[Mortality rate and influencing factors among index partners of HIV discordant couples in the context of antiretroviral therapy, Zhumadian, Henan province, 2008-2014]

OBJECTIVE

To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian, Henan province.

METHODS

An open and prospective cohort survey was conducted annually during 2008-2014. Information about the index partners ' demographic characteristics, CD4(+) T(CD4)cell counts, viral load, AIDS-related syndromes, date of therapy initiation, level of treatment institution, and outcome of death were collected. Life table was used to calculate survival rate, and Cox proportional hazards model was used to analyze the mortality related factors.

RESULTS

Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014, 350 were fatal, with the mortality rate of 1.88 per 100 person years(95%CI: 1.86-1.90). The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64%, 97.70%, 95.62%, 93.54%, 91.25%, 86.86% and 82.36% respectively. Factors related to the survival of the index partners of HIV discordant couples were age ≥ 50 years(HR=3.48, 95% CI: 2.67-4.55), junior high school or above education level(HR=0.75, 95% CI: 0.56-1.00), baseline CD4 cell counts >350 cells per μl(HR=0.55, 95% CI: 0.42-0.72), baseline viral load >400 copies/ml(HR=1.71, 95% CI: 1.32-2.22)and initiating treatment prior to cohort entry(HR=0.65, 95% CI: 0.41-1.05).

CONCLUSIONS

The mortality rate of index partners receiving antiretroviral therapy was relatively low, indicating a better effect of long-term treatment on patients' survival. It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy, improve the timeliness and adherence of the treatment, keeping patients' immunity level. Meanwhile, much attention should be paid to the drug resistance due to long term treatment and treatment failure.

The Kaiser Permanente Northern California research program on genes, environment, and health (RPGEH) pregnancy cohort: study design, methodology and baseline characteristics

Background

Exposures during the prenatal period may have lasting effects on maternal and child health outcomes. To better understand the effects of the in utero environment on children’s short- and long-term health, large representative pregnancy cohorts with comprehensive information on a broad range of environmental influences (including biological and behavioral) and the ability to link to prenatal, child and maternal health outcomes are needed. The Research Program on Genes, Environment and Health (RPGEH) pregnancy cohort at Kaiser Permanente Northern California (KPNC) was established to create a resource for conducting research to better understand factors influencing women’s and children’s health. Recruitment is integrated into routine clinical prenatal care at KPNC, an integrated health care delivery system. We detail the study design, data collection, and methodologies for establishing this cohort. We also describe the baseline characteristics and the cohort’s representativeness of the underlying pregnant population in KPNC.

Methods

While recruitment is ongoing, as of October 2014, the RPGEH pregnancy cohort included 16,977 pregnancies (53 % from racial and ethnic minorities). RPGEH pregnancy cohort participants consented to have blood samples obtained in the first trimester (mean gestational age 9.1 weeks ± 4.2 SD) and second trimester (mean gestational age 18.1 weeks ± 5.5 SD) to be stored for future use. Women were invited to complete a questionnaire on health history and lifestyle. Information on women’s clinical and health assessments before, during and after pregnancy and women and children’s health outcomes are available in the health system’s electronic health records, which also allows long-term follow-up.

Discussion

This large, racially- and ethnically-diverse cohort of pregnancies with prenatal biospecimens and clinical data is a valuable resource for future studies on in utero environmental exposures and maternal and child perinatal and long term health outcomes. The baseline characteristics of RPGEH Pregnancy Cohort demonstrate that it is highly representative of the underlying population living in the broader community in Northern California.

Electronic supplementary material

The online version of this article (doi:10.1186/s12884-016-1150-2) contains supplementary material, which is available to authorized users.

A Longitudinal HbA1c Model Elucidates Genes Linked to Disease Progression on Metformin

One-third of type-2 diabetic patients respond poorly to metformin. Despite extensive research, the impact of genetic and nongenetic factors on long-term outcome is unknown. In this study we combine nonlinear mixed effect modeling with computational genetic methodologies to identify predictors of long-term response. In all, 1,056 patients contributed their genetic, demographic, and long-term HbA1c data. The top nine variants (of 12,000 variants in 267 candidate genes) accounted for approximately one-third of the variability in the disease progression parameter. Average serum creatinine level, age, and weight were determinants of symptomatic response; however, explaining negligible variability. Two single nucleotide polymorphisms (SNPs) in CSMD1 gene (rs2617102, rs2954625) and one SNP in a pharmacologically relevant SLC22A2 gene (rs316009) influenced disease progression, with minor alleles leading to less and more favorable outcomes, respectively. Overall, our study highlights the influence of genetic factors on long-term HbA1c response and provides a computational model, which when validated, may be used to individualize treatment.

Higher all-cause hospitalization among patients with chronic hepatitis C: the Chronic Hepatitis Cohort Study (CHeCS), 2006-2013

In the United States, hospitalization among patients with chronic hepatitis C virus (HCV) infection is high. The healthcare burden associated with hospitalization is not clearly known. We analysed data from the Chronic Hepatitis Cohort Study, an observational cohort of patients receiving care at four integrated healthcare systems, collected from 2006 to 2013 to determine all-cause hospitalization rates of patients with chronic HCV infection and the other health system patients. To compare the hospitalization rates, we selected two health system patients for each chronic HCV patient using their propensity score (PS). Propensity score matching was conducted by site, gender, race, age and household income to minimize differences attributable to these characteristics. We also compared primary reason for hospitalization between chronic HCV patients and the other health system patients. Overall, 10 131 patients with chronic HCV infection and 20 262 health system patients were selected from the 1 867 802 health system patients and were matched by PS. All-cause hospitalization rates were 27.4 (27.0-27.8) and 7.4 (7.2-7.5) per 100 persons-year (PY) for chronic HCV patients and for the other health system patients, respectively. Compared to health system patients, hospitalization rates were significantly higher by site, gender, age group, race and household income among chronic HCV patients (P < 0.001). Compared to health system patients, chronic HCV patients were more likely to be hospitalized from liver-related conditions (RR = 24.8, P < 0.001). Hence, patients with chronic HCV infection had approximately 3.7-fold higher all-cause hospitalization rate than other health system patients. These findings highlight the incremental costs and healthcare burden of patients with chronic HCV infection associated with hospitalization.

[Value of perineural invasion in prostatectomy specimen in the assessment on tumor progression and prognosis]

OBJECTIVE

To assess perineural invasion in prostatectomy specimen(PNIp)on tumor progression and prognosis after radical prostatectomy.

METHODS

Retrospective analysis including 502 prostate cancer patients admitted in Renji Hospital, School of Medicine, Shanghai Jiaotong University from December 2002 to May 2014 was studied.Differences of serum prostate specific antigen(PSA), Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion, positive surgical margin, seminal invasion, pelvic lymph node metastasis, nadir PSA were analyzed in patients with PNIp and without PNIp. Logistic regression analysis, Log-rank test and Cox regression analysis was used to analyzed the data, respectively.

RESULTS

There were 91 patients with PNIp(18.1%) and 411 patients without PNIp(81.9%). Differences of serum PSA, Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion, seminal invasion, nadir PSA between the two groups were found(all P<0.05). In the multivariable logistic regression analysis, PNIp was independent predictor of Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion(OR=1.515, 1.955, 2.069, 1.859, all P<0.05). One hundred and twenty-one patients with biochemical serum recurrence(26.7%). Serum PSA, Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, PNIp, seminal invasion were related to biochemical serum recurrence(P<0.05). In the multivariable cox regression analysis, serum PSA, Gleason score of prostate biopsy, PNIp, seminal invasion were independent predictors of biochemical serum recurrence(HR=1.021, 1.441, 1.663, 3.257, all P<0.05).

CONCLUSION

PNIp is the important predictor of the tumor progression and prognosis of prostate cancer.

Nanoconjugation prolongs endosomal signaling of the epidermal growth factor receptor and enhances apoptosis

It is becoming increasingly clear that intracellular signaling can be subject to strict spatial control. As the covalent attachment of a signaling ligand to a nanoparticle (NP) impacts ligand-receptor binding, uptake, and trafficking, nanoconjugation provides new opportunities for manipulating intracellular signaling in a controlled fashion. To establish the effect of nanoconjugation on epidermal growth factor (EGF) mediated signaling, we investigate here the intracellular fate of nanoconjugated EGF (NP-EGF) and its bound receptor (EGFR) by quantitative correlated darkfield/fluorescence microscopy and density-based endosomal fractionation. We demonstrate that nanoconjugation prolongs the dwell time of phosphorylated receptors in the early endosomes and that the retention of activated EGFR in the early endosomes is accompanied by an EGF mediated apoptosis at effective concentrations that do not induce apoptosis in the case of free EGF. Overall, these findings indicate nanoconjugation as a rational strategy for modifying signaling that acts by modulating the temporo-spatial distribution of the activated EGF-EGFR ligand-receptor complex.

Association between Excess Bodyweight and Intake of Red Meat and Vegetables among Urban and Rural Adult Chinese in Nanjing, China

The objective of this study was to examine the association of red meat and vegetable consumption with excess bodyweight. This is a cross sectional study, conducted between October 2000 and March 2001. Participants included 23,316 local residents aged 35 and above from 45 administrative villages randomly selected from urban and rural areas of Nanjing, China, with a population of 5.6 million. The response rate was 90.1%. Logistic regression model was used for the analysis. The prevalence of excess body weight, overweight and obesity was 34.1%, 28.2% and 6.0%, respectively. After adjustment for age, educational attainment, family average income, occupational and leisure-time physical activity, smoking, drinking, consumption of white meat, consumption of rice and cooking oil as well as fruits, participants in the moderate or higher level of red meat consumption were more likely to have excess body weight (OR: 1.13 (95% CI=1.02, 1.26) and 1.15 (1.02, 12.9) for males; 1.11 (0.98, 1.25) and 1.25 (1.10, 1.42) for females respectively), compared with those in the lower level of red meat consumption. There was no statistically significant association for consumption of vegetables. Consumption of more red meat was suggested to be a factor contributing to body weight gain in China. For residents who want to have healthy body weight, it is important to consume less red meat in the process of socioeconomic transition. Asia Pac J Public Health 2007; 19(3): 3-9.

