Association of the IRF5 SNP rs2004640 with systemic sclerosis in Han Chinese

Systemic sclerosis (SSc) is a complex disease involving multiple genetic factors. An association of the IRF5 polymorphism with SSc was reported in Caucasian populations of Europe and North America, as well as in Japanese populations. The present study aimed to examine whether the SSc-associated SNP rs2004640 of IRF5 gene confer susceptibility to SSc and clinical features of SSc in a Han Chinese population. A Han Chinese cohort consisting of 424 SSc patients and 502 healthy controls were examined in the study. TaqMan assays were carried out to examine the SNP. Exact p-values were obtained (Fisher’s test) from 2x2 tables of allele counts and disease status. SSc patients of Han Chinese showed increased homozygous TT genotype of the rs2004640 (p = 0.027, odds ratio (OR) = 1.4, CI =1.03-1.93), which was significantly associated with pulmonary fibrosis of SSc and ATA-positive SSc of Han Chinese. The lcSSc and ACA-positive SSc of Han Chinese appeared also in association with the increased T allele frequency. However, the Chinese dcSSc did not show any association with the rs2004640. The results were consistent with previous reports in other ethnic populations in supporting the notion that polymorphisms of IRF5 may play an important role in susceptibility to SSc.

Analysis and forecast for multidrug-resistant Acinetobacter baumannii Infections among liver transplant recipients

BACKGROUND

Acinetobacter baumannii (Ab) has become an important pathogenic bacterium with specific epidemic features in the intensive care unit. We explored the epidemiology of multidrug-resistant Ab infections among liver transplant recipients at the Liver Transplantation Center, 1st Affiliated Hospital of Shanghai Jiao Tong University.

METHODS

Seventeen multidrug-resistant Ab strains were isolated from the sputum and bronchoalveolar lavage fluid specimens of 249 liver transplant recipients from January 2007 to December 2009. The drug resistance and minimum inhibitory concentration (MIC) for the 17 Ab strains were determined. The Ab strains were genotyped with the use of repetitive element-based polymerase chain reaction. The risk factors were also characterized by single-factor and multifactor analysis to the clinical data of the 249 liver transplant recipients.

RESULTS

The drug sensitivity results showed that the 17 Ab strains isolated displayed 100% drug resistance rate to aminoglycosides (gentamicin), quinolones (ciprofloxacin), penicillins (piperacillin), cephalosporins (ceftazidime, cefotaxime, and cefepime), and carbapenems (imipenem and meropenem). The 17 Ab strains could be divided into 3 genotypes: 1, 1, and 15 strains for types A, C, and B, respectively. Fungal culture positivity after operation (odds ratio [OR], 5.470) and tracheal intubation twice (OR, 11.538) were the independent risk factors for multidrug-resistant Ab strain infection.

CONCLUSIONS

Type B multidrug-resistant Ab strains are prevalent in the liver transplantation center, and they could be transmitted clonally. Liver transplant recipients with postoperational fungal culture positivity and tracheal intubation twice are prone to multidrug-resistant Ab infections. Therefore, a high degree of vigilance should be paid to those recipients to avoid nosocomial Ab infections.

Strain-specific antiviral activity of iminosugars against human influenza A viruses

Objectives

Drugs that target host cell processes can be employed to complement drugs that specifically target viruses, and iminosugar compounds that inhibit host α-glucosidases have been reported to show antiviral activity against multiple viruses. Here the effect and mechanism of two iminosugar α-glucosidase inhibitors, N-butyl-deoxynojirimycin (NB-DNJ) and N-nonyl-deoxynojirimycin (NN-DNJ), on human influenza A viruses was examined.

Methods

The viruses examined were a recently circulating seasonal influenza A(H3N2) virus strain A/Brisbane/10/2007, an older H3N2 strain A/Udorn/307/72, and A/Lviv/N6/2009, a strain representative of the currently circulating pandemic influenza A(H1N1)pdm09 virus.

Results

The inhibitors had the strongest effect on Brisbane/10 and NN-DNJ was more potent than NB-DNJ. Both compounds showed antiviral activity in cell culture against three human influenza A viruses in a strain-specific manner. Consistent with its action as an α-glucosidase inhibitor, NN-DNJ treatment resulted in an altered glycan processing of influenza haemagglutinin (HA) and neuraminidase (NA), confirmed by MS. NN-DNJ treatment was found to reduce the cell surface expression of the H3 subtype HA. The level of sialidase activity of NA was reduced in infected cells, but the addition of exogenous sialidase to the cells did not complement the NN-DNJ-mediated inhibition of virus replication. Using reassortant viruses, the drug susceptibility profile was determined to correlate with the origin of the HA.

Conclusions

NN-DNJ inhibits influenza A virus replication in a strain-specific manner that is dependent on the HA.

Single-nucleotide polymorphism analysis of GH, GHR, and IGF-1 genes in minipigs

Tibetan (TB) and Bama (BM) miniature pigs are two popular pig breeds that are used as experimental animals in China due to their small body size. Here, we analyzed single-nucleotide polymorphisms (SNPs) in gene fragments that are closely related to growth traits [growth hormone (GH), growth hormone receptor (GHR), and insulin-like growth factor (IGF)-1)] in these pig breeds and a large white (LW) control pig breed. On the basis of the analysis of 100 BMs, 108 TBs, and 50 LWs, the polymorphic distribution levels of GH, GHR, and IGF-1 were significantly different among these three pig breeds. According to correlation analyses between SNPs and five growth traits--body weight (BW), body length (BL), withers height (WH), chest circumference (CC), and abdomen circumference (AC)--three SNP loci in BMs and four SNP loci in TBs significantly affected growth traits. Three SNP sites in BMs and four SNP sites in TBs significantly affected growth traits. SNPs located in the GH gene fragment significantly affected BL and CC at locus 12 and BL at locus 45 in BMs, and also BW, WH, CC, and AC at locus 45 and WH and CC at locus 93 in TBs. One SNP at locus 85 in the BM GHR gene fragment significantly affected all growth traits. All indices were significantly reduced with a mixture of alleles at locus 85. These results provide more information regarding the genetic background of these minipig species and indicate useful selection markers for pig breeding programs.

Comparison of linear measurements between CBCT orthogonally synthesized cephalograms and conventional cephalograms

OBJECTIVES

The purposes of the study are to investigate the consistency of linear measurements between CBCT orthogonally synthesized cephalograms and conventional cephalograms and to evaluate the influence of different magnifications on these comparisons based on a simulation algorithm.

METHODS

Conventional cephalograms and CBCT scans were taken on 12 dry skulls with spherical metal markers. Orthogonally synthesized cephalograms were created from CBCT data. Linear parameters on both cephalograms were measured via Photoshop CS v. 5.0 (Adobe(®) Systems, San Jose, CA), named measurement group (MG). Bland-Altman analysis was utilized to assess the agreement of two imaging modalities. Reproducibility was investigated using paired t-test. By a specific mathematical programme "cepha", corresponding linear parameters [mandibular corpus length (Go-Me), mandibular ramus length (Co-Go), posterior facial height (Go-S)] on these two types of cephalograms were calculated, named simulation group (SG). Bland-Altman analysis was used to assess the agreement between MG and SG. Simulated linear measurements with varying magnifications were generated based on "cepha" as well. Bland-Altman analysis was used to assess the agreement of simulated measurements between two modalities.

RESULTS

Bland-Altman analysis suggested the agreement between measurements on conventional cephalograms and orthogonally synthesized cephalograms, with a mean bias of 0.47 mm. Comparison between MG and SG showed that the difference did not reach clinical significance. The consistency between simulated measurements of both modalities with four different magnifications was demonstrated.

CONCLUSIONS

Normative data of conventional cephalograms could be used for CBCT orthogonally synthesized cephalograms during this transitional period.

InPBi single crystals grown by molecular beam epitaxy

InPBi was predicted to be the most robust infrared optoelectronic material but also the most difficult to synthesize within In-VBi (V = P, As and Sb) 25 years ago. We report the first successful growth of InPBi single crystals with Bi concentration far beyond the doping level by gas source molecular beam epitaxy. The InPBi thin films reveal excellent surface, structural and optical qualities making it a promising new III-V compound family member for heterostructures. The Bi concentration is found to be 2.4 ± 0.4% with 94 ± 5% Bi atoms at substitutional sites. Optical absorption indicates a band gap of 1.23 eV at room temperature while photoluminescence shows unexpectedly strong and broad light emission at 1.4-2.7 μm which can't be explained by the existing theory.

Study of electrode pattern design for a CZT-based PET detector

We are developing a 1 mm resolution small animal positron emission tomography (PET) system using 3D positioning cadmium zinc telluride photon detectors comprising 40 mm × 40 mm × 5 mm crystals metalized with a cross-strip electrode pattern with a 1 mm anode strip pitch. We optimized the electrode pattern design for intrinsic sensitivity and spatial, energy and time resolution performance using a test detector comprising cathode and steering electrode strips of varying dimensions. The study found 3 and 5 mm width cathode strips locate charge-shared photon interactions near cathode strip boundaries with equal precision. 3 mm width cathode strips exhibited large time resolution variability as a function of photon interaction location between the anode and cathode planes (~26 to ~127.5 ns full width at half maximum (FWHM) for 0.5 mm and 4.2 mm depths, respectively). 5 mm width cathode strips by contrast exhibited more stable time resolution for the same interaction locations (~34 to ~83 ns FWHM), provided more linear spatial positioning in the direction orthogonal to the electrode planes, and as much as 68.4% improvement in photon sensitivity over the 3 mm wide cathode strips. The results were understood by analyzing the cathode strips' weighting functions, which indicated a stronger 'small pixel' effect in the 3 mm wide cathode strips. Photon sensitivity and anode energy resolution were seen to improve with decreasing steering electrode bias from 0 to -80 V w.r.t. the anode potential. A slight improvement in energy resolution was seen for wider steering electrode strips (400 versus 100 µm) for charge-shared photon interactions. Although this study successfully focused on electrode pattern features for PET performance, the results are generally applicable to semiconductor photon detectors employing cross-trip electrode patterns.

Contralateral c7 transfer for treatment of brachial plexus root avulsion

Since the first report of the clinical application of contralateral C7 transfer, this procedure has become widely accepted and is used in the treatment of brachial plexus root avulsion injuries. The technique of this procedure has been markedly improved during the past years. The prespinal route may lead to a shorter nerve graft or even to direct coaptation. The results differ a lot from the different studies. There are many factors affecting the results of contralateral C7 transfer, such as age, time for regeneration and techniques of contralateral C7 transfer. Although dividing C7 will not cause a permanent loss in sensory and motor function of the healthy limb, it is worth pointing out that the C7 transection level should not be too distal, otherwise the fibers from the upper and lower trunk could be injured and permanent motor and sensory deficits may occur. Also, the surgeons should balance the risks and benefits for the patient before making the decision to operate in this manner.

Impact of psm-mec in the mobile genetic element on the clinical characteristics and outcome of SCCmec-II methicillin-resistant Staphylococcus aureus bacteraemia in Japan

Over-expression of alpha-phenol-soluble modulins (PSMs) results in high virulence of community-associated methicillin-resistant Staphylococcus aureus (MRSA). The psm-mec gene, located in the mobile genetic element SCCmec-II, suppresses PSMαs production. Fifty-two patients with MRSA bacteraemia were enrolled. MRSA isolates were evaluated with regard to the psm-mec gene sequence, bacterial virulence, and the minimum inhibitory concentration (MIC) of vancomycin and teicoplanin. Fifty-one MRSA isolates were classified as SCCmec-II, and 10 had one point mutation in the psm-mec promoter. We compared clinical characteristics and outcomes between mutant MRSA and wild-type MRSA. Production of PSMα3 in mutant MRSA was significantly increased, but biofilm formation was suppressed. Wild-type MRSA caused more catheter-related bloodstream infections (30/41 vs. 3/10, p 0.0028), whereas mutant MRSA formed more deep abscesses (4/10 vs. 3/41, p 0.035). Bacteraemia caused by mutant MRSA was associated with reduced 30-day mortality (1/10 vs. 13/41, p 0.25), although this difference was not significant. The MIC90 of teicoplanin was higher for wild-type MRSA (1.5 mg/L vs. 1 mg/L), but the MIC of vancomycin was not different between the two groups. The 30-day mortality of MRSA with a high MIC of teicoplanin (≥1.5 mg/L) was higher than that of strains with a lower MIC (≤0.75 mg/L) (6/10 vs. 6/33, p 0.017). Mutation of the psm-mec promoter contributes to virulence of SCCmec-II MRSA, and the product of psm-mec may determine the clinical characteristics of bacteraemia caused by SCCmec-II MRSA, but it does not affect mortality.

Genetic variations of ISL1 associated with human congenital heart disease in Chinese Han people

Congenital heart disease (CHD) is the most common birth abnormality, but the etiology of CHD is unknown. ISL1 may play a fundamental role in cardiac morphogenesis, and mutations of this gene could cause CHD. To evaluate whether genetic variations of ISL1 are associated with CHD in Chinese Han people, polymerase chain reaction restriction fragment-length polymorphism and SNaPshot were used to examine 9 polymorphisms of ISL1 in 233 patients with CHD as well as 288 healthy controls. We found that one SNP (rs1017) in ISL1 was significantly associated with simple CHD. Genetic variation of ISL1 was confirmed to be associated with the risk of CHD. ISL1 is related to the atrial septal defect group and the ventricular septal defect group, and the genotypes were associated with the occurrence of CHD in the dominant mode of inheritance. We concluded that rs1017 contributed to the risk of CHD in Chinese Han people, and ISL1 may be involved in the formation and development of the heart.

Associated analysis of single nucleotide polymorphisms found on exon 3 of the IGF-1 gene with Tibetan miniature pig growth traits

The IGF-1 gene is an important regulating factor that has a growth-promoting effect on growth hormone. The IGF-1 gene promotes muscle cell differentiation in the muscle cell formation process. The IGF-1 gene also regulates the growth of skeletal muscle during skeletal muscle growth. In addition, the IGF-1 gene plays an important role in the formation of mammals and poultry embryos, and the process of postnatal growth. The IGF-1 gene has been implicated as a candidate gene for the regulation of pig growth traits. We analyzed exon 3 of the IGF-1 gene polymorphism in Tibetan miniature pigs (N = 128) by polymerase chain reaction-single-strand conformation polymorphism and DNA sequencing. One single nucleotide polymorphism (T40C) was found on exon 3 of the IGF-1 gene. Statistical analysis of genotype frequencies revealed that the T allele was dominant in Tibetan miniature pigs at the T40C locus. The association analysis showed that the IGF-1 mutation had an effect on the body weight, body length, and chest circumference of pigs aged 6-8 months. In addition, the IGF-1 mutation had an effect on body weight in pigs aged 9-11 months (P < 0.05). We speculated that the pigs with the TT genotype grow more rapidly compared to those with the TC genotype. The TC genotype of the Tibetan miniature pig has a smaller body type. This information provides a theoretical basis for the genetic background of Tibetan miniature pigs.

Combined blockade of angiotensin II type 1 receptor and activation of peroxisome proliferator-activated receptor-γ by telmisartan effectively inhibits vascularization and growth of murine endometriosis-like lesions

STUDY QUESTION

Is telmisartan effective in the treatment of endometriosis?

SUMMARY ANSWER

Combined blockade of angiotensin II type 1 receptor (AT1R) and activation of peroxisome proliferator-activated receptor (PPAR)-γ by telmisartan inhibits vascularization and growth of murine endometriosis-like lesions.

WHAT IS KNOWN ALREADY

AT1R and PPAR-γ are involved in the regulation of inflammation, proliferation and angiogenesis. These processes are also crucial for the pathogenesis of endometriosis and both receptors are expressed in endometrial tissue. Telmisartan is a partial agonist of PPAR-γ, which additionally blocks AT1R.

STUDY DESIGN, SIZE, DURATION

This was a randomized study in the mouse dorsal skinfold chamber and peