emergency department and to explore the relationship between the two. Methods: The general information questionnaire, workplace violence scale and professional quality of life scale were used to investigate 957 emergency department nurses of 28 Level II hospitals and above. Results: The scores of each dimension of the professional quality of life scale for nurses in the emergency department were: compassion satisfaction score was 29.91±7.82, the burnout score was 26.63±5.66, and the second trauma score was 23.17±5.94. The total score of compassion fatigue is 49.80±10.42. The incidence of workplace violence was 77.6%. Workplace violence was negatively correlated with compassion satisfaction (r=-0.250, P<0.01) , and positively correlated with burnout, secondary trauma, and total compassion fatigue (r=0.349、0.340、0.384, P<0.01) . Whether there is only non-physical violence in the compassion satisfaction, burnout, secondary trauma, compassion fatigue total score is not statistically significant. Conclusion: Compassion fatigue is more serious in emergency department nurses, and the incidence of workplace violence is higher. Workplace violence has a positive effect on compassion fatigue. Nursing managers should actively prevent workplace violence and improve the working environment, thus reducing empathy fatigue.

Actions of putative embryokines on development of the preimplantation bovine embryo to the blastocyst stage

Once it enters the uterus at d 4 to 5 after ovulation, the preimplantation bovine embryo is controlled in its development by regulatory signaling molecules from the mother called embryokines. Here, several cell-signaling molecules whose genes are expressed in the endometrium during d 5 to 7 after estrus were tested for the ability to affect the competence of the embryo for further development and the characteristics of the resultant blastocysts. Molecules tested were C-natriuretic peptide (CNP), IL-8, bovine morphogenetic protein 4 (BMP-4), IL-6, and leukemia inhibitory factor (LIF). None of the cell-signaling molecules tested improved the competence of the embryo to become a blastocyst; in fact, BMP-4 decreased development. All molecules modified attributes of the blastocyst formed in culture. In particular, CNP increased the number of cells in the ICM, whereas IL-8 decreased inner cell mass cell numbers and tended to increase the proportion of blastocysts that were hatching or hatched. In addition, BMP-4 decreased the proportion of blastocysts that were hatching. Interleukin-6 and, to a lesser extent, LIF activated the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in the inner cell mass, and LIF increased the percent of cells in the blastocyst that were positive for both NANOG and phosphorylated (activated) STAT3. In conclusion, our results indicate that CNP, IL-8, IL-6, LIF, and BMP-4 can modify embryonic development of the cow in a manner that affects characteristics of the resultant blastocyst. Further research is required to understand how these changes in characteristics of the blastocyst would affect competence of the embryo to establish and maintain pregnancy.

MicroRNA-889 promotes cell proliferation in colorectal cancer by targeting DAB2IP

OBJECTIVE

Colorectal cancer (CRC) remains one of the most frequent lethal malignant tumors worldwide. The correlation between miR-889 expression and CRC progression has not been well identified in the recent literature. Here, we aim to detect the role and mechanism of miR-889 in CRC.

PATIENTS AND METHODS

First, miRNA RT-PCR (Real Time-Polymerase Chain Reaction) was performed to determine miR-889 expression in CRC tissues and cells. The proliferative capacity of cells transfected with miR-889 mimics, miR-889 inhibitor or NC was measured by CCK-8 (cell counting kit-8), colony formation and EdU (5-Ethynyl-2'-deoxyuridine) assays. The online bioinformatics sites were chosen to predict possible downstream regulatory genes of miR-899. The dual-luciferase report assay was conducted to verify the relation between DAB2IP (DAB2 interacting protein) and miR-899. The expression changes of DAB2IP were assessed by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot.

RESULTS

MiR-889 was upregulated in CRC tissues and CRC cells, and upregulated miR-889 was confirmed to promote cell growth in vitro. Dual-luciferase reporter, qRT-PCR, and Western blot assays suggested that DAB2IP might be regulated by miR-889. The effects of miR-889 on proliferation could be abolished by DAB2IP through confirmatory experiments. By directly targeting DAB2IP, miR-889 served as a vital part in accelerating CRC cell proliferation.

CONCLUSIONS

Our current study substantiated that miR-889 might participate in controlling CRC proliferation by regulating DAB2IP, which provides potential and prospective therapeutic target for CRC.

Immunogenicity and safety of different sequential schedules of Sabin strain-based inactivated poliovirus vaccination: A randomized, controlled, open-label, phase IV clinical trial in China

BACKGROUND

The immunogenicity and safety of the sequential schedule of Sabin strain-based inactivated poliovirus vaccine (sIPV) and bivalent oral poliovirus vaccine (bOPV) remains poorly understood in Chinese population.

METHODS

A multi-center, open-label, randomized controlled trial was performed involving 648 healthy infants aged 2 months from Inner Mongolia, Shanxi, and Hebei provinces. These participants were divided into three groups: sIPV-bOPV-bOPV, sIPV-sIPV-bOPV, and sIPV-sIPV-sIPV. Doses were administered sequentially at age 2, 3, and 4 months. Neutralisation assays were tested using sera collected at 2 months and 5 months.

RESULTS

A total of 569 were included in the per-protocol analysis. The seroconversion rates of poliovirus type 1 and 3 were 100% in all three groups, the seroconversion rate of poliovirus type 2 was 91.53% (173/189) (95% CI: 86.62-95.08) in the sIPV-bOPV-bOPV group, 98.38% (182/185) (95% CI: 95.33-99.66) in the sIPV-sIPV-bOPV group, and 99.49% (194/195) (95% CI: 97.18-99.99) in the sIPV-sIPV-sIPV group. For the seroconversion rate of poliovirus types 1 and 3, the sIPV-bOPV-bOPV and sIPV-sIPV-bOPV groups were non-inferior to the sIPV-sIPV-sIPV group. For the seroconversion rate of poliovirus type 2, the sIPV-sIPV-bOPV group was non-inferior to the sIPV-sIPV-sIPV group, and the sIPV-bOPV-bOPV group was inferior to the sIPV-sIPV-sIPV group. All three groups exhibited good safety, with two serious adverse events reported, that were unrelated to vaccine.

CONCLUSIONS

In china, a new vaccination schedule that including 2 doses of IPV in the national immunization programs is essential. Trial registration ClinicalTrials.govNCT04054492.

[Survey of snail distribution in Four-lake Basin of Hubei Province]

OBJECTIVE

To investigate the distribution of Oncomelania snails in Four-Lake Basin of Hubei Province, so as to provide scientific evidence for the development of snail control interventions.

METHODS

The snail distribution was surveyed by means of the retrospective study and cross-sectional survey in the Four-Lake Basin in Spring of 2016. The data pertaining to the endemic situation of schistosomiasis were collected and analyzed in the Four-Lake Basin from 2008 to 2018, and the associations of snail habitat areas with the prevalence of Schistosoma japonicum in humans and bovines were examined.

RESULTS

There were 16 003 snail habitats in the 9 schistosomiasis-endemic counties (districts) in the Four-Lake Basin in 2016, covering an area of 246 million m². The mean density of living snails was 0.622 5 snails/0.1 m², which was relatively high in weed-type settings (0.688 0 snails/0.1 m²) and ditches (0.706 4 snails/0.1 m²). Type I (current snail habitats, 53.03%) and Ⅱ- Ⅳ (historical snail habitats, 46.97%) settings were predominant snail habitats. A big change was seen in snail habitats in dry farmland, marshland and paddy farmland, and environmental modification resulted in satisfactory snail control effectiveness. In addition, the area of snail habitats positively correlated with the changes in the prevalence of S. japonicum infections in humans (r = 0.842, P < 0.01) and livestock (r = 0.695, P < 0.01).

CONCLUSIONS

The integrate strategy with an emphasis on the control of the source of S. japonicum infections results in remarkable snail control effectiveness in the Four-Lake Basin; however, there is a risk of re-emerging snail habitats.

Application of citronella and rose hydrosols reduced enzymatic browning of fresh-cut taro

Hydrosols are byproducts produced by steam distillation of aromatic plant materials. Previous studies reported hydrosols owned effectively inhibitory effects on microbials, but few focused on the effects in reducing enzymatic browning of fresh-cut products. Here, application of citronella hydrosol (CH) and rose hydrosol (RH) obviously reduced values of L*, a* and b* in surfaces of fresh-cut taros, suggesting these hydrosols could reduce browning severity. About 500 ml/L of RH and CH reduced total phenol contents, and activities of phenylalanine ammonia lyase (PAL), peroxidase (POD) and polyphenol oxidase (PPO), suggesting hydrosols suppressed browning development by reducing PAL, POD and PPO activities. Studies reported terpenoids had potential inhibition on PPO activity. Chemical composition analysis showed that RH and CH extracts contained abundant terpenoids. These imply that terpenoids contained in two hydrosols might have contributed to the reduction of enzyme activity. This study indicates that hydrosols might be promising natural anti-browning agents for fresh-cut foods. PRACTICAL APPLICATIONS: Hydrosols are the byproducts of essential oil from steam distillation. The work described here shows that application of citronella and rose hydrosols significantly reduced the browning of fresh-cut taros. Moreover, aromatic hydrosols also present inhibitory activity against microorganisms and are generally considered safe for human health. These suggested that aromatic hydrosols are the natural and useful anti-browning agents to preserve the quality of fresh cut foods, and can be well integrated into industrial procedures.

[Establishment of animal model of bacterial microleakage at implant-abutment interface]

Objective: To study the bacterial microleakage at the interface between dental implant and abutment in rats. Methods: Under aseptic conditions, suspension of 0.25 μl of Porphyromonas gingivalis (Pg) (10(9) CFU/ml) was added into the customized implant. After the abutment was connected, the suspension was cultured in an Ep (eppendorf) tube containing 1 ml brain heart infusion (BHI) culture medium. After 7 days and 14 days, the liquid in the Ep tube was taken and inoculated, and the growth of bacteria was observed. Six male SD rats with 12 implants were divided into experimental group (4 implants), negative control group (4 implants) and blank control group (4 implants). All 6 rats had two implants implanted in their bilateral upper jaws. During the second operation, suspension of 0.25 μl Pg (10(9) CFU/ml) was added to the inner part of the implant of the experimental group, culture solution of 0.25 μl was added to the control group and nothing was added to the blank control group. The amount of Pg and total bacteria in each group were evaluated by quantitative real-time PCR (qPCR). The inflammatory cell infiltrate in the peri-implant mucosa was evaluated histomorphometrically. Results: The in vitro model directly verified the presence of bacterial microleakage at implant-abutment interface (IAI), and the animal model confirmed the existence of microleakage through the infiltrate of inflammatory cells near the micro-gap in the experimental group indirectly. In vitro experiments found that Pg had penetrated from the implant within a week by observation and culture. In animal study, the presence of 10(2)-10(4) Pg was detected in the experimental group and it was not detected in the negative control group and the blank control group. At the same time, under the light microscope, in the experimental group, there were inflammatory cells aggregation in the connective tissue around the micro-gap and the density of inflammatory cells gradually decreased from the micro-gap to coronal and the apical of the connective tissue, while there were only scattered inflammatory cells in the connective tissue around the blank control group and the negative control group. In the experimental group, inflammatory cells density in area of 0.25-0.50 mm, 0-0.25 mm coronal to the micro-gap and 0-0.25 mm, 0.25-0.50 mm apical to the mico-gap was respectively, 976 (655), 1 673 (1 245), 2 267 (819) and 895 (162) cells/mm(2),which was significantly more than the blank control group in the corresponding position [respectively 201 (180), 321 (351), 309 (236) and 218 (272) cells/mm(2)] (P<0.05). Conclusions: Pg in the dental implants of rats can be found in the microleakage through implant-abutment interface, and cause the soft tissue inflammation around the implant, and the inflammation has certain distribution characteristics.

Successful management of anesthesia complications in a child with Crouzon syndrome

Crouzon syndrome (CS) is a rare autosomal dominant inherited disorder caused by mutations in the fibroblast growth factor receptor 2 (FGFR2) gene. The disease is characterized by premature fusion of the coronal and sagittal sutures of the skull, resulting in clinical manifestations of midfacial hypoplasia, shallow orbit, maxillary dysplasia, and occasional upper respiratory obstruction. This article presents the case of a child aged 2 years and 7 months with CS scheduled for bilateral tonsillectomy and adenoidectomy. The patient had a difficult procedure of extubation and was reintubated and the tracheal intubation was removed 2 days after surgery. The CS is a rare condition with physical characteristics that can result in difficult airway manipulation. It is important for anesthesiologists to recognize and avoid potential airway complications in the management of such patients through detailed preoperative evaluation and careful observation after surgery to reduce perioperative risks.

Response to adrenocorticotropic hormone or corticotrophin-releasing hormone and vasopressin in lactating cows fed an immunomodulatory supplement under thermoneutral or acute heat stress conditions

Adrenal responsiveness was tested in nonpregnant, lactating Holstein dairy cows fed diets supplemented with OmniGen-AF (OG; Phibro Animal Health Corp., Teaneck, NJ), an immune modulator, and in nonsupplemented control (CON) cows following bolus infusions of a combination of corticotropin-releasing hormone (CRH; 0.3 µg/kg of BW) and arginine vasopressin (VP; 1.0 µg/kg of BW) or ACTH (0.1 IU/kg of BW) in 2 environments: thermoneutral [TN; temperature-humidity index (THI) <60] for 24 h/d and heat stress (HS; THI >68 for 17 h/d). Cows (506) were initially fed OG (n = 254) or CON (n = 252) diets for 44 d before selection of a subgroup of cows (n = 12; 6 OG, 6 CON) for the study. The 2 subgroups were balanced for parity, milk yield, and days in milk. All cows were transported to and housed in 2 environmentally controlled rooms at the University of Arizona Agricultural Research Complex (Tucson). Cows were given 3 d to acclimate to the rooms and then underwent 12 d of TN conditions and then 8 d of HS conditions for a total of 24 d on experiment. Cows were infused with CRH-VP on d 9 of TN and on d 1 of HS and with ACTH on d 10 of TN and on d 2 of HS. Hormone infusions took place at 1000 h (0 h) on each infusion day. Blood samples, taken in 30-min intervals, were first collected at 0800 h (-2 h) and were drawn until 1800 h (8 h). Before infusion, serum progesterone was elevated in OG cows compared with CON cows. Infusion of releasing factors (CRH-VP or ACTH) caused increases in serum cortisol and progesterone, but cortisol release was greater in CON cows than in OG cows during HS, whereas progesterone did not differ between the 2 treatments. Serum ACTH increased following infusion of releasing factors, but this increase was greater following CRH-VP infusion than ACTH infusion. Serum bovine corticosteroid-binding globulin also increased following infusion of releasing factors in both treatment groups, but this increase was greater during HS in cows fed OG. The free cortisol index (FCI) increased following CRH-VP and ACTH and was higher in HS than in TN for both OG and CON cows. However, the FCI response was blunted in OG cows compared with CON cows during HS. Heat stress enhanced the adrenal response to releasing factors. Additionally, the adrenal cortisol and FCI response to releasing factors was reduced during acute heat stress in cows fed OG. Collectively, these data suggest that OG supplementation reduced the adrenal responsiveness to factors regulating cortisol secretion during acute HS.

A232 EFFICACY OF TOFACITINIB FOR THE TREATMENT OF MODERATE-TO-SEVERE ULCERATIVE COLITIS: REAL-WORLD DATA

Background

A significant proportion of patients with moderate to severe ulcerative colitis (UC) do not respond to therapy, which includes thiopurines, glucocorticoids, and antagonists to tumour necrosis factor-α and integrin. Tofacitinib, a Janus Kinase inhibitor, has emerged as an efficacious and safe treatment for moderate to severe ulcerative colitis. However, it is not known if this efficacy translates into real-life effectiveness in a regular clinical practice.

Aims

We aimed to assess the rate of clinical response and clinical remission at 3 and 6 months after tofacitinib initiation. Secondary endpoints included rate of biomarker normalization, corticosteroids-free clinical remission and severe infections.

Methods

We conducted a multi-center retrospective observational study of adult patients with active UC started on tofacitinib from January 1, 2015 to October 1, 2019 at the McGill University Health Center and Hotel-Dieu de Lévis. A positive clinical response was defined as a decrease of ≥3 in the partial Mayo score. Clinical remission was defined as partial Mayo score of ≤2. Biomarker normalization was defined as fecal calprotectin ≤250ug/g. Severe infection was defined as an infection requiring hospitalization.

Results

During the study period, 40 patients with UC were started on tofacitinib. Amongst the patients, 85% (n=34) had failed ≥1 biologic and 50% (n=20) had failed ≥3 biologics. At the time of this preliminary analysis, 38 patients had undergone 3 months of treatment and 30 patients had undergone 6 months of treatment. At 3 months, a clinical response was seen in 89.5% of patients (n=34) and clinical remission occurred in 63.2% (n=24). At 6 months, clinical response occurred in 73.3% of patients (n=22) and clinical remission was sustained in 53.33% (n=16). Biochemical normalization occurred in 29.0% (n=11) and 30.0% (n=9) at 3 and 6 months, respectively. Additionally, 63.2% (n=24) and 43.3% of patients (n=13) achieved steroid-free clinical remission at 3 and 6 months, respectively. In the interim, one patient developed a serious infection requiring discontinuation of drug.

Conclusions

Our preliminary analysis demonstrates that in a real-life setting, tofacitinib is an effective treatment for inducing clinical remission in refractory UC patients. Further data will be complied to better assess the efficacy over a longer follow up.