[Effect of SIRT1 deficiency on function of brown adipose tissue in obese mice]

OBJECTIVE

To investigate the effect of silent mating type information regulation 2 homolog 1 (SIRT1) deficiency on function of brown adipose tissue (BAT) in high-fat diet (HFD)-induced obese mice.

METHODS

Male SIRT1 deficient heterozygous (SIRT1(+ /-)) mice and their wild-type (WT) littermates were challenged with a HFD diet for 16 weeks to induce obesity model.Energy metabolic cages were used to measure oxygen consumption and heat production, and cold tolerance test was to evaluate the adaptive thermogenic function.With brown fat collected after the diet intervention, determination techniques were adopted included HE staining for morphologic changes, immunohistochemical staining and Western blotting for uncoupling protein 1 (UCP1) expression, quantitative real-time PCR for relative content of mitochondria DNA (mtDNA).

RESULTS

Compared to WT controls, SIRT1(+ /-) mice displayed significant decreases in both oxygen consumption and heat production[(2 681±297) vs (3 017±313) ml·kg(-1)·h(-1,) (19.05±2.40) vs (21.15±2.49) kcal·kg(-1)·h(-1,) both P<0.05)], as well as an impairment in maintaining their body temperature during the cold challenge.HE staining revealed the accumulation of larger lipid droplets in BAT of SIRT1(+ /-) mice, and both immunohistochemical staining and Western blotting indicated an obvious reduction in expression of UCP1 (P<0.05). Quantitative real-time PCR showed a significant decrease in the relative mtDNA content in BAT of SIRT1(+ /-) mice (0.38±0.10 vs 1.00±0.40, P<0.05).

CONCLUSION

SIRT1 deficiency promotes BAT dysfunction, meaning that whitening in obese mice.

Clinicopathological features of invasive lobular carcinoma of the breast: A nationwide multicenter study in China

OBJECTIVE

To analyze the clinicopathological features of invasive lobular carcinoma (ILC) and compare them with invasive ductal carcinoma (IDC), hoping to find the fact of ILC in China and assist the decision makers with proper individualized treatment.

MATERIALS AND METHODS

A nationwide multicenter retrospective study was performed. A total of 4211 primary breast cancer cases were randomly selected from 1999 to 2008 in seven regions of China. ILC cases were compared with IDC by clinicopathological features and molecular subtypes.

RESULTS

A total of 135 (3.2%) ILC and 3471 (82.4%) IDC cases were included for analysis. The age, tumor size, menopausal state, family history, nodal status, and stage of ILC were similar to that of IDC. ILC was more likely to be positive for estrogen receptor (65.5% vs. 57.7%) and progesterone receptor (64.7% vs. 58.5%), and less likely to overexpress human epidermal growth factor receptor-2 (17.3% vs. 23.6%). Even though, these differences are not significant, the proportion of luminal A type of ILC is significantly larger than that of IDC (54.8% vs. 42.7%; P < 0.05).

CONCLUSION

ILC has a larger proportion of luminal A type compared with IDC. Larger sample size study for better known of molecular subtypes of ILC is needed in future to individualize the treatment decision.

[The influence of patatin-like phospholipase domain-containing protein 3 on palmitic acid-induced hepatocyte apoptosis]

OBJECTIVE

To explore the influence of patatin-like phospholipase domain-containing protein 3 (PNPLA3) on palmitic acid (PA)-induced hepatocyte apoptosis and its mechanism.

METHODS

Human hepatocarcinoma cell line HepG2 cells were transfected with PNPLA3(WT)-pcDNA3.1 (PNPLA3(WT) group) and PNPLA3(I148M)-pcDNA3.1 (PNPLA3(I148M) group) plasmids respectively to overexpress wild type or mutant type PNPLA3, and cells transfected with empty vector pcDNA3.1 (NC group) were set as control group.After 24 h PA incubation, Oil red staining was used to determine lipid deposition, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) was used to measure apoptosis.Western blot was used to detect the protein level of endoplasmic reticulum (ER) stress and associated apoptosis.Enzyme-linked immunosorbent assay (ELISA) was used to test lysolecithin (LPC) levels in the cellular supernatant.

RESULTS

After 24 h PA incubation, there was no significant difference in lipid deposition among three groups.Compared to NC group, the cell apoptosis rates of PNPLA3(WT) and PNPLA3(I148M) groups were increased by 2 times and 3 times respectively.The levels of ER stress PRKR-like endoplasmic reticulum kinase (PERK) pathway associated proteins, immunoglobulin-binding protein (BIP), p-PERK, p-eIF2α, and ER stress associated apoptosis pathway proteins, CCAAT/enhancer binding homologous protein (CHOP), p53 upregulated modulator of apoptosis (PUMA), Bax, caspase-3 were higher, and were more significant in PNPLA3(I148M) group.The LPC level in the supernatant of PNPLA3(WT) and PNPLA3(I148M) groups were about 5 times and 1.5 times of NC group respectively after PA incubation.

CONCLUSION

PNPLA3 may be involved in palmitic acid-induced apoptosis mediated by hepatocyte ER stress through regulating LPC metabolism.

Anti-Müllerian hormone promotes pre-antral follicle growth, but inhibits antral follicle maturation and dominant follicle selection in primates

STUDY QUESTION

What are the direct effects and physiological role of anti-Müllerian hormone (AMH) during primate follicular development and function at specific stages of folliculogenesis?

SUMMARY ANSWER

AMH actions in the primate ovary may be stage-dependent, directly promoting pre-antral follicle growth while inhibiting antral follicle maturation and dominant follicle selection.

WHAT IS KNOWN ALREADY

AMH is expressed in the adult ovary, particularly in developing follicles. Studies in mice suggest that AMH suppresses pre-antral follicle growth in vitro, and inhibits primordial follicle recruitment and FSH-stimulated antral follicle steroidogenesis.

STUDY DESIGN, SIZE, DURATION

For in vitro study, secondary follicles were isolated from ovaries of 12 rhesus macaques and cultured for 5 weeks. For in vivo study, intraovarian infusion was conducted on five monkeys for the entire follicular phase during two spontaneous menstrual cycles.

PARTICIPANTS/MATERIALS, SETTING, METHODS

For in vitro study, individual follicles were cultured in a 5% O2 environment, in alpha minimum essential medium supplemented with recombinant human FSH. Follicles were randomly assigned to treatments of recombinant human AMH protein or neutralizing anti-human AMH antibody (AMH-Ab). Follicle survival, growth, steroid production, steroidogenic enzyme expression, and oocyte maturation were assessed. For in vivo study, ovaries were infused with control vehicle or AMH-Ab during the follicular phase of the menstrual cycle. Cycle length, serum steroid levels, and antral follicle growth were evaluated.

MAIN RESULTS AND THE ROLE OF CHANCE

AMH exposure during culture weeks 0-3 (pre-antral stage) promoted, while AMH-Ab delayed, antrum formation of growing follicles compared with controls. AMH treatment during culture weeks 3-5 (antral stage) decreased (P < 0.05) estradiol (E2) production, as well as the mRNA expression of cytochrome P450 family 19 subfamily A polypeptide 1, by antral follicles relative to controls, whereas AMH-Ab increased (P < 0.05) follicular mRNA levels of the enzyme. Intraovarian infusion of AMH-Ab during the follicular phase of the menstrual cycle increased (P < 0.05) the average levels of serum E2 compared with those of the control cycles. Three of the five AMH-Ab-treated ovaries displayed multiple (n = 2-9) medium-to-large (2-8 mm) antral follicles at the mid-cycle E2 peak, whereas only one large (4-7 mm) antral follicle was observed in all monkeys during their control cycles. The average levels of serum progesterone were higher (P < 0.05) during the luteal phase of cycles following the AMH-Ab infusion relative to the vehicle infusion.

LIMITATIONS, REASONS FOR CAUTION

The in vitro study of AMH actions on cultured individual macaque follicles was limited to the interval from the secondary to small antral stage. A sequential study design was used for in vivo experiments, which may limit the power of the study.

WIDER IMPLICATIONS OF THE FINDINGS

The current study provides novel information on direct actions and role of AMH during primate follicular development, and selection of a dominant follicle by the late follicular phase of the menstrual cycle. We hypothesize that AMH acts positively on follicular growth during the pre-antral stage in primates, but negatively impacts antral follicle maturation, which is different from what is reported in the mouse model.

STUDY FUNDING/COMPETING INTERESTS

NIH NICHD R01HD082208, NIH ORWH/NICHD K12HD043488 (BIRCWH), NIH OD P51OD011092 (ONPRC), Collins Medical Trust. There are no conflicts of interest.

TRIAL REGISTRATION NUMBER

Not applicable.

Endothelial microparticles induce vascular endothelial cell injury in children with Kawasaki disease

OBJECTIVE

To explore the role of microparticles produced by endothelial cells in the injury of vascular endothelial cells.

MATERIALS AND METHODS

We stimulated human umbilical vein endothelial cells (HUVEC) with TNF-α in vitro, analyzed the change of cellular morphology, and measured EMP level in the supernatant with a flow cytometer. Then, we evaluated the corresponding clinical indicators and the role of EMP in endothelial injury.

RESULTS

The endothelial cellular morphology underwent significant changes, and a large number of microparticles were secreted. In turn, these microparticles blocked cell cycle and induced apoptosis.

CONCLUSIONS

The microparticles produced by endothelial cells play an important role in the injury of vascular endothelial cells.

[Clinical characteristics and outcome of patients with dilated-hypertrophic cardiomyopathy]

OBJECTIVE

To define the clinical characteristics and outcome of patients with dilated-hypertrophic cardiomyopathy (D-HCM).

METHODS

Clinical data of HCM patients hospitalized from January 2002 to December 2015 in our hospital were retrospectively analyzed. Patients were divided into D-HCM and classic HCM patients. The D-HCM patients were followed up by phone.

RESULTS

A total of 616 consecutive HCM patients were evaluated. Twenty one patients (3.4%) were diagnosed with D-HCM (average age(58.8±10.4) years, 13 males). It took (14.2±7.1)years for classic HCM patients to develop D-HCM. Compared to classic HCM patients, D-HCM patients were younger at the time of first HCM diagnosis ((39.7±10.4) years old vs. (48.5±9.5) years old, P<0.001) and had higher ratio of sudden cardiac death family history (19.0%(4/21) vs. 2.5%(14/558), P=0.003), more patients of future D-HCM patients had ventricular tachycardia (38.1%(8/21) vs. 5.7%(32/558), P<0.001) and higher Troponin-I(66.7%(14/21) vs. 9.3%(52/558), P<0.001) before the left ventricular cavity enlargement. Moreover, MLVWH ((24.8±4.2) mm vs. (17.2±3.5) mm, P<0.001) was significantly thicker and LAD ((39.8±5.9) mm vs. (35.2±3.3) mm, P<0.001) was significantly larger in D-HCM patients than in classical HCM patients. During the(3.8±1.9) years follow up period, 12 out of 21 D-HCM patients died (57.1%), 5 cases(23.8%)died of severe heart failure and 7 cases(33.3%) died of sudden cardiac death. One patient received heart transplantation.

CONCLUSIONS

Few classical HCM patients progressed into D-HCM in this cohort. Patients diagnosed as HCM at young age, HCM patients with abnormal Troponin I and ventricular tachycardia are at higher risk of developing D-HCM. The prognosis of D-HCM is very poor, and heart failure and sudden cardiac death are the main causes of death.

Hyperoxia induces inflammation and regulates cytokine production in alveolar epithelium through TLR2/4-NF-κB-dependent mechanism

OBJECTIVE

It has been reported that inflammation of lung could be induced by proinflammatory factor under hyperoxia, which may be attributed by increasing generation of reactive oxygen species (ROS).

MATERIALS AND METHODS

In the present study, with human epithelial lung cancer cell line A549 treated with hyperoxia as in vitro model, we found that hyperoxia stimulation induced TLR2/4 activity in A549 cells. ROS inhibitor NAC was used to investigate the role of ROS in hyperoxia-induced inflammatory cytokines secretion.

RESULTS

Results of mRNA to protein level showed that elevated TLR2/4 activity and hyperoxia-induced inflammatory cytokines secretion could be significantly attenuated by NAC. EMSA results showed the activation of nuclear factor-κB (NF-κB) increased after 2-h hyperoxia stimulation, and the ROS inhibitor blocked TLR2/4 and NF-κB activity.

CONCLUSIONS

Data suggested that the TLR2/4-NF-κB pathway is involved in hyperoxia-induced inflammatory cytokines secretion in A549 human type II alveolar epithelial cells.

Universality analysis of the existence of substantia nigra "swallow tail" appearance of non-Parkinson patients in 3T SWI

OBJECTIVE

To use the 3.0T susceptibility-weighted imaging (SWI) for universality analysis of the "swallow tail" appearance in the substantia nigra of non-Parkinson disease and discuss its lack of the value of imaging diagnosis of Parkinson disease (PD).

PATIENTS AND METHODS

Take 3.0TMR SWI in 60 PD patients (Group PD) and non-PD volunteers (Group N-PD), on the map of range analyze morphology and number of "swallow tail" appearance in substantia nigra of N-PD group volunteers, and compare the performance image of the corresponding region of the patients in the PD group.

RESULTS

After, 15 patients with lesions in the brain stem and significant motion artifacts were excluded. Forty-nine cases of group N-PD (96.08%) had typical "swallow tail" appearance in the bilateral or unilateral substantia nigra compacta posterolateral. All 54 patients with group PD (100%) lacked the "drop" rear elliptical high signal.

CONCLUSIONS

On the 3.0T SWI range map, the "swallow tail" appearance is ubiquitous in the substantia nigra of patients with non-PD. The deficiency of the signs has high sensitivity and specificity for PD diagnosis.

Pretreatment plasma fibrinogen as an independent prognostic indicator of prostate cancer patients treated with androgen deprivation therapy

BACKGROUND

Hyperfibrinogen is thought to be associated with a higher risk of invasion and metastasis, as well as a worse outcome for multiple types of cancer. However, the prognostic significance of plasma fibrinogen has not been investigated in prostate cancer with hormonal therapy. The objective of this study was to evaluate its roles in prostate cancer patients treated with androgen deprivation therapy (ADT).

METHODS

A total of 290 patients who underwent ADT as first-line therapy for prostate cancer were retrospectively analyzed. The fibrinogen level was measured at the time of diagnosis. Patients were categorized using a cutoff point of 3.225 g l(-1) according to a calculation by the receiver operating curve analysis. Correlations between the fibrinogen and clinical characteristics were analyzed. Meanwhile, univariable and multivariable cox regression analyses were performed to determine the associations of fibrinogen with progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). Prognostic accuracy was evaluated with the Harrell concordance index.

RESULTS

Compared with patients with a lower fibrinogen level (<3.225 g l(-1)), patients with a higher fibrinogen level were more likely to have higher PSA, Gleason score, risk stratification and incidence of metastasis (P<0.05). Multivariable analyses identified hyperfibrinogen as an independent prognostic factor for PFS (hazard ratio (HR)=2.000, P<0.001), CSS (HR=2.209, P=0.006) and OS (HR=1.965, P=0.009). The final models built by the addition of fibrinogen improved predictive accuracy (c-index: 0.750, 0.799 and 0.767) for PFS, CSS and OS compared with the clinicopathological base models (c-index: 0.730, 0.778 and 0.746), which included Gleason score and metastasis.

CONCLUSIONS

The pretreatment plasma fibrinogen level was associated with tumor progression and might have a significant role in the prognosis of the prostate cancer patients treated with ADT. Thus, we recommend adding fibrinogen to traditional prognostic model, which may improve its predictive accuracy.

Abstract P3-07-21: Non-alcoholic fatty liver disease induced by selective estrogen receptor modulators is a protective factor for breast cancer survival

Purpose: Non-alcoholic fatty liver disease (NAFLD) induced by selective estrogen receptor modulators (SERMs) treatment may be related to treatment efficacy for the antagonism of circulating estrogens. We conducted a retrospective study to investigate the relationship between survival outcomes and NAFLD in breast cancer patients treated with tamoxifen or toremifene.

Patients and methods: 785 eligible patients received tamoxifen or toremifene in Sun Yat-sen university cancer center from January 2005 to December 2009 were included in our study. All patients have at less one abdominal ultrasonography measurement at baseline and every year's follow-up. Patients who diagnosed NAFLD by ultrasonography during three-year's follow-up were classified into NAFLD cohort, others were classified into no-NAFLD cohort. Univariate and multivariate Cox regression was utilized to analyse the relationship between NAFLD and disease-free survival (DFS) and overall survival (OS).

Results:158 patients had reported NAFLD in the first 3 years' follow-up. Patients who developed NAFLD had better DFS and OS than those not developing NAFLD. The 5-years DFS was 91.56% and 85.01% at NAFLD and no-NAFLD cohort (univariate hazard ratio [HR]: 0.59 [95%CI 0.37-0.96], P=0.034), respectively. The 5-years OS was 96.64% and 93.31% at NAFLD and no-NAFLD cohort (univariate HR: 0.39 [95%CI 0.16-0.99], P=0.047), respectively. Multivariate analysis revealed that NAFLD is an independent prognostic factor on DFS in breast cancer patients with SERMs treated. Women treated with SERMs experienced NAFLD in the first three-year's follow-up had a reduced risk of DFS of 42% (multivariate HR: 0.58; [95%CI 0.36-0.95], P=0.032) compared with patients without NAFLD.

Conclusion: NAFLD induced by SERMs seems to be associated with better survival outcomes and may therefore be helpful in predicting treatment responses in breast cancer patients treated with SERMs.

Citation Format: Wang S, Zheng Q, Nie M, Xu F, Xia W, Yuan Z, Peng R, An X, Qin T, Qin G. Non-alcoholic fatty liver disease induced by selective estrogen receptor modulators is a protective factor for breast cancer survival. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-21.

miR-125a-5p expression is associated with the age of breast cancer patients

Dysregulated miR-125 observed in multiple cancer types has suggested that it is involved in malignant proliferation and invasion. However, the clinical significance of miR-125 in human breast cancer (BC) has not yet been fully elucidated. In the present study, the expression of miR-125a-5p/3p and miR-125b in 143 pairs of BC and normal adjacent tissues (NATs) was measured by real-time quantitative PCR, and the correlation between expression and clinicopathological features was explored. miR-125a-5p and miR-125b were significantly down-regulated in BC tissue samples compared with their matched NAT samples, while the difference in miR-125a-3p expression between BC tissues and NATs was not statistically significant. The expression level of miR-125a-5p was found to be significantly higher in younger patients (<35 years) than in older patients (≥35, P = 0.005). When the patients were divided into three groups according to age (<35, 36-48, and ≥48 years), a gradual reduction in miR-125a-5p expression was observed in BC tissue samples that correlated to increases in age (P = 0.009). There were no significant correlations between miR-125 expression and other clinicopathological features including tumor size, histological grade, hormone receptor status, Her-2 status, and lymph node metastasis. Taken together, these findings suggest that miR-125a-5p may play an important role in BC progression in an age-dependent manner, and that the down-regulation of miR-125a-5p and miR-125b may serve as independent predictors for breast cancer.

Visualization of nigrosomes-1 in 3T MR susceptibility weighted imaging and its absence in diagnosing Parkinson's disease

OBJECTIVE

To assess the imaging features of nigrosomes-1 in the substantia nigra through 3T MR susceptibility weighted imaging (SWI) and its disease-specific changes for the diagnosis of Parkinson's disease (PD).

PATIENTS AND METHODS

A total of 116 subjects were included in this study and allocated into 3 groups: 54 patients diagnosed with PD were assigned to the PD group, 51 age- and sex-matched volunteers without PD served as the control N-PD group, and 11 clinically suspected PD patients were allocated to the undiagnosed (UD) group. All patients received 3.0T superconducting MRI scanning on xxx. The images were analyzed and compared to assess the ability of nigrosomes-1 signals to depict PD pathology.

RESULTS

The signals of nigrosomes-1 were strong, droplet-like or oval in shape, and were found in 49 patients from the N-PD group (96.08%), on both sides of the SN (47 cases) and unilaterally (2 cases). In contrast, these signals were absent in all 54 cases from the PD group, and were undetected in 7 out of 11 cases in the UD group, 7 cases without the "drop" and 1 case with narrow strips of hyperintensity were clinically proven to PD, 2 cases with the typical hyperintensity were clinically proven to Parkinson's plus syndrome, 2 cases with slightly wider strip of hyperintensity were less sensitive to the drug levodopa.

CONCLUSIONS

The absence of typical droplet-like or oval-shaped nigrosomes-1 signals in 3.0T MR SWI may prove useful in identifying PD and Parkinson's syndrome with high sensitivity and specificity.

Diabetes mellitus affects the biomechanical function of the callus and the expression of TGF-beta1 and BMP2 in an early stage of fracture healing

Transforming growth factor beta 1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2) are important regulators of bone repair and regeneration. In this study, we examined whether TGF-β1 and BMP-2 expressions were delayed during bone healing in type 1 diabetes mellitus. Tibial fractures were created in 95 diabetic and 95 control adult male Wistar rats of 10 weeks of age. At 1, 2, 3, 4, and 5 weeks after fracture induction, five rats were sacrificed from each group. The expressions of TGF-β1 and BMP2 in the fractured tibias were measured by immunohistochemistry and quantitative reverse-transcription polymerase chain reaction, weekly for the first 5 weeks post-fracture. Mechanical parameters (bending rigidity, torsional rigidity, destruction torque) of the healing bones were also assessed at 3, 4, and 5 weeks post-fracture, after the rats were sacrificed. The bending rigidity, torsional rigidity and destruction torque of the two groups increased continuously during the healing process. The diabetes group had lower mean values for bending rigidity, torsional rigidity and destruction torque compared with the control group (P<0.05). TGF-β1 and BMP-2 expression were significantly lower (P<0.05) in the control group than in the diabetes group at postoperative weeks 1, 2, and 3. Peak levels of TGF-β1 and BMP-2 expression were delayed by 1 week in the diabetes group compared with the control group. Our results demonstrate that there was a delayed recovery in the biomechanical function of the fractured bones in diabetic rats. This delay may be associated with a delayed expression of the growth factors TGF-β1 and BMP-2.

Molecular cloning and characterization of GbMECT and GbMECP gene promoters from Ginkgo biloba

Ginkgolides are key pharmaceutical components in Ginkgo biloba. Using the cDNA sequence of the MECP and MECT genes to design primers, we obtained the promoters of these genes from Ginkgo genomic DNA using the genome walking method. The two promoters were 744 and 982 bp in length, respectively. The cis-elements of the GbMECPs and GbMECT promoters were predicted and analyzed using the plant cis-acting regulatory element database. We found major cis-elements in the sequence of the GbMECT and GbMECPs promoters. The GbMECP promoter contains six TATA boxes and eight CAAT boxes. The GbMECT contains five TATA boxes and seven CAAT boxes. Furthermore, some cis-elements in the promoters of GbMECPs and GbMECT included hormone and light-regulated elements, UB-B-induced elements, and stress-related dehydration-responsive elements. Expression analysis results showed that the MECP gene is mainly involved in responses to CCC (cycocel) and UV-B, and that MECT is mainly involved in responses to wounding treatment. These results also showed that the expression model was consistent with the cis-elements present. During the annual growth cycle, the level of GbMECPs was significantly correlated with terpene lactones accumulation in leaves. A fitted quadratic curve showed the best model for correlating GbMECPs with terpene lactones in leaves. These results will help us to understand the transcriptional regulatory mechanisms involved in key gene expression and ginkgolide accumulation in G. biloba.

Antifungal modes of action of tea tree oil and its two characteristic components against Botrytis cinerea

AIMS

The essential oil of Melaleuca alternifolia (tea tree) has been evaluated as a potential eco-friendly antifungal agent against Botrytis cinerea. In this study, we investigated the antifungal activity and mode of action of tea tree oil (TTO) and its components against B. cinerea.

METHODS AND RESULTS

Of the components we tested in contact phase, terpinen-4-ol had the highest antifungal activity, followed by TTO, α-terpineol, terpinolene, then 1,8-cineole. As one of characteristic components of TTO, terpinen-4-ol treatment led to pronounced alterations in mycelial morphology, cellular ultrastructure, membrane permeability under scanning electron microscope, transmission electron microscope and fluorescent microscope, and also reduced the ergosterol content of fungi. As another characteristic component, 1,8-cineole caused serious intracellular damage but only slightly affected B. cinerea otherwise. When terpinen-4-ol and 1,8-cineole were used together, the synergistic antifungal activity was significantly higher than either component by itself.

CONCLUSIONS

The results of our study confirmed that terpinen-4-ol and 1,8-cineole act mainly on the cell membranes and organelles of B. cinerea, respectively, and when combined are similar to TTO in antifungal activity due to their differences.

SIGNIFICANCE AND IMPACT OF THE STUDY

Understanding the mechanism of terpinen-4-ol and 1,8-cineole antifungal action to B. cinerea is helpful for investigation on their synergistic effect and explaining antifungal action modes of TTO.

Differential expression of glypican-3 (GPC3) in lung squamous cell carcinoma and lung adenocarcinoma and its clinical significance

In this study, we examined the expression of glypican-3 (GPC3) in the 2 most common histological types of lung cancer, squamous cell carcinoma and adenocarcinoma, and explored the relationship between GPC3 expression and the prognosis of these 2 types of lung cancers. Lung cancer tissues and paracancerous tissues were collected from a total of 60 patients with lung squamous cell carcinoma or lung adenocarcinoma. GPC3 gene and protein expression in the tissue samples was examined using fluorescence-based real-time quantitative polymerase chain reaction, immunohistochemistry, and western blot analysis. In addition, the serological levels of GPC3 protein in lung cancer patients were analyzed using enzyme-linked immunosorbent assays. The overall expression of GPC3 protein in lung cancer was 45% (21/60). No GPC3 expression was detected in paracancerous lung tissues. Positive expression of GPC3 protein in lung squamous cell carcinoma was significantly higher than that in lung adenocarcinoma (70 vs 20%, P < 0.001). Among GPC3-positive lung squamous cell carcinoma and lung adenocarcinoma samples, samples collected from patients with lymph node metastasis and patients with poorly differentiated cancer exhibited more pronounced GPC-3 expression. GPC3 protein expression was significantly higher in lung squamous cell carcinoma than in lung adenocarcinoma. GPC3 may be a candidate marker for detecting lung squamous cell carcinoma.

Peripheral neuron plasticity is enhanced by brief electrical stimulation and overrides attenuated regrowth in experimental diabetes

Peripheral nerve regrowth is less robust than commonly assumed, particularly when it accompanies common clinical scenarios such as diabetes mellitus. Brief extracellular electrical stimulation (ES) facilitates the regeneration of peripheral nerves in part through early activation of the conditioning injury response and BDNF. Here, we explored intrinsic neuronal responses to ES to identify whether ES might impact experimental diabetes, where regeneration is attenuated. ES altered several regeneration related molecules including rises in tubulin, Shh (Sonic hedgehog) and GAP43 mRNAs. ES was associated with rises in neuronal intracellular calcium but its strict linkage to regrowth was not confirmed. In contrast, we identified PI3K-PTEN involvement, an association previously linked to diabetic regenerative impairment. Following ES there were declines in PTEN protein and mRNA both in vitro and in vivo and a PI3K inhibitor blocked its action. In vitro, isolated diabetic neurons were capable of mounting robust responsiveness to ES. In vivo, ES improved electrophysiological and behavioral indices of nerve regrowth in a chronic diabetic model of mice with pre-existing neuropathy. Regrowth of myelinated axons and reinnervation of the epidermis were greater following ES than sham stimulation. Taken together, these findings identify a role for ES in supporting regeneration during the challenges of diabetes mellitus.

Expression changes in epithelial cell adhesion molecule during colorectal cancer tumorigenesis

We investigated the relationship between the expression of epithelial cell adhesion molecule (EpCAM) and the occurrence and development of colon cancer. Fifty colon cancer tissues and adjacent normal tissues were collected, while 40 normal intestinal mucosa tissues were collected as the blank group. EpCAM expression was detected by immunohistochemistry and the patients were followed-up to evaluate the prognosis. The positive expression rate of EpCAM reached 93.7% in patients with colorectal carcinoma, which was significantly higher than that in the negative control group and blank group (14.8 and 12.7%, P < 0.05, respectively). There was no significant difference between the control group and blank group regarding EpCAM expression. No direct relationship was observed between EpCAM expression and patient age, gender, and other characteristics. EpCAM was overexpressed in colorectal cancer and had a high detection rate. EpCAM can be used as a diagnostic biomarker for clinical detection of colorectal cancer.

Postural change from lateral to supine is an important mechanism enhancing cephalic spread after injection of intrathecal 0.5% plain bupivacaine for cesarean section

BACKGROUND

Spinal anesthesia is widely used for cesarean section, but the factors that affect the spread of the block in pregnant patients are still not fully explained. This study was designed to investigate the effect of postural changes on sensory block level.

METHODS

Thirty patients scheduled for elective cesarean section under combined spinal-epidural anesthesia were randomly allocated into three groups. After intrathecal injection of 0.5% plain bupivacaine 7.5mg, patients in group S were immediately placed in the supine position with left tilt, patients in group L5 were kept lateral for 5 min and then turned to the supine position with left tilt, and patients in group L10 were kept lateral for 10 min and then turned to the supine position with left tilt.

RESULTS

At 5 min, median cephalad level of sensory block was lower in groups L5 and L10 compared with group S (corrected P<0.001); at 10 min, median cephalad sensory block level was lower in group L10 compared with group S (corrected P<0.001) and group L5 (corrected P<0.001), and lower in group L5 compared with group S (corrected P=0.033); at 15 min, median cephalad level of sensory block was lower in group L10 compared with group S (corrected P=0.003) and group L5 (corrected P=0.015).

CONCLUSIONS

In our population, using 0.5% plain bupivacaine 7.5mg, postural change from the lateral position to the supine position is an important mechanism enhancing cephalic spread of spinal anesthesia during late pregnancy.