Dynamics of Plasma EGFR T790M Mutation in Advanced NSCLC: A Multicenter Study

BACKGROUND

Droplet digital polymerase chain reaction (ddPCR) is an emerging technology for quantitative cell-free DNA oncology applications. However, a ddPCR assay for the epidermal growth factor receptor (EGFR) p.Thr790Met (T790M) mutation suitable for clinical use remains to be established with analytical and clinical validations.

OBJECTIVE

We aimed to develop and validate a new ddPCR assay to quantify the T790M mutation in plasma for monitoring and predicting the progression of advanced non-small-cell lung cancer (NSCLC).

METHODS

Specificity of the ddPCR assay was evaluated with genomic DNA samples from healthy individuals. The inter- and intraday variations of the assay were evaluated using mixtures of plasmid DNA containing wild-type EGFR and T790M mutation sequences. We assessed the clinical utility of the T790M assay in a multicenter prospective study in patients with advanced NSCLC receiving tyrosine kinase inhibitor (TKI) treatment by analyzing longitudinal plasma DNA samples.

RESULTS

We set the criteria for a positive call when the following conditions were satisfied: (1) T790M mutation frequency > 0.098% (3 standard deviations above the background signal); (2) at least two positive droplets in duplicate ddPCR reactions. Among the 62 patients with advanced NSCLC exhibiting resistance to TKI treatment, 15 had one or more serial plasma samples that tested positive for T790M. T790M mutation was detected in the plasma as early as 205 days (median 95 days) before disease progression, determined by imaging analysis. Plasma T790M concentrations also correlated with intervention after disease progression.

CONCLUSIONS

We developed a ddPCR assay to quantify the T790M mutation in plasma. Quantification of longitudinal plasma T790M mutation may allow noninvasive assessment of drug resistance and guide follow-up treatment in TKI-treated patients with NSCLC.

TRIAL REGISTRATION

Clinical Trials.gov identifier: NCT02804100.

[Heritability of alcohol intake among adult twins, calculate by the structural equation model]

Objective: To explore the genetic and environmental effects on alcohol intake. Methods: Data on 9 231 pairs of adult twins of the same sex was collected from the Chinese National Twin Registry (CNTR), between 2015 and 2018 and used in this study. Structural equation model was used to estimate the effects of genetic and environmental factors on alcohol intake. Results: A total of 9 231 pairs of twins were included in the analysis, of which 6 085 pairs were monozygotic (MZ). The average age of MZ was (36.91±13.07) years old, and males accounted for 56.80%. The average age of dizygotic twins (DZ) was (35.22±12.48) years old, and males accounted for 55.91%. There were 350 pairs of alcohol-drinking twins were with high-risk, accounting for 1.90% and another 367 pairs (1.99%) were with medium-risk. Alcohol-drinkers with medium-risk were affected by additive genetics, common and unique environmental factors, seen among the twins. The overall heritability appeared as 24.3% (95%CI: 0 to 56.8%). Furthermore, 50.7% of the variation (95%CI: 20.4%-79.0%) could be explained by the common environmental factors and 24.9% (95%CI: 18.3%-36.5%) by unique environmental factors. High-risk related drinking behavior was affected by both common and unique environmental factors. The common environmental component appeared as 75.6% (95%CI: 69.6%-80.8%) and unique environmental component as 24.4% (95%CI: 19.2%-30.4%), respectively. Gender difference was seen in the heritability of those with medium or high-risk drinking behaviors. The heritability of men was 30.8% (95%CI: 9.8%-53.5%), while in women it was mainly affected by the environment. Conclusion: Both alcohol drinkers with medium and high-risk drinking behaviors were mainly affected by the environment factors and gender. With the increase of drinking volume, the effect of environment on drinking behaviors became more obvious.

AB0530 CHARACTERISTICS AND MEDIUM-TERM OUTCOMES OF TAKAYASU ARTERITIS–RELATED RENAL ARTERY STENOSIS: ANALYSIS OF A LARGE CHINESE COHORT

Background:

The incidence of renal artery stenosis in Takayasu arteritis (TA) was 20%–60% according to previous reports. The specific characteristics of patients with TA-related renal artery stenosis and the effect of revascularization procedures on prognosis have not been fully investigated.

Objectives:

To investigate the characteristics of patients with TA-related renal artery stenosis and identify the predictors of medium-term adverse outcomes.

Methods:

Data for 567 patients registered in a large prospective observational cohort-the East China Takayasu arteritis cohort-up to April 30, 2019, were retrospectively analyzed.

Results:

Renal artery stenosis was confirmed in 172/567 (30.34%) patients, with left renal artery involvement seen in 73/172 (42.44%) patients. Renal insufficiency at presentation (HR = 2.37, 95% CI: 1.76-15.83, p = 0.03), bilateral renal artery involvement (HR = 6.95, 95% CI: 1.18-21.55, p = 0.01), and severe (>75%) stenosis (HR = 4.75, 95% CI 1.08-11.33, p = 0.05) were predictors of adverse outcomes. Revascularization was performed for 46/172 (26.74%) patients. Patients without preoperative treatment had higher rate of restenosis (44.44% vs. 15.79%, p < 0.01) and hypertension deterioration (25.93% vs. 10.53%, p < 0.01) after the procedure. Non-receipt of preoperative treatment (HR = 6.5, 95% CI: 1.77-32.98, p = 0.04) and active disease at revascularization (HR = 4.21, 95% CI 2.01-21.44, p = 0.04) were independent predictors of adverse outcomes after revascularization.

Conclusion:

Patients with uncontrolled or worsening hypertension or/and renal function may benefit from revascularization. Those who have received preoperative treatment may have more favorable revascularization outcomes. Prognosis appears to be poorer for patients with renal insufficiency at presentation, bilateral artery involvement, and severe stenosis.

References:

[1]Watanabe Y, Miyata T, Tanemoto K. Current clinical features of new patients with Takayasu arteritis observed from a cross-country research in Japan: age and sex specificity. Circulation 2015; 132: 1701-9.

[2]Peng M, Jiang XJ, Dong H, et al. Etiology of renal artery stenosis in 2047 patients: a single-center retrospective analysis during a 15-year period in China. J Hum Hypertens 2016; 30: 124-8

Disclosure of Interests:

None declared

[Heritability of coronary heart disease, based on the data from the Chinese adult twins]

Objective: To analyze the heritability of coronary heart disease (CHD) among the Chinese twin adults. Methods: A total of 20 477 same-sex twin pairs aged 25 years and older from the Chinese National Twin Registry were interviewed. Structure equation model was used to estimate the heritability of CHD. Results: After adjusting for age and gender, the overall heritability of CHD was 0.75(0.68-0.81). Stratified analyses showed that genetic factors play a more important role in CHD incidence in ≥40 years or female twins. While the development of CHD was mainly influenced by environmental factors in 25-39 years or male twins. Conclusion: CHD is influenced by both genetic and environmental factors and the heritability is high.

Seasonal nitrogen uptake strategies in a temperate desert ecosystem depends on N form and plant species

Symbiotic plants might be able to regulate a limited nitrogen (N) pool, thus avoiding and reducing competition for resources, through the uptake of different chemical N forms. Our aim was to see whether coexisting herbs showed preference for different forms of N in a temperate desert. We conducted a situ experiment using the ¹⁵ N labeling method in the Gurbantunggut Desert of Northwestern China dominated by Erodium oxyrrhynchum, Hyalea pulchella, Nonea caspica and Lactuca undulata during their growing period (April and May). Four desert herb species preferentially relied on ¹⁵ N-NO₃ for their N nutrition. Multi-factor analysis of variance (ANOVA) analysis results showed that species, N forms, months, and soil depths strongly affected N uptake rate. The uptake rate by herbs was higher in May than in April, and higher at 0-5 cm than at 5-15 cm soil layers. Erodium oxyrrhynchum, N. caspica and L. undulata showed different preference on N form over months. Erodium oxyrrhynchum and L. undulata changed their uptake preference from more ¹⁵ N-Glycine in April to more ¹⁵ N-NH4 in May. Although the N uptake rate of four desert herbs varied across different soil depths and months, all species absorbed more inorganic N compared with organic N. The higher preference for ¹⁵ N-NO₃ and ¹⁵ N-NH4 over ¹⁵ N-Gly possibly reflects adaptation to different N forms in temperate desert.

Clinical analysis of an anchor nail combined with a titanium cable in the treatment of lower patella fractures

OBJECTIVE

This study was performed to evaluate the clinical effect of an anchor nail and titanium cable for lower patella fractures and identify an effective treatment.

METHODS

Thirty-five patients with lower patella fractures were treated using anchor nail and titanium cable technology. The anchor was fixed to the main part of the patella; the lower patella was then fixed. A bone tunnel was created, and the titanium cable was fixed. The fracture was allowed to heal without tension. Postoperative radiographs were obtained at regular follow-up evaluations. The Böstman function scores were used to assess postoperative complications.

RESULTS

All patients were followed for an average of 15 months. The fracture healing time ranged from 12 to 24 weeks. The postoperative Böstman function scores were as follows: average, 28.6 points; excellent and good scores in 28 and 7 patients, respectively (100% rate of excellent and good scores). At 6 and 12 months postoperatively, the maximum degree of active extension of the affected knee joint was comparable with that of the healthy contralateral joint.

CONCLUSION

The combination of an anchor nail and titanium cable for lower patella fractures is simple and clinically satisfactory, restores knee function well, and is a worthy orthopedic method.

[Birth weight predicts physical indicators in adulthood: a large population-based study in Chinese twins]

Objective: To quantitate the association between birth weight and phenotypes of physical indicators in adulthood, i.e. BMI and waist circumference (WC) and to what degree genetic or environmental factors affect birth weight-obesity association. Methods: A total of 6 623 gender matched twin pairs aged 25 to 79 years were recruited through the Chinese National Twin Registry. The twins reported their own birth weight, current height and weight, and WC using a self-administered questionnaire. BMI was calculated according to the self-reports of body height and weight. Within twin-pair design was used to quantitate the association between birth weight and phenotypes related to obesity while bivariate structural equation models were used to decompose the phenotype correlation. Results: After adjusted for multiple factors, twin-pair analyses within monozygotic (MZ) showed that, on average, a 1.0 kg increase in birth weight corresponded to an increase of 0.33 kg/m(2) in BMI and 0.95 cm in WC in adulthood (P<0.001). Bivariate structural equation models showed significant positive unique environmental correlation between birth weight and the two obesity-related phenotypes. Conclusion: The study supported the role of twin-specific supply line factors on relationship between birth weight and physical indicators in adulthood.

Plasma fluoroacetic acid concentrations: Symptoms, hematological, and biochemical characteristics in patients with fluoroacetic acid poisoning in the emergency department

Fluoroacetic acid (FAcOH) was once a highly toxic rodenticide widely used in the world. In the past, studies on the toxicity of FAcOH have focused on animal experiments. The toxicity of FAcOH to humans and the changes of FAcOH in plasma have not been studied. Therefore, the present study aimed to describe the changes of plasma FAcOH concentrations, hematological, and biochemical characteristics in patients with FAcOH intoxication. According to clinical symptoms, 68 patients from the emergency department were divided into different groups: convulsion group, unconsciousness group, death group, and control groups. Plasma FAcOH concentrations, hematological, and biochemical parameters were investigated. Results demonstrated that patients in the convulsion group and the unconsciousness group had a significant increase (p < 0.01) in the level of neuron-specific enolase (NSE), creatine kinase MB (CKMB), glucose (GLU), and white blood cell count (WBC) and a significant decrease (p < 0.01) in serum potassium compared with the control group, respectively. Moreover, patients in the death group had a significant increase (p < 0.01) in the level of NSE, CKMB, N-terminal pro-brain natriuretic peptide, GLU, and WBC and a significant decrease (p < 0.01) in serum potassium and total calcium compared with the survival group. The concentrations of FAcOH in plasma in the convulsion group, the unconsciousness group, and the death group were 72.31 ± 42.29, 118.33 ± 55.41, and 163.78 ± 43.32 μg/mL, respectively. These changes and the plasma FAcOH concentrations may increase our understanding of the toxicity of FAcOH to humans and may help doctors to judge the clinical prognosis of patients with FAcOH intoxication.

Anodic and Mechanical Behavior of Carbon Fiber Reinforced Polymer as a Dual-Functional Material in Chloride-Contaminated Concrete

Carbon fiber reinforced polymer (CFRP) has been used as a dual-functional material in a hybrid intervention system (ICCP-SS) which integrates the impressed current cathodic protection (ICCP) and structural strengthening (SS). The mechanical behavior of CFRP as an anode has been investigated in some solution environments. However, the anodic and mechanical behavior of CFRP bonded to concrete is unclear. This paper focuses on the anodic and mechanical performance of CFRP bonded to the chloride-contaminated concrete by conducting an electrochemical (EC) test. The method of bonding the CFRP to the concrete and the shape of the steel embedded in the concrete were considered. The current densities of 20 mA/m² and 100 mA/m² were applied during 120-day and 310-day EC tests. The electrode potentials and driving voltages were recorded, and the bond interfaces of the CFRP were inspected after EC test. The residual tensile strength and failure modes of the CFRP were analyzed after tensile tests. Finally, the long-term performance of CFRP as a dual-functional material in ICCP-SS system was discussed. Results show that the externally bonding CFRP in ICCP-SS system can not only protect the steel in chloride-contaminated concrete effectively but also maintain 70% of the original tensile strength of CFRP at a charge density of 744 A·h/m². The expected service period of CFRP as a dual-functional material bonded to the chloride-contaminated concrete was determined to be more than 42.5 years.

Advances in molecular biology of Paeonia L

Molecular biology can serve as a tool to solve the limitations of traditional breeding and cultivation techniques related to flower patterns, the improvement of flower color, and the regulation of flowering and stress resistance. These characteristics of molecular biology ensured its significant role in improving the efficiency of breeding and germplasm amelioration of Paeonia. This review describes the advances in molecular biology of Paeonia, including: (1) the application of molecular markers; (2) genomics, transcriptomics, proteomics, metabolomics, and microRNA studies; (3) studies of functional genes; and (4) molecular biology techniques. This review also points out select limitations in current molecular biology, analyzes the direction of Paeonia molecular biology research, and provides advice for future research objectives.

Analysis of related factors of orolingual angioedema after rt-PA intravenous thrombolytic therapy

OBJECTIVE

Orolingual angioedema (OA) is a rare clinical complication with a potentially fatal risk that occurs after the intravenous application of alteplase (rt-PA) in patients with acute ischemic stroke. The purpose of this work is to investigate the related factors of OA in patients with acute ischemic stroke after the administration of intravenous thrombolytic therapy, to improve the predictive ability of OA during intravenous thrombolytic therapy, and to reduce the prevalence of complications.

PATIENTS AND METHODS

We recruited 1223 cases of patients with acute ischemic stroke that were treated in the Department of Neurology No. 4 of the Tianjin Huanhu Hospital from June 2014 to April 2015. The clinical manifestations of rt-PA related OA were recorded, the clinical prevalence was counted, related factors of OA after intravenous thrombolytic therapy were analyzed, and the risk assessment of rt-PA related OA was conducted.

RESULTS

14 cases of patients developed OA, with a prevalence rate of 1.14%. Among them, 5 had a history of urticaria, 4 of drug allergy, and 3 of food allergy. Among the 14 cases of patients, 10 developed OA in the process of intravenous thrombolysis and 4 after intravenous thrombolysis, 12 showed lip edema, 9 showed extensive swelling of tongue, 3 showed swelling of lateral tongue, 3 were complicated by respiratory distress, 10 showed infarction in the middle cerebral artery territory, and 6 had previously been given oral ACEI drugs.

CONCLUSIONS

Orolingual angioedema is a rare complication that occurs after rt-PA intravenous thrombolytic therapy; when serious, it may endanger a patient's life. If patients take an oral hypotension such as ACEI drugs before the onset of OA, they have a history of allergies, or the lesion is an infraction in the dominated area of the middle cerebral artery, the risk of OA after rt-PA intravenous thrombolytic therapy will be increased. The prevalence of OA should be monitored during the rt-PA intravenous thrombolytic therapy process; timely detection and early intervention should be conducted, which can avoid serious adverse consequences.

Obesity Prevalence in Alabama: Trends from 2011 to 2017 and Evaluation of a State Obesity Program

Background

Alabama, one of the southeastern states in the US, suffers from a heavy burden of obesity. In 2014, Alabama launched a state program named ’ALProHealth’, aiming to prevent and reduce obesity prevalence. The objective of this study is to evaluate the potential impact of the ALProHealth Program on the prevalence of obesity in Alabama from 2014 to 2017.

Methods

Data for this study come from the Behavioral Risk Factor Surveillance System (BRFSS). An interrupted time series design was employed. The state obesity prevalence trend for the pre-program period (2011-2014) was estimated and compared with the post-program period (2015-2017). Statistical analyses were conducted using segmented linear regression. Indiana was chosen as the control group in this study.

Results

The obesity prevalence in Alabama significantly increased from 31.8% in 2011 to 36.2% in 2017, increasing by 0.81% on average each year (95% CI: 0.47 to 1.15, p = 0.002). Before the ALProHealth Program, the obesity prevalence increased by 0.59% (p = 0.11) and 0.32% (p = 0.34) in both Alabama and Indiana respectively, though it is not statistically significant. After the program implementation, the slope of obesity prevalence increased by 0.43 (p = 0.45) and 0.03 (p = 0.96) in Alabama and Indiana respectively, though change is not significant. When comparing Alabama and Indiana, the rate of slope change is higher in Alabama (0.73) compared with Indiana (0.093), indicating the rate of slope change in obesity prevalence increased faster in Alabama than Indiana.

Conclusions

To sum up, the study found no evidence that the ALProHealth Program contributed to the decrease of obesity prevalence in Alabama. One possible reason is that there was low program coverage. Future studies should examine the potential effectiveness of other programs using a similar conceptual model as ALProHealth Program.

Key messages

In 2014, Alabama launched a state program named ‘ALProHealth’, aiming to prevent and reduce obesity prevalence. The study found no evidence that the ALProHealth Program contributed to the statewide decrease of obesity prevalence in Alabama, which may attribute to low program coverage.

A bactericidal permeability-increasing protein (BPI) from manila clam Ruditapes philippinarum: Investigation on the antibacterial activities and antibacterial action mode

Bactericidal permeability-increasing protein (BPI) is an antimicrobial protein with potent endotoxin-neutralising activity and plays a crucial role in innate immunity against bacterial infection. In the present study, a bpi (designed as rpbpi) was identified and characterized from manila clam Ruditapes philippinarum. Multiple alignments and phylogenetic analysis suggested that rpbpi was a new member of the bpis family. In non-stimulated clams, rpbpi transcripts were ubiquitously expressed in all tested tissues with the highest expression level in hemocytes. After Vibrio anguillarum challenge, the expression levels of rpbpi mRNA in hemocytes were up-regulated significantly at 3 h and 48 h compared with that in the control, which were 4.01- and 19.10-fold (P < 0.05), respectively. The recombinant RpBPI (rRpBPI) showed high antibacterial activities against Gram-negative bacteria Escherichia coli and V. anguillarum, but not Staphylococcus aureus. Moreover, membrane integrity analysis revealed that rRpBPI increased the membrane permeability of Gram-negative bacteria, and then resulted in cell death. Overall, our results suggested that RpBPI played an important role in the elimination of invaded bacteria through membrane-disruptive activity.

P11.07 LAPTM5 functions as a tumor suppressor via CD40 - NFêB pathway inhibition and represents a potential biomarker for temozolomide sensitivity in CD40 proficient glioblastoma

BACKGROUND

Glioma therapy is challenged by the invasive nature of glioma resulting in tumor recurrence and treatment resistance. Lysosomal protein transmembrane 5 (LAPTM5) was identified to inhibit invasion by screening for invasion-associated genes in glioma. The aim of this study was to decipher the function of LAPTM5 in glioblastoma and its interaction with the CD40 receptor which was shown to be highly expressed in up to 40% of glioblastoma.

METHODS

LAPTM5 expression was correlated with clinical outcome of glioma patients. Knockdown of LAPTM5 was performed in different glioma cell lines to analyze the impact on clonogenicity, invasiveness, sensitivity to temozolomide chemotherapy and tumorigenicity in-vitro and in-vivo in a subcutaneous xenograft mouse model. Expression array was used to elucidate the underlying pathways. CD40 knockdown and overexpression was induced to prove the crosstalk of LAPTM5 and CD40.

RESULTS

LAPTM5 expression correlated with better overall survival in high grade glioma patients and acted as a tumor suppressor in CD40 positive glioblastoma cells. LAPTM5 inhibited CD40-mediated NFκB activation resulting in anti-invasive, anti-clonogenic and temozolomide sensitizing effects in-vitro and in-vivo. Vice-versa, knockdown of LAPTM5 enhanced tumorigenicity by activation of the NFκB pathway which was overcome by NFκB inhibition. Importantly, CD40 expression was required for LAPTM5-mediated tumor suppressive activity.

CONCLUSION

LAPTM5 conveyed tumor suppressive and temozolomide sensitizing effects in CD40-positive glioblastoma by inhibition of CD40-mediated NFκB activation and thereby might provide a reasonable biomarker for sensitivity to temozolomide in CD40-positive glioblastoma.

The Chinese National Twin Registry: a 'gold mine' for scientific research

The Chinese National Twin Registry (CNTR) currently includes data from 61 566 twin pair from 11 provinces or cities in China. Of these, 31 705, 15 060 and 13 531 pairs are monozygotic, same-sex dizygotic and opposite-sex dizygotic pairs, respectively, determined by opposite sex or intrapair similarity. Since its establishment in 2001, the CNTR has provided an important resource for analysing genetic and environmental influences on chronic diseases especially cardiovascular diseases. Recently, the CNTR has focused on collecting biologic specimens from disease-concordant or disease-discordant twin pairs or from twin pairs reared apart. More than 8000 pairs of these twins have been registered, and blood samples have been collected from more than 1500 pairs. In this review, we summarize the main findings from univariate and multivariate genetic effects analyses, gene-environment interaction studies, omics studies exploring DNA methylation and metabolomic markers associated with phenotypes. There remains further scope for CNTR research and data mining. The plan for future development of the CNTR is described. The CNTR welcomes worldwide collaboration.

A macin identified from Venerupis philippinarum: Investigation on antibacterial activities and action mode

In the present study, a macin was cloned and characterized from clam Venerupis philippinarum (designed as VpMacin). The full-length cDNA of VpMacin was of 579 bp, encoding a peptide of 87 amino acids with the predicted molecular weight of 9.7 kDa. Analysis of the conserved domain suggested that VpMacin was a new member of the macin family. In non-stimulated clams, VpMacin transcripts exhibited different tissue expression pattern, and highly expressed in the tissues of gills and hepatopancreas. Generally, the temporal expression of VpMacin transcripts was significantly induced in hemocytes of clams post Vibrio anguillarum challenge. Moreover, the recombinant VpMacin protein (rVpMacin) showed obvious antimicrobial activities against Gram-positive and Gram-negative bacteria. After incubated with 40 μM rVpMacin, all detected Escherichia coli could be killed within 60 min. Membrane integrity analysis revealed that rVpMacin could increase the membrane permeability of bacteria and then resulted in cell death. Overall, our results suggested that VpMacin had an important function in host defense against invasive pathogens.

Preparation of reduced graphite oxide loaded with cobalt(II) and nitrogen co-doped carbon polyhedrons from a metal-organic framework (type ZIF-67), and its application to electrochemical determination of metronidazole

The integration of derivatives of granular metal-organic frameworks (MOFs) and an electrically conductive carbon substrate is an effective way to circumvent the deficiency of powdered pristine MOFs or MOF-derived carbon in practical application. The authors describe the use of graphite oxide (GO) as a substrate for in-situ assembly with the zeolitic imidazole framework ZIF-67. The GO and ZIF-67 composites were converted, via pyrolysis, into reduced graphite oxide loaded with Co/N-co-doped carbon polyhedrons (ZIF-67C@rGO). By using various amounts of GO, a series of ZIF-67C@rGO-x with different fractions of GO were synthesized and utilized as electrode modifiers for the detection of the antibiotic metronidazole (MNZ). The results revealed that the ZIF-67C@rGO-0.06 display best sensing performance. This is likely to be due to its hierarchically open pores, abundant active sites and good electrical conductivity. The sensor, best operated near a working potential around -0.6 V (vs. SCE), has a linear response in the 0.5 to 1000 μM MNZ concentration range and a 0.05 μM detection limit. The sensor was applied to the analysis of pharmaceutical samples where it showed excellent selectivity, good repeatability and satisfying recoveries. Graphical abstract Schematic representation of preparation and application of ZIF-67C@rGO-x.

Integrated analysis of differentially expressed genes in esophageal squamous cell carcinoma using bioinformatics

Esophageal squamous cell carcinoma (ESCC) is a deadly disease. To identify key genes in esophageal squamous cell carcinoma, we followed a strategy utilizing the laiurger microarray dataset (GSE38129) as the training set and another independent microarray dataset (GSE20347) as the validation set. Following quality control, differentially expressed genes (DEGs) were obtained using R software. Functional enrichment analysis was performed using DAVID database and the DEG co-expression network was established with Weighted Gene Co-Expression Network Analysis (WGCNA) and visualized by Cytoscape. The prognosis-related hub genes were then identified by Kaplan-Meier analysis based on the TCGA database. A total of 188 DEGs were obtained; 88 up-regulated genes and 100 down-regulated. The up-regulated DEGs were significantly associated with extracellular matrix organization and disassembly while down-regulated DEGs were significantly related to keratinocyte differentiation. Blue and turquoise co-expression modules were established and 18 hub genes were identified. The blue module was associated with mitotic nuclear division, cell division and mitotic cytokinesis and the turquoise module was associated with collagen catabolic process, extracellular matrix organization and keratinocyte differentiation. We established that the TPX2, CDK1 and CEP55 blue module hub genes were associated with relapse-free survival, and our overall results not only identify key genes but also provide potential novel biomarkers for ESCC diagnosis and treatment.

[Changes of eye care use among rural adults under the reform of New Rural Cooperative Medical Scheme: the Handan Eye Study]

Objective: To assess the utilization of eye care services in the rural area of Handan, China under the New Rural Cooperative Medical Scheme, and to analyze the factors associated with the uptake of these services. Methods: In a cohort population-based study, subjects who joined both the baseline (2006-2007) and follow-up (2012-2013) were included. Information of demographic characteristics, participation in the New Rural Cooperative Medical Insurance and use of eye care services, comprehensive ophthalmic examinations, blood pressure and fasting was collected. The protocol got approved by the ethics committee of Beijing Tongren Hospital, and each subject signed the informed consent. Results: Of 5 193 eligible participants, 549 [10.6%; 95% confidence interval (CI), 9.8%-11.4%] had used eye care services, and the prevalence had no significant difference from baseline surveys (P=0.20). The municipal hospitals undertook 50.1% of eye care services. "No need" (4 422, 95.2%) was the most common reason cited for not using an eye care service; 2 875 (65.0%) of these participants had at least one type of eye diseases, 3 505 (79.3%) had at least one type of ocular complaints. In the multiple binary logistics regression model, participants who were elder [adjusted odds ratio (OR), 1.319; 95%CI, 1.177-1.478], were female (adjusted OR, 1.466; 95%CI, 1.085-1.981), had a diabetes history (adjusted OR, 1.930; 95%CI, 1.381-2.696), had a low income (adjusted OR, 0.826; 95%CI, 0.688-0.922), had ocular complaints (adjusted OR, 3.556; 95%CI, 2.484-5.091), had refractive errors (adjusted OR, 1.256; 95%CI, 1.007-1.567), had visual impairment (adjusted OR, 4.398; 95%CI, 2.667-7.253) or had cataract (adjusted OR, 1.278; 95%CI, 1.013-1.612) were more likely to take an eye care service. Conclusions: Under the New Rural Cooperative Medical Scheme, the prevalence of New Rural Cooperative Medical Insurance was increased significantly, but the rate of eye care use in the rural area was still low. Further efforts towards higher quality medical service in county hospitals and village clinics as well as better education about eye disease among the rural population may raise the eye care use in rural areas. (Chin J Ophthalmol, 2018, 54:570-579).

Enhanced Photodetection Properties of Tellurium@Selenium Roll-to-Roll Nanotube Heterojunctions

Non-layered tellurium (Te) is a promising material for applications in transistor and optoelectronic devices for its advantages in excellent intrinsic electronic and optoelectronic properties. However, the poor photodetection performance and relatively uncertain stability of tellurene under ambient conditions greatly limit the practical applications. In order to improve the performance of tellurene-based materials, Te@Se roll-to-roll nanotubes with different selenium (Se) contents synthesized by epitaxial growth of Se on Te nanotubes are, for the first time, employed to fabricate working electrodes for photoelectrochemical (PEC)-type broadband photodetection. They exhibit not only a preferably enhanced capacity for self-powered broadband photodetection but also significantly improved photocurrent density and stability in various aqueous environments (HCl, NaCl, and KOH solutions), compared to tellurene-based photodetectors. It is anticipated that the present work can open up new possibilities for high-performance tellurene-based optoelectronic devices.