Funding Agencies

None

[Treatment of parotid hemangioma in children]

Objective:To summarize the treatment and effect of children with parotid hemangioma. Method:Thirty-three children with parotid hemangioma were treated with drug in 22 cases, 9 of which received propranolol orally, accounting for 27%; 13 cases underwent B-ultrasound guided bleomycin injection, accounting for 40%; another 11 cases were used. The treatment of surgical removal of hemangioma, accounting for 33%. Result:In 22 children with drug therapy, the evaluation criteria were evaluated by Achauer et al. 12 cases of grade Ⅳ, accounting for 54.5%; 7 cases of grade Ⅲ, accounting for 31.8%; 2 cases of grade Ⅱ, accounting for 9%. For example, accounted for 4.5%; 2 of them（1 in gradeⅠand Ⅱ） were treated with drug therapy for 6 months after surgical resection of hemangioma. Eleven children underwent surgical resection of hemangioma, and 8 patients underwent complete resection of the tumor, accounting for 73%. Among them, 3 patients had residual hemangiomas during operation, and the residual tumor was treated with bleomycin. This group of medications showed that children aged<12 months, after oral propranolol, the tumors were reduced to varying degrees, the most significant change within 1 week after administration, and then the tumor was further reduced until the end of treatment. Conclusion:B-ultrasoun lower bleomycin injection in children with parotid hemangioma is effective, and the incidence of adverse reactions is low, but multiple courses of treatment are required. For patients with poor drug treatment, recurrence or limited range, surgical resection of blood vessels can be selected. Tumor surgery should pay attention to the choice of indications and surgical operation skills, reduce the risk of facial nerve injury and postoperative facial scars. There are many different treatments for infantile hemangioma, but there is still no treatment for all children. The drug treatment of this group showed that after oral propranolol, the tumors were all reduced to varying degrees, the color became lighter, the texture became softer, and the change was most significant within 1 week after administration, and then the tumor was further reduced until the end of treatment. B-ultrasound guided bleomycin injection in children with parotid hemangioma is effective. After 1-2 courses of treatment, the tumor shrinks significantly and the incidence of adverse reactions is low. Drug treatment of parotid hemangioma in children is simple. A safe and effective method. For children with poor drug treatment, recurrence or limited range, surgical treatment of hemangioma can be selected. Surgery should pay attention to the choice of indications and surgical operation skills, reduce the risk of facial nerve injury and postoperative facial scars.

43 Actions of colony-stimulating factor 3 on the maturing oocyte and developing embryo in cattle

Colony-stimulating factor 3 (CSF3), also known as granulocyte colony-stimulating factor, has been reported to improve blastocyst yield when administered during oocyte maturation in the pig and to increase pregnancy outcomes in specific IVF patient populations when infused transvaginally. Here, we tested whether recombinant bovine CSF3 can act on the bovine oocyte during maturation or on the developing embryo to modify competence for development to the blastocyst stage. For Experiment 1, oocytes were matured with 0, 1, 10, or 100ngmL−1 of CSF3. Oocytes were then fertilised and embryos were cultured in serum-free medium for 7.5 days. There was no effect of CSF3 on cleavage rate or on development to the blastocyst stage except that 100ngmL−1 reduced (P=0.0366) the percentage of putative zygotes (P=0.0366) and cleaved embryos (P=0.0254) becoming blastocysts. Expression of transcripts for 93 genes in blastocysts was evaluated by RT-PCR using the Fluidigm platform. Transcript abundance was affected (P&lt;0.05) by one or more concentrations of CSF3 for 4 genes only (CYP11A1, NOTCH2, RAC1, and YAP1). For Experiment 2, cumulus-oocyte complexes were fertilised with either X- or Y-sorted semen for 18-22h. Putative zygotes were cultured in medium containing 0, 1, 10, or 100ngmL−1 of CSF3. There was no effect of CSF3, sex, or the interaction on the percentage of putative zygotes that cleaved or on the percentage of putative zygotes or cleaved embryos becoming blastocysts. Gene expression was not determined. For Experiment 3, CSF3 (0, 1, 10, and 100ngmL−1) was added from Day 4 to 7.5 of development. Again, there was no effect of CSF3 on development to the blastocyst stage. Transcript abundance for a total of 10 genes was increased (P&lt;0.05) by 100ngmL−1 of CSF3, including markers of epiblast (NANOG, SOX2), hypoblast (ALPL, FN1, KDM2B, and PDGFRA), both epiblast and hypoblast (HNF4A), and trophectoderm (TJAP1). Results are indicative that high concentrations of CSF2 can reduce oocyte competence and act on the embryo to affect characteristics of the blastocyst. Support was provided by the Elanco and Larson Endowment Fund.

49 Expression and actions of the dickkopf-1 receptors KREMEN1 and KREMEN2 in the bovine pre-implantation embryo

Dickkopf-1 (DKK1) is a secreted inhibitor of canonical WNT signaling expressed in the endometrium that can increase the competence of bovine blastocysts to establish pregnancy after transfer into recipients. The mechanism by which DKK1 regulates embryo function is not known. KREMEN1 and KREMEN2 are paralogs that function as DKK1 transmembrane receptors. Binding of DKK1 to KREMEN leads to internalization of the LRP5/6 WNT co-receptor and inhibition of β-catentin (CTNNB1)-dependent WNT signaling. Here we evaluated whether the bovine pre-implantation embryo expresses KREMEN1 and KREMEN2 and whether knockdown of KREMEN1 would alter embryonic development and accumulation of CTNNB1. In the first experiment, expression of KREMEN1 and KREMEN2 was determined in individual matured oocytes and embryos at the 2-cell, 3-4-cell, 5-8-cell, 9-16-cell, morula, and blastocyst stages of development (n=4) using RT-qPCR with GAPDH and YWHAZ as internal controls. Data were analysed by analysis of variance using GLM procedure of SAS (SAS Institute Inc.; stage, replicate in model), and Tukey test for multiple comparisons. Expression of both KREMEN1 (P&lt;0.0001) and KREMEN2 (P=0.003) varied between stages of development. There was a large decline in transcript abundance for KREMEN1 after the 9-16-cell stage. Expression (fold-change) relative to housekeeping genes was 0.29, 0.47, 0.27, 0.47, 0.34, 0.05, and 0.01 (standard error=0.08) for oocyte, 2-cell, 4-cell, 5-8 cell, 9-16-cell, morula, and blastocyst stages, respectively. Expression of KREMEN2 was low at early stages of development, increased at the 8-16 cell and morula stages (i.e. after embryonic genome activation), and then declined. Expression (fold-change) relative to housekeeping genes was 0.00, 0.04, 0.03, 0.05, 0.12, 0.15, and 0.01 (standard error=0.04) for oocyte, 2-cell, 4-cell, 5-8-cell, 9-16-cell, morula, and blastocyst stages, respectively. In the second experiment, we determined effects of a GapmeR antisense oligonucleotide directed against KREMEN1 on development to the blastocyst stage and amounts of immunoreactive CTNNB1 in the blastocyst. The experiment was performed in 3 replicates using 217 putative zygotes per treatment. The GapmeR treatment did not affect cleavage rate (78.5±0.02% for GapmeR vs. 71.7%±0.02% for vehicle; P=0.21), percent putative zygotes becoming blastocysts (23.4±0.02% vs. 20.0±0.02%; P=0.57), or the percent of cleaved embryos becoming blastocysts (30.6±0.03% vs. 28.8±0.03%; P=0.88). Amounts of immunoreactive CTNNB1 were determined in blastocysts collected at 168h after insemination (n=7/treatment). Treatment with GapmeR tended (P=0.08) to increase the fluorescence intensity of CTNNB1 (1761±68 vs. 1583±72 units). In summary, KREMEN1 is expressed before genome embryonic activation, whereas KREMEN2 is expressed in 8-16 cells and morula. Knocking down KREMEN1 does not compromise embryonic development, but preliminary studies indicate KREMEN1 can regulate CTNNB1 abundance. Support was provided by USDA-NIFA 2017-67015-26452.

213 WNT inhibition by dickkopf WNT signalling pathway inhibitor 1 (DKK1) cannot replace IWR-1 during derivation of bovine embryonic stem cells

Understanding the signalling pathways involved with derivation of embryonic stem cells could enhance our understanding of pluripotency in pre-implantation embryos. Recently, the small molecule IWR-1 has been shown to promote derivation of mouse epiblast stem cells and pluripotent bovine and porcine embryonic stem cells (ESC). IWR-1 blocks WNT signalling mediated by β-catenin-targeted gene expression through stabilisation of Axin2, a member of the destruction complex that induces β-catenin degradation. Here, we evaluated whether dickkopf WNT signalling pathway inhibitor 1 (DKK1) can replace IWR-1 for establishment of bovine pluripotent ESC. If so, it is likely that the actions of IWR-1 to promote pluripotency involve inhibition of WNT signalling. Treatment of bovine embryos with 100ngmL−1 recombinant human DKK1 beginning at Day 5 of development decreased (P=0.02) immunofluorescent labelling of β-catenin in the resulting blastocysts (n=41-45/group), indicating that bovine embryos are responsive to DKK1 treatment. For ESC derivation, blastocysts were plated on top of feeder cells and cultured in ESC medium supplemented with 2.5 µM IWR-1 (n=21), 100ngmL−1 DKK1 (n=34), or vehicle (n=23). Cells were passaged every 5 to 7 days in their respective treatment medium. Seven days after plating, 57.9±14.7% of blastocysts in IWR-1 ESC medium developed outgrowth, which was lower (P=0.02) than the proportion of blastocysts with outgrowth in DKK1 medium (92.4±5.2%) or vehicle (81.9±10.0%). Outgrowth size did not differ among treatments. Labelling with CDX2 indicated that the majority of cells in outgrowths were trophectoderm cells. Thus, IWR-1 inhibits competence of blastocysts to form trophectoderm outgrowths during derivation of ESC. The percent of blastocysts from which cell lines were derived after 4 passages were 48% (10/21) for IWR-1, 41% (14/34) for DKK1, and 48% (11/23) for vehicle. Immunolabelling for the pluripotency marker SOX2 showed that only cells grown in IWR-1 medium were positive, whereas most of the cells derived in the other two media were not. Thus, IWR-1 could not be replaced by DKK1 for maintaining pluripotency. Immunoreactive β-catenin was abundantly distributed on the membrane of cells cultured with IWR-1 but not with DKK1 or vehicle-treated cells. Thus, β-catenin distribution to the cell membrane is linked with bovine pluripotency. Overall, results indicate that maintenance of pluripotency by IWR-1 may involve mechanisms other than WNT inhibition, and may be related to the localization of β-catenin to the plasma membrane.

Statistical Analysis of the Heart and Lung Mass in Forensic Anatomical Cases and Its Forensic Significance

Abstract

Objective To investigate the differences of heart mass and lung mass in forensic autopsy cases and to explore their application value in forensic identification. Methods The data from 1 614 autopsy cases accepted by center of Medico-legal Investigation of China Medical University between 2007 to 2016 were collected. The correlation of heart and lung mass with age, height, body weight, and body mass index （BMI）, as well as differences in different causes of death were analyzed by GraphPad Prism 6.0 software. Results The heart mass and lung mass of males were higher than those of females （P<0.05）. The heart mass of males and females was positively correlated with age, height, body weight and body mass index （BMI） （P<0.05）. The heart mass of patients dying from sudden cardiac death （SCD） was significantly higher than those dying from other causes of death. The lung mass of patients dying from drowning and delayed treatment was higher than those dying from other causes of death （P<0.05）. Conclusion In forensic practice, measurement of the heart mass and lung mass has certain significance for differential diagnosis and diagnosis of different causes of death.

[Advances in the research of application of dental stem cells in neural tissue engineering]

Dental stem cell is a kind of stem cell isolated from dental hard tissue or periodontal tissue, including dental pulp stem cell, stem cell from human exfoliated deciduous teeth, stem cell from root apical papilla, periodontal ligament stem cell, dental follicle progenitor cell, and so on. As seed cell, dental stem cell provides safe and efficient cell source for nerve tissue engineering research. The review aims to introduce the characteristics of these dental stem cells in promoting the regeneration and preparation of nerve and the clinical application.

[Clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the department of cardiology in general hospitals]

Objective: To explore the clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the cardiology department in general hospital. Methods: Cross-sectional survey method was used in this study. From August 2017 to September 2018, 508 outpatients of our department with suspected mental disorders, who complained of physical discomfort and screened by the "Three Questions" method recommended by the Chinese Expert Consensus on Psychological Prescriptions of Cardiovascular Patients in 2014, were consecutively included. General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Patient Health Questionnaire-15 (PHQ-15) and self-made general demographic questionnaire (including age, sex, marital status, educational level, occupation, duration of disease, clinical diagnosis and the process of medical treatment for the main somatic symptoms in recent one year) were used to investigate these patients, under the assistance of unified training psychological consultants. The detection rate of anxiety and depression, the degree and distribution of somatization symptoms in outpatients with mental disorders were analyzed, and the related factors affecting the occurrence of somatization symptoms were screened by multivariate logistic regression. Results: The selected patients were (51.3±10.1) years old, of which 37.8% (192/508) were males and 62.2% (316/508) were females. The total detection rate of anxiety/depression was 86.8% (441/508), and the detection rate of somatization symptoms was 93.1% (473/508). The number of positive symptom items in PHQ-15 was 8.0±2.7, and the detection rate of anxiety/depression was 78.6% (372/473) in patients with somatization symptoms. There were significant differences in the proportion of women, the average number of outpatient visits and hospitalizations in the past one year, GAD-7 score and PHQ-9 score among the patients with mild, moderate and severe somatization symptoms (all P<0.05). PHQ-15 score was positively correlated with GAD-7 score (r=0.524 5, P<0.001) and PHQ-9 score (r=0.574 9, P<0.001) in patients with somatization symptoms. Stepwise logistic regression analysis showed that total scores of PHQ-9 (OR=8.020, 95%CI 3.470-18.930, P<0.001) and GAD-7 (OR=6.526, 95%CI 2.903-13.045, P<0.001) and female (OR=4.440, 95%CI 1.059-9.073, P=0.011) were related factors of somatizations. Conclusions: The incidence of somatization symptoms is high in patients with psychological disorders in outpatients of cardiology department in general hospital. Anxiety, depression and gender are the main related risk factors of somatization symptoms in this patient cohort. Degree of anxiety and depression increased in proportion to the severity of somatization symptoms. Anxiety, depression and female is related to somatization symptoms.

[Overlap gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer]

Objective: The aim of the current study is to compare the short-term clinical outcomes between Billroth-I reconstruction using an overlap method and delta-shaped anastomosis in totally laparoscopic distal gastrectomy (TLDG). Method: A retrospective cohort study was performed. The following inclusion criteria were applied: (1) Preoperative gastroscopy and CT confirmed that the tumor is located in the antrum of the stomach, and the biopsy suggested adenocarcinoma; (2) Chest, abdomen and pelvis enhanced CT showed no evidence of distant metastasis; (3) Preoperative gastric reconstruction CT or endoscopic ultrasonography suggested that the clinical stage of the tumor is stage I-III. (4) During the operation, the tumor position was confirmed to be located in the antrum of the stomach by nanocarbon injection or gastroscope; (5) Complete laparoscopic radical gastrectomy for distal gastrectomy, and the gastrointestinal reconstruction was performed by delta-shaped anastomosis or overlap anastomosis. And the following exclusion criteria were applied: (1) History of gastric surgery; (2) Patients who cannot tolerate laparoscopic surgery because of comorbidities. Finally, data on 43 consecutive patients who underwent TLDG with Billroth-I reconstruction between January 2016 and November 2018 in Peking Union Medical College Hospital were retrospectively reviewed. Patients were divided into those who underwent Billroth-I reconstruction using an overlap method (n=20) or using delta-shaped anastomosis (n=23). The demographic and clinical characteristics and perioperative data of the two groups were analyzed. Measurement data that conformed to the normal distribution were expressed as the mean ± s, and differences between groups were compared using Student's t-test; comparisons between the counting data groups were performed using the χ(2) test or the continuously corrected χ(2) test. Results: The demographic and clinical characteristics were similar between the delta-shaped group and the overlap group (P>0.05). There was no significant difference between groups regarding operation time [(185.9±22.8) minutes vs. (184.0±25.8) minutes, t=0.260, P=0.796], blood loss [(50.9±36.0) ml vs. (47.0±30.8) ml, t=0.375, P=0.709], number of stapler reloads used for anastomosis (5.1±0.3 vs. 5.2±0.6, t=-0.465, P=0.651), time to flatus [(3.3±0.9) days vs. (3.6±0.9) days, t=-1.067, P=0.292) and postoperative hospitalization [(8.8±3.1) days vs. (10.4±3.8) days,t=-1.494, P=0.143]. As for the delta-shaped group and the overlap group, the anastomotic leakage rate was 4.3% (1/23) and 0 (χ(2)=0.000, P=1.000), respectively. The incidence of anastomotic bleeding was 4.3% (1/23) and 5.0% (1/20) (χ(2)=0.000, P=1.000), while the incidence of intra-abdominal hemorrhage was 4.3% (1/23) and 0 (χ(2)=0.000, P=1.000). The incidence of gastric emptying disorders was 4.3% (1/23) and 30.0% (6/20), respectively (χ(2)=3.454, P=0.063). All complications were cured after conservative treatment or symptomatic treatment. Conclusion: The overlap method for Billroth-I reconstruction is safe and feasible.

Genetic variants in GRHL3 and risk for neural tube defects: A case-control and case-parent triad/control study

BACKGROUND

Neural tube defects (NTDs) are the most common severe birth defects with complex etiologies. Previous studies conducted on animals have suggested that the Grhl3 gene is essential for closure of the spinal neural tube, but little evidence from human studies on the variants of GRHL3 gene has been provided, especially the common genetic variants.

METHODS

To investigate the relationship between common genetic variants of GRHL3 and the risk for NTDs, we performed a case-control study and a case-parent triad/control study. Fast-target enrichment sequencing was performed to screen exon regions from 503 NTD cases, and three tag SNPs (single nucleotide polymorphisms, including rs12030057, rs2486668, and rs545809) were selected according to the sequencing results. Then, Sequenom MassARRAY genotyping was performed in 757 case parents and 519 controls to obtain genotype information of the target variant sites among all NTD triads and controls.

RESULTS

The genotype distributions of all SNPs were in accordance with Hardy-Weinberg Equilibrium (HWE) in the control population. In the case-control study, significant associations were found between C27G genetic variants on rs2486668 and risk for spina bifida and encephalocele, respectively, under different genetic models. Consistently, in the case-parent triad/control study, GG genotype on rs2486668 was associated with increased risk for spina bifida, with a RR of 2.15 (95% CI: 1.20-3.83). However, no parent-of-origin effect was found for any tag SNPs.

CONCLUSION

The GRHL3 C67G missense variant may increase the risk for spina bifida and encephalocele phenotypes.

microRNA-155 attenuates profibrotic effects of transforming growth factor-beta on human lung fibroblasts

Transforming growth factor-beta (TGF-β) functions in fibrogenesis as a profibrotic mediator, regulating cell proliferation, migration, apoptosis and collagen production of fibroblasts. microRNA-155 (miR-155), the expression of which has been related to bleomycin-induced idiopathic pulmonary fibrosis, has been involved in TGF-β induced epithelial-mesenchymal transition. Here, we found that miR-155 expression was decreased in human pulmonary fibroblasts by TGF-β treatment. We overexpressed miR-155 in fibroblasts to investigate the functional impact of miR-155 on TGF-β-induced fibrotic phenotype of fibroblasts. It is suggested that miR-155 overexpression attenuated the stimulatory effect of TGF-β on fibroblast proliferation, migration and collagen synthesis, by evidence from assessment of cell cycle, viability, apoptosis, migration and collagen content. Furthermore, quantitative measurement showed that SMAD1 gene expression was decreased following miR-155 inhibition, thereby demonstrating an indirect miRNA-SMAD interaction that links miR-155 to TGF-β signaling. Our work helped uncover an miRNA-mediated mechanism of fibroblast response to TGF-β. Moreover, it will help to achieve a better understanding of the regulatory roles of miR-155 in fibrogenesis.

[The 471st case: duodenal ulcer, mucor infection, and elevated IgG(4)]

Mucor infection is rarely reported in non-immunocompromised population, especially in isolated gastrointestinal tracts. IgG(4)-related diseases (IgG(4)-RD) have been recognized in recent years, but secondary causes of IgG(4) elevation should be differentiated. We reported a young man with duodenal mass and ulcer and high serum IgG(4) level. Histological biopsy of the mass revealed positive mucor mycelium and infiltration of IgG(4) positive plasma cells. Serum IgG(4) decreased to normal range after surgical resection and systemic antifungal treatment. This case suggests that isolated mucor mycosis infection can develop in the digestive tract and mimics as IgG(4)-related disease.

Role of the health sector in EIA

EIA is an obligation for many projects in many countries. Consideration of human health within EIA is also an obligation. This results in an invaluable opportunity for early consideration of a variety of environmental health determinants, leading to minimization of noxious exposures and promotion of the salutogenic factors involved in plans and projects in many sectors. In other words, EIA can be an extremely powerful vehicle to scaling up primary prevention - by far the most effective strategy in public health. This opportunity is further enriched by the recent revision of the EU Directive on EIA, which makes better provision for human health considerations in EIA, in particular referring to the need to address “significant” health effects of plans and projects - without elaborating further.

The health sector can play a key role in EIA by: recognizing the opportunity and its potential, so far under-exploited; engage in dialogue with other sectors, on specific applications; make institutional arrangements so as to secure manpower and competences to contribute to EIA; advocate for a high level of human health consideration in EIAs on the ground.

This process requires careful consideration of needs and constraints of EIA, including a need to establish a common language with other sectors, the identification of realistic, achievable goals, as well as long-term objectives, the consolidation of available methods and tools and a need to engage in possibly unfamiliar conversations. A pragmatic, operational decision on what constitutes significant health effects in the context of EIA may be a good starting point to measure the readiness of the health sector to undertake this journey.

The amended EIA directive creates opportunities for public health

Environmental Impact Assessment (EIA) is conducted by the developer as part of the process of seeking consent to proceed with the project. The developer may be a public authority or a private company. The Directive for Environmental Impact Assessment (EIA) (2011/92/EU) was amended in 2014 (2014/52/EU). The changes are now transposed into national regulations across European Union Member States. These changes have an influence beyond EU borders, for example, through the policies of the European Investment Bank and the European Bank of Reconstruction and Development. The amendments to the Directive create both opportunities and challenges for public health. The opportunities stem from the changes that have been made to the Directive. Population and human health are now on the list of core topics that must be considered in an EIA. The other core topics to be assessed are each ‘determinants of health’, for example: biodiversity; land, soil, water, air and climate; and material assets, cultural heritage and the landscape. The Directive now requires the interaction between these factors to be considered. The amended Directive includes other issues that are relevant to human health, for example, climate change and vulnerability (exposure and resilience) to major accidents and/or disasters. The developer’s assessment must be prepared by Competent Experts. The changes also pose challenges. These are technical. For example, human health needs to be assessed within the framework of EIA. The changes also pose challenges to the public health workforce. There is a need to ensure there is capacity to participate in EIA. The EIA is typically prepared by the developer and reviewed by the competent authority. There is a role for public health expertise in these complementary activities. This presentation will focus on the opportunities created by the changes to the Directive and the opportunities this creates. It will also touch on the challenges.

CD103+ T and Dendritic Cells Indicate a Favorable Prognosis in Oral Cancer

T cells and dendritic cells (DCs) that are positive for the tissue-resident marker CD103 play a vital role in antitumor immunity. In this study, multiplexed immunohistochemistry was applied to stain CD103 and the T-cell marker CD8 as well as the DC marker CD11c on formalin-fixed, paraffin-embedded oral squamous cell carcinoma (OSCC) tissues. Then, the density of CD103⁺CD8⁺ and CD103⁺CD11c⁺ tumor-infiltrating lymphocytes (TILs) in the intratumoral and stromal regions was calculated, and the correlation of CD103⁺CD8⁺ TIL and CD103⁺CD11c⁺ TIL density with OSCC patient prognosis was analyzed. The results revealed that CD103⁺CD8⁺ TILs and CD103⁺CD11c⁺ TILs were abundant in the stromal region and that increased stromal CD103⁺CD8⁺ TIL and intratumoral CD103⁺CD11c⁺ TIL density indicated a favorable prognosis. Moreover, we freshly isolated TILs from OSCC samples and performed flow cytometry to verify that CD103⁺CD8⁺ TILs display a tissue-resident memory T-cell (Trm) phenotype, and we discriminated CD103⁺CD11c⁺ TILs from tumor-associated macrophages.

[Comparison of protective ileostomy and transverse colostomy through specimen extraction auxiliary incision following laparoscopic low anterior resection for rectal cancer]

Objective: To introduce a new technique of protective ostomy using the specimen extraction auxiliary incision following laparoscopic low anterior resection for rectal cancer, and to compare the pros and cons of loop ileostomy (LI) and loop transverse colostomy (LTC). Methods: A retrospective cohort study was performed. The data of patients who underwent laparoscopic low anterior resection for rectal cancer and ostomy using the auxiliary incision in Peking Union Medical College Hospital from January 2010 to December 2017 were retrospectively analyzed. Inclusion criteria: (1) patient underwent neoadjuvant chemoradiotherapy before operation; (2) patient was classified as tumor stage II or III; (3) patient was followed up and underwent stoma closure at our center; (4) ostomy was performed through specimen extraction incision. Patients with multiple gastrointestinal carcinomas or inflammatory bowel disease were excluded. Two hundred and eight patients were included in the study and divided into the LI group (n=86) and LTC group (n=122). The operation parameters and postoperative complications were compared between the two groups. Results: There were 135 males and 73 females (1.85∶1.00). Mean age of the 208 patients was (59.6±11.6) years (range 29-85 years). There were no significant differences between LI and LTC groups in baseline data (all P>0.05). All of the patients completed surgery successfully. The severe complication rate after ostomy was 2.9% (6/208). In the fecal diversion period, LI group showed significantly faster defecation [(1.6±1.0) days vs. (2.2±1.9) days, t=-2.918, P=0.004] and lower incidence of parastomal hernia [8.1% (7/86) vs. 19.7% (24/122), χ(2)=5.290, P=0.021], but higher incidence of peristomal dermatitis [18.6% (16/86) vs. 4.9% (6/122), χ(2)=9.990, P=0.002] as compared to LTC group. The incidence of renal insufficiency was lower in LTC group, though the difference was not significant [4.9% (6/122) vs. 10.5% (9/86), χ(2)=2.320, P=0.128]. The severe complication rate after stoma closure was 1.9% (4/208). In the stoma closure period, a significantly higher incidence of wound infection was noted in LTC group [18.0% (22/122) vs. 4.7% (4/86), χ(2)=8.258, P=0.004]. There were no significant differences between the two groups in the incidence of anastomotic leakage, stenosis, and incisional hernia (all P>0.05). All complications were improved after treatment. Conclusions: Both LI and LTC through auxiliary incision following laparoscopic low anterior resection for rectal cancer are safe and feasible. LTC is an optional method for those patients with sensitive skin.

P1889Quantitative global proteomics and lysine acetylome analysis of changes in left atrial appendage tissue from valvular heart disease patients with atrial fibrillation

Background

Previous studies have shown that acetylation plays a critical role in regulating the progress of cardiovascular diseases by acetylated histone and non-histones protein. However, the global lysine acetylome during atrial fibrillation (AF) were not fully understood.

Purpose

The aim of the present study was to identify the underlying mechanisms of AF via profiling of the quantitative changes of global proteomics and lysine acetylome in the left atrial appendage (LAA) tissues from valvular heart disease patients with AF.

Methods

This study obtained LAA specimens from patients undergoing cardiac surgery for severe valvular heart disease. The LAA specimens were obtained from both 9 patients with AF and with sinus rhythm (SR). The changes of proteome and acetylome in the AF-LAA vs SR-LAA tissues were studied using dimethyl-labeling, HPLC fractionation, affinity enrichment, LC-MS/MS analysis, database Search and bioinformatic analysis. The acetylated levels of each lysine acetylated site were normalized on the basis of the corresponding protein abundance.

Results

The bioinformatic analysis indicates 294 up-regulated (AF/SR ratio >1.3) proteins and 169 down-regulated (AF/SR ratio <1/1.3) proteins in the AF-LAA vs SR-LAA were detected. Moreover, 3,880 sites in 1,044 proteins were quantified. Motif analysis of the identified acetylated peptides indicated that a total of 14 significantly enriched amino acid sequence motifs from −10 to +10 surrounding the acetylated lysine (Kac) were defined according to 3412 peptides from 1115 proteins. Among the quantified acetylated sites and proteins, 231 up-regulated acetylated sites in 130 proteins and 121 down-regulated acetylated sites in 74 proteins were detected. The enrichment-based clustering analysis showed that energy metabolism and cardiac contraction-related proteins were highly differentially expressed in the AF-LAA vs SR-LAA. Meanwhile, the protein-protein interaction network of the differentially expressed acetylated proteins demonstrated that there were 146 nodes and 569 interactions in the network and quite a lot of interactions in energy metabolism-related proteins and in cardiac contraction-related proteins. Furthermore, the acetylated levels of most differentially expressed energy metabolism-related proteins involving in oxidative phosphorylation, TCA cycle, respiratory ETC, fatty acid metabolism were up-regulated. On the contrary, the acetylated levels of most acetylated sites in differentially expressed cardiac contraction-related proteins including the key contraction proteins were down-regulated.

Interaction network of Ac-proteins

Conclusions

This study details and expands our understanding of the changes of proteome and lysine acetylome in the LAA tissues from valvular heart disease patients with AF. The data suggest important expression differences of acetylated proteins related to energy metabolism and cardiac contraction which may be involved in the matrix of AF formation and maintainence.

Acknowledgement/Funding

This work was supported by the grants from the National Natural Science Foundation of China (no. 81600273, no. 81570310, no.81770337 and no.81870258)