Abstract P1-08-25: Withdrawn

This abstract was withdrawn by the authors.

Citation Format: Zhao H, Gong Y, Ye F, Ling H, Hu X. Withdrawn [abstract].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 P1-08-25.

Abstract P2-01-13: The splicing factor PHD finger protein 5A inhibits apoptosis to promote breast cancer progression

Background: All the widely accepted hallmarks of cancer are known to be affected by aberrant splicing (AS), and splicing dysregulation itself is considered a valuable therapeutic target. Understanding the AS that promote cancer progression is crucial for the development of effective strategies for treating breast cancer.

Methods: An in vivo CRISPR screen targeting RNA-binding proteins (RBPs) was performed to reveal the key splicing modulator (PHD finger protein 5A, PHF5A) of breast tumor progression. Immunohistochemistry method and survival analysis were performed using a tissue microarray (TMA) containing 450 breast carcinoma. Proliferation, transwell migration and in vivo tumor formation assays were utilized to assess the biological role of PHF5A. RNA sequencing and RT-PCR assay were used to identify PHF5A-regulated AS events in breast cancer cells. Biological functions and molecular pathways of the affected genes were investigated through a gene ontology (GO) analysis. Flow cytometry and Western blot analysis were used for apoptotic assessments. The correlation between PHF5A expression and AS events was further analysed using mRNA-Seq data of 40 paired breast cancer and adjacent normal breast tissues. And the correlation between the levels of PHF5A and cleaved caspase-3 were evaluated in the TMA.

Results: According to RNA sequencing analysis of MCF10 cell series (MCF10A, MCF10AT, MCF10DCIS and MCF10CA1a), 159 RBPs were found to be up-regulated in cancer cells compared with non-cancer cells. And the CRISPR screen targeting these 159 RBPs systematically identified highest-ranking genes including PHF5A. In TMA cohort, high PHF5A expression was correlated with poor disease-free survival. PHF5A is frequently up-regulated in breast cancer and is essential for cancer cell proliferation, migration and tumor formation. Knockdown of PHF5A induces genome-wide AS events. The RT-PCR assay of MCF10CA1a cells showed that splicing changes of nine arbitrarily selected target genes were all modulated by PHF5A. GO analysis showed that PHF5A-regulated AS events were involved in apoptotic and anti-apoptotic pathways, among which FAS-activated serine/threonine kinase (FASTK) AS showed significant PSI (percent spliced in) difference. PHF5A knockdown appeared to switch full-length FASTK (FASTK-L) to an intron 5-retained variant (herein termed FASTK short, FASTK-S) in MCF10CA1a cells. The knockdown of PHF5A resulted in cleavage of caspase-3 and poly-ADP-ribose polymerase and conversion of the FASTK-L (61 kDa) and FASTK-S (42 kDa) proteins. Intriguingly, cells transduced with exogenous FASTK-S showed the most significant apoptotic effect, whereas the FASTK-L group presented a decreased apoptotic effect. The PHF5A ratios of paired non-tumor to tumor tissue were negatively correlated with the FASTK PSI differences between non-tumor and tumor tissues. A strong negative correlation was found between the PHF5A and cleaved caspase-3 levels in TMA.

Conclusions: PHF5A depletion sensitizes cancer cells to apoptotic signaling partially through AS-mediated FASTK isoform conversion. This apoptotic suppressor plays a key role in breast cancer progression and acts as a prognostic indicator, and should be critically considered for optimization of the current therapeutic strategy.

Citation Format: Zheng Y-Z, Xue M-Z, Shen H-J, Li X-G, Ma D, Gong Y, Hu X, Shao Z-M. The splicing factor PHD finger protein 5A inhibits apoptosis to promote breast cancer progression [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 P2-01-13.

Abstract P4-09-09: Association between socioeconomic factors at diagnosis and survival in non-metastatic breast cancer: A population-based study

Background: Breast cancer is a severe public health problem for women worldwide. Race disparities and regional disparities are documented regarding incidence, mortality, and survival of breast cancer patients. However, the associations between socioeconomic status and survival outcomes of breast cancer remain unclear and require a comprehensive large-scale investigation of specific socioeconomic factors. Furthermore, no model has included both histological and socioeconomic factors together to predict survival of breast cancer. In this study, we sought to develop nomograms to predict overall survival (OS) and breast cancer-specific survival (BCSS) with consideration of socioeconomic factors for non-metastasis breast cancer.

Methods: We included a total of 274,108 female patients, diagnosed with malignant breast cancer between 2007 and 2014from the Surveillance, Epidemiology, and End Results (SEER) database. Socioeconomic factors involving marital status, insurance status, residence, median household income, poverty rate, unemployment rate and education level were included in the analysis. OS and BCSS were evaluated with log-rank tests and Kaplan-Meier estimates. We identified and integrated significant prognostic factors for OS and BCSS using univariate and multivariate Cox regression analysis to construct nomograms. Calibration plots and concordance indexes were used to evaluate the accuracy and discrimination of the models.

Results: Among different age subgroups, insured patients were more likely to have better survival than uninsured patients or patients with Medicaid (P<0.001), and especially for patients who were aged 18 to 35 years old at diagnosis, uninsured patients associated with poor BCSS than Medicaid patients (P<0.05). Through multivariate analysis, we found non-Hispanic black patients experienced worst survival compared with the White and other races (P<0.001). Interestingly, married (vs. single vs. separated/divorced/widowed; P<0.001) and insured (vs. Medicaid vs. uninsured; P<0.001) patients had a better prognosis. Living in the non-metro area increased the risk of death (hazard ratio [HR], 1.084, P<0.05). Furthermore, living in counties with higher median household income (>US $72,800) had favorable impacts on OS (HR 0.843, P<0.001). Four and five socioeconomic factors were involved in constructing the nomograms for 3 years-, 5 years- and 7 years- OS and BCSS, respectively. The C-indexes of the final nomograms were higher than those of the TNM staging system for predicting OS (0.776 vs 0.678; P < 0.001) and BCSS (0.842 vs 0.776; P < 0.001), respectively. The performance of the nomograms for predicting OS was significantly lower when excluding the socioeconomic factors (P < 0.001).

Conclusion: Some certain socioeconomic factors (i.e., marital status, insurance status, median household income, and residence) play essential roles in predicting survival of non-metastasis breast cancer. We constructed and validated nomograms including socioeconomic factors to provide more comprehensive and realistic survival estimation. Besides, these findings may highlight the importance of developing health-related policies and the necessity of targeted social support-based interventions for those high-risk patients.

Citation Format: Ji P, Gong Y, Hu X, Hong D, Shao Z-M. Association between socioeconomic factors at diagnosis and survival in non-metastatic breast cancer: A population-based study [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 P4-09-09.

Abstract P2-08-36: Comparing prognostic performance of different lymph node staging systems among patients with breast cancer

Background: Metastatic regional lymph nodes (LN) is a strong predictor of worse long-term outcome after resection of breast cancer. This study aimed to compare the prognostic performance of American Joint Committee on Cancer (AJCC) N stage relative to lymph node ratio (LNR), log odds of metastatic lymph nodes (LODDS), number of removed lymph nodes (NRLNs), and number of negative lymph nodes (NNLNs) in breast cancer patients.

Methods: All of the breast cancer patients who underwent surgery between 2004 and 2012 were identified from the Surveillance, Epidemiology, and End Results database. Restricted cubic spline functions were used to characterize the association between continuous variables and the risk of death and determine the optimal cut-off points. The Cox proportional hazards models were constructed, and the relative discriminative abilities of the different LN staging systems were assessed using the Akaike's Information Criterion (AIC) and the Harrell's concordance index (C-index).

Results: A total of 264,096 breast cancer patients were enrolled, and 177,598 (67.2%) had no lymph node metastasis, whereas 86,498 (32.8%) had lymph node metastasis. 187,785 (71.1%) patients had a limited number of LNs harvested (NRLN <10). The median follow-up time was 73 months, and the 8-year overall survival (OS) and breast cancer-specific survival (BCSS) were 82.6% and 90.4%, respectively. LNR, LODDS, NRLNs, and NNLNs were all nonlinearly associated with OS and BCSS. Patients with metastatic LN had an increased risk of OS (hazards ratio: 2.32, 95% confidence interval: 2.27–2.37; P < 0.001) and BCSS (hazards ratio: 4.53, 95% confidence interval: 4.40–4.66; P < 0.001). When LNR was equal to 0 or 1, there was a heterogeneity of outcomes, and LODDS still yielded informative values compared to LNR. Among the entire cohort, LNR modeled as a continuous variable had a somewhat better prognostic performance (AIC: 923231.4 and C-index: 0.722 for OS; AIC: 482962.3 and C-index: 0.817 for BCSS) than any of other LN staging systems. However, a model with AJCC N stage showed the best fit in patients with a limited number of LNs harvested (AIC: 501321.8 and C-index: 0.699 for OS; AIC: 212605.6 and C-index: 0.809 for BCSS). When assessed among patients with metastatic LN, LODDS outperformed other staging systems including AJCC N stage, LNR, NRLNs and NNLNs, whenever assessed using continuous (AIC: 428626.2 and C index: 0.728 for OS; AIC: 296886.8 and C index: 0.770 for BCSS) or categorical (AIC: 429527.5 and C index: 0.722 for OS; AIC: 297796.6 and C index: 0.762 for BCSS) cutoff values.

Conclusions: Although LNR assessed as a continuous variable was the most potent method to stratify patients regardless of LN status, the prognostic superiority of LNR is confounded by a limited LN harvest. LODDS was a better and more powerful predictor of survival when patients were LN positive, especially among those patients with either very low or high LNR.

Citation Format: Gong Y, Ji P, Jiang Y-Z, Hu X, Shao Z-M. Comparing prognostic performance of different lymph node staging systems among patients with 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 P2-08-36.

Abstract OT3-05-04: Phase II study of atezolizumab, cobimetinib, and eribulin in patients with recurrent or metastatic inflammatory breast cancer (IBC)

Background: IBCs that do not completely respond to chemotherapy often have dysregulated immune pathways, and novel therapies are needed to improve outcomes in recurrent/metastatic disease. One-third of IBCs express the atezolizumab target PD-L1, and cobimetinib increases PD-L1 expression; thus, we hypothesize that atezolizumab and cobimetinib may act synergistically in IBC. The FDA-approved agent eribulin is active in IBC and has anti-stem cell activity and can reverse the IBC phenotype of epithelial-to-mesenchymal transition. Hence the use of eribulin as a chemotherapy backbone in combination with other novel agents is well justified.

Trial Design: This single-arm, open-label trial is enrolling patients with recurrent IBC or de novo metastatic IBC that has progressed on at least 1 line of standard chemotherapy. During a 4-week pharmacodynamic window, patients have an upfront biopsy, receive atezolizumab and cobimetinib treatment for 4 weeks, and have a second biopsy. Triple-combination treatment then commences, with standard eribulin dosing. After 4 cycles of eribulin, patients receive maintenance targeted therapy until disease progression or intolerable toxicity.

Eligibility Criteria: Patients with metastatic IBC of any molecular subtype must have measurable disease (per RECIST 1.1) amenable to biopsy. Patients with HER2+ disease must have received both pertuzumab and T-DM1. Patients with treated stable brain metastases are allowed. Patients must have recovered from the acute effects of any prior therapies and have adequate hematologic, organ, and cardiac function. Patients with autoimmune diseases or a history of pneumonitis are ineligible.

Specific Aims: The primary objective is to determine the overall response rate (ORR) of the combination therapy. Secondary objectives include determining the safety and tolerability, clinical benefit rate, response duration, progression-free survival, 2-year overall survival rate and predictive biomarker analyses.

Statistical Methods: The trial will enroll up to 9 patients in its phase I/safety lead-in portion and up to 33 patients total. A Bayesian optimal interval design is used to efficiently determine the maximum tolerated cobimetinib dose in phase I. Patients start cobimetinib at the FDA-approved dose of 60 mg/day with a target toxicity rate is 0.3. Phase II will enroll 24 patients to determine the efficacy of the triple-combination therapy. The historical ORR in metastatic IBC is 10%; our sample size provides 80% power to detect an ORR improvement to 25%.

Accrual: The trial has enrolled 7 patients since its start in August 2017.

Citation Format: Alexander A, Marx AN, Reddy SM, Reuben JM, Le-Petross HC, Lane D, Huang ML, Krishnamurthy S, Gong Y, Gombos DS, Patel N, Tung CI, Allen RC, Kandl TJ, Wu J, Liu S, Patel AB, Futreal A, Wistuba I, Layman RM, Valero V, Tripathy D, Ueno NT, Lim B. Phase II study of atezolizumab, cobimetinib, and eribulin in patients with recurrent or metastatic inflammatory breast cancer (IBC) [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 OT3-05-04.

Monolithic multiple colour emission from InGaN grown on patterned non-polar GaN

A novel overgrowth approach has been developed in order to create a multiple-facet structure consisting of only non-polar and semi-polar GaN facets without involving any c-plane facets, allowing the major drawbacks of utilising c-plane GaN for the growth of III-nitride optoelectronics to be eliminated. Such a multiple-facet structure can be achieved by means of overgrowth on non-polar GaN micro-rod arrays on r-plane sapphire. InGaN multiple quantum wells (MQWs) are then grown on the multiple-facet templates. Due to the different efficiencies of indium incorporation on non-polar and semi-polar GaN facets, multiple-colour InGaN/GaN MQWs have been obtained. Photoluminescence (PL) measurements have demonstrated that the multiple-colour emissions with a tunable intensity ratio of different wavelength emissions can be achieved simply through controlling the overgrowth conditions. Detailed cathodoluminescence measurements and excitation-power dependent PL measurements have been performed, further validating the approach of employing the multiple facet templates for the growth of multiple colour InGaN/GaN MQWs. It is worth highlighting that the approach potentially paves the way for the growth of monolithic phosphor-free white emitters in the future.

Indoleamine 2,3-Dioxygenase (IDO) Regulates Th17/Treg Immunity in Experimental IgA Nephropathy

IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide. Current studies have shown that the Th17/Treg immune balance may be involved in the occurrence of IgAN, but the exact mechanism is still unclear. Indoleamine 2,3-dioxygenase (IDO) is an enzyme that catalyses degradation of tryptophan (Trp) through the kynurenine (Kyn) pathway; it can control inflammation and immune response by inducing Trp starvation. IDO may be a key molecule in regulating the Th17/Treg immune balance. However, it is not clear whether IDO is involved in the IgAN disease occurrence by regulating the Th17/Treg immune balance. In this study, an IgAN mouse model was established. The mice were intraperitoneally inoculated with IDO inhibitor 1-MT or agonist ISS-ODN to observe whether the IDO signalling pathway participates in the occurrence and development of IgAN by regulating the Th17/Treg immune balance. The results showed that IDO inhibitor 1-MT significantly increased renal injury and glomerular IgA accumulation and up-regulated Th17/Treg and Th17-related cytokine expression in IgAN mice, while ISS-ODN significantly decreased renal injury and glomerular IgA accumulation, down-regulated Th17/Treg expression and inhibited Th17-related cytokine expression in IgAN mice. In conclusion, IDO was involved in the occurrence and progress of IgAN by regulating the Th17/ Treg balance.

The recessive C locus in the MITF gene plays a key regulatory role in the plumage colour pattern of duck (Anas platyrhynchos)

1. The c/c alleles are responsible for the white plumage colour of ducks; however, the gene corresponding to this locus is still unclear. In order to identify the locus-related candidate gene associated with duck's plumage colour pattern, it was necessary to analyse the whole genome resequencing data. 2. A total of 929,465 SNPs in chromosome 13 and 1,688 SNPs in the region of the Microphthalmia-Associated Transcription Factor (MITF) gene were identified from whole genome resequencing data analysis. After construction of an F_ST plot from chromosome 13, MITF was highlighted as a candidate gene, possessing the highest F_ST value (0.811) on chromosome 13. 3. Six novel SNPs were discovered, located in the intronic region of the MITF gene. F2 progeny of Kaiya × Liancheng ducks (N = 1,061) were selected for genotyping by the Restriction Fragment Length Polymorphism (RFLP) technique. Association analysis using Haploview software was used for validation of the results. 4. Association results between SNPs and phenotypes showed significant association with corresponding phenotypes. All the significantly associated SNPs were located in the identified candidate gene. 5. The identified candidate gene provided novel information which is important in marker-assisted selection and breeding of duck and for the investigation of the C locus recessive white genetic mechanisms underlying plumage colour pattern.

Dynamics of the Phanerochaete carnosa transcriptome during growth on aspen and spruce

BACKGROUND

The basidiomycete Phanerochaete carnosa is a white-rot species that has been mainly isolated from coniferous softwood. Given the particular recalcitrance of softwoods to bioconversion, we conducted a comparative transcriptomic analysis of P. carnosa following growth on wood powder from one softwood (spruce; Picea glauca) and one hardwood (aspen; Populus tremuloides). P. carnosa was grown on each substrate for over one month, and mycelia were harvested at five time points for total RNA sequencing. Residual wood powder was also analyzed for total sugar and lignin composition.

RESULTS

Following a slightly longer lag phase of growth on spruce, radial expansion of the P. carnosa colony was similar on spruce and aspen. Consistent with this observation, the pattern of gene expression by P. carnosa on each substrate converged following the initial adaptation. On both substrates, highest transcript abundances were attributed to genes predicted to encode manganese peroxidases (MnP), along with auxiliary activities from carbohydrate-active enzyme (CAZy) families AA3 and AA5. In addition, a lytic polysaccharide monooxygenase from family AA9 was steadily expressed throughout growth on both substrates. P450 sequences from clans CPY52 and CYP64 accounted for 50% or more of the most highly expressed P450s, which were also the P450 clans that were expanded in the P. carnosa genome relative to other white-rot fungi.

CONCLUSIONS

The inclusion of five growth points and two wood substrates was important to revealing differences in the expression profiles of specific sequences within large glycoside hydrolase families (e.g., GH5 and GH16), and permitted co-expression analyses that identified new targets for study, including non-catalytic proteins and proteins with unknown function.

Cyclin-dependent kinase 7 is a potential therapeutic target in papillary thyroid carcinoma

Given the pathological incidence of metastases or radioiodine-refractory papillary thyroid carcinoma (PTC) is increasing worldwide, patients have little alternatives when choosing effective drugs. Therefore, it is necessary to develop new therapeutic targets for PTC treatment. CDK7 is a member of the cyclindependent protein kinase (CDK) family, which plays an important role in various types of cancers. In this study, we found CDK7 were upregulated in PTC cell lines compared to normal thyroid cells using qRT-PCR and Western blot. Furthermore, using cell counting kit-8 (CCK-8) assay and 5-ethynyl-2-deoxyuridine (EdU) assay, we discovered cell growth ratio was positively correlated to the expression level of CDK7. Cell cycle analysis showed that the cells with higher CDK7 expression levels were prone to be in S phase. More importantly, we tested the inhibitory effects of BS-181 on CDK7 both in vitro and in vivo. Results obtained from this study indicated that BS-181 not only suppressed the cell proliferation in vitro, but also inhibited the tumor growth in nude mouse without changing mRNA and protein levels of CDK7. In conclusion, our study might provide a novel potential target for PTC therapy.

Trends in procedure type, patient characteristics, and outcomes among persons with knee osteoarthritis undergoing bariatric surgery, 2005-2014

OBJECTIVE

To evaluate trends in the utilization, clinical characteristics, and inpatient outcomes among persons with knee osteoarthritis undergoing bariatric surgery.

METHOD

We used the National Inpatient Sample (NIS) to examine trends of bariatric surgeries performed on adults with clinically documented knee osteoarthritis between 2005 and 2014. We abstracted hospital setting, procedure, demographic and clinical characteristics, and inpatient surgical outcomes from each discharge. We examined temporal trends using linear regression and Cochran-Armitage test for trend.

RESULTS

The utilization of bariatric surgery among persons with knee osteoarthritis from 2005 to 2014 remained consistent, with an annual total of about 3,300 procedures performed nationally. The most common procedure type changed from laparoscopic Roux-en-Y (65%) in 2005-2006 to laparoscopic sleeve gastrectomy (58%) in 2013-2014. The median age, proportion on Medicare, and age- and sex-adjusted prevalence of diabetes increased from 46 to 51 years, 7-23%, and 28-32%, respectively. From 2005 to 2014, the median adjusted costs, in 2017 USD, for laparoscopic and open Roux-en-Y surgeries decreased from $15,100 to $13,300 (p < 0.01) and $14,100 to $10,100 (p = 0.0001), respectively, whereas the costs of laparoscopic sleeve gastrectomy and laparoscopic banding did not change significantly. In-hospital mortality remained at 0.0-0.1% from 2005 to 2014.

CONCLUSION

Although growing evidence suggests that bariatric surgery is associated with improvements in osteoarthritis pain and functional status, the utilization of bariatric surgery among morbidly obese persons with knee osteoarthritis remained consistent from 2005 to 2014. Bariatric surgery in persons with knee osteoarthritis is generally safe, as inpatient complication and mortality rates remained low despite an increase in age and number of comorbidities.

Screening for syphilis with dual algorithms: analysis of discordant and concordant serology results in a population with a low prevalence of syphilis

BACKGROUND

Currently, many laboratories have switched the traditional screening algorithm (TSA) to reverse screening algorithm (RSA) for the efficiencies in high-volume syphilis screening. However, confusions have been arisen regarding this paradigm shift.

OBJECTIVE

To compare the performance of two algorithms with head-to-head mode.

METHODS

Sera screening for syphilis were tested in parallel with chemiluminescence immunoassay (CIA) and toluidine red unheated serum test (TRUST). CIA-reactive sera from the RSA were reflexively tested with TRUST and confirmed with Treponema pallidum particle agglutination assay (TPPA), while the TRUST-reactive serology from the TSA were afterwards tested with TPPA.

RESULTS

A total of 110 663 serum samples were screened. The RSA identified 2259 (2.0%) CIA-reactive results, of which 377 (16.7%) showed TPPA nonreactive results, while the TSA identified 934 (0.8%) TRUST-reactive results, of which 67 (7.2%) showed TPPA-nonreactive results. Among the 2259 CIA-reactive results, 1392 (61.6%) were TRUST-nonreactive, of which 350 (25.1%) were TPPA-nonreactive. A total of 182 sera from the 350 TPPA-nonreactive sera were further tested by a second CIA (VITROS Syphilis TPA, VITROS TPA), of which 155 (85.2%) were nonreactive and 27 (14.8%) were reactive. The 27 VITROS TPA-reactive sera were further tested with a treponemal Western blot assay (Euroimmun IgG Western Blot, EuroWB), of which 11 (41%) were indeterminate, 6 (22%) were nonreactive and 10 (37%) were reactive. Among the 10 EuroWB-reactive sera, two seroconverted to TPPA 1:80+/- after 1-year follow-up. Of 867 CIA-reactive/TRUST-reactive results, 27 (3.1%) were TPPA-nonreactive.

CONCLUSIONS

The RSA identified more patients with reactive treponemal serology. However, it also yielded an increased likely false-reactive rate compared with the TSA, especially those results with low index values and TRUST-nonreactive serology, were necessary to retest with a second treponemal test. Further testing results with TPPA, VITROS TPA and EuroWB suggested the false-reactive CIA screening results and the likely false-nonreactive TPPA results when the reactive treponemal results screened with RSA were to be identified.

[Preoperative diagnosis and evaluation of cochlear implantation in patients with cochlear nerve deficiency]

Cochlear nerve deficiency (CND) refers to a small or absent cochlear branch of the vestibulocochlear nerve (VCN) or cochlear nerve (CN). Congenitally deaf children with CND who received cochlear implants (CIs) generally exhibit poorer auditory performance than CI children without CND. It is important to confirm the integrity of the auditory pathway before surgery. High-resolution computed tomography (HRCT) and three-dimensional magnetic resonance imaging (3D MRI) are major techniques used to diagnosis CND. In this paper, we reviewed the methods of preoperative evaluation, cochlear nerve embryonic development, techniques for diagnosis and outcomes of cochlear implantation.

KLF4 is a tumor suppressor in anaplastic meningioma stem-like cells and human meningiomas

Meningiomas are the most common primary tumors in central nervous system. While recent studies have revealed genetic clues to lower grade human meningiomas, the molecular determinants driving the progression and recurrence of anaplastic meningioma, the most malignant subtype with a low prevalence but high morbidity, are still poorly understood. It has been proposed that high recurrence rates of malignant meningiomas are linked to cancer stem cells. Indeed, tumor stem-like cells have been isolated from various meningioma subtypes, but never been obtained from anaplastic meningioma. In this study, we successfully isolated stem-like cells from human anaplastic meningioma. These cells are capable of forming spheres and initiating xenograft tumors that recapitulate anaplastic meningioma phenotypes, and thus could serve as an in vitro model for malignant meningiomas. KLF4, a transcription factor known for its role in stemness maintenance, was identified as one of the most frequently mutated genes in the benign secretory meningioma. Interestingly, we found that KLF4 is downregulated in anaplastic meningioma compared with low-grade meningioma subtypes. By manipulating KLF4 expression in anaplastic meningioma stem-like cells, we demonstrated that KLF4 acts as a tumor suppressor during malignant progression in meningioma, affecting apoptosis, proliferation, invasion, and cell cycle. These results suggest a potential therapeutic value of KLF4 for clinical intervention of anaplastic meningioma.

Molecular epidemiology and genetic diversity of duck hepatitis A virus type 3 in Shandong province of China, 2012-2014

 The infections with duck hepatitis A virus type 3 (DHAV-3) become common in eastern Asia. To better understand the molecular evolution and genetic variation of DHAV-3, a total of 482 dead Cherry Valley duckling liver samples collected from Shandong province of China during 2012-2014 were tested, and the complete P1 coding sequences of 18 DHAV-3 strains were analyzed. The detection rate of DHAV-3 was 64.5% (311/482) in clinical liver samples and 73.0% (92/126) in duckling flocks. The P1 genes of the 18 DHAV-3 isolates shared 91.9%-99.0% nucleotide similarity and 95.2%-100% amino acid similarity with those of the other 26 reference strains. Based on the P1 and VP1 gene sequences, phylogenetic analysis results indicated that the genotyping of DHAV-3 strains presented a distinct geographical distribution. Except B63 strain, all Chinese strains isolated from different host species (duck or goose) at different time were classed into the CH genotype. All Korean and Vietnamese strains belonged to the KV genotype, and all the Korean strains were clustered into KV1 subgenotype, while B63 strain and the Vietnamese strains from different host species (duck or goose) were clustered into KV2 subgenotype. Ten variable amino acid residues were highly conserved within genotypes or subgenotypes in the VP0, VP3 and VP1, respectively, which were possibly the geographic molecular markers of DHAV-3. To the best of our knowledge, this is the first study about the genetic variation of the P1 gene of different DHAV-3 strains, which will be helpful for understanding of the molecular epidemiology of DHAV-3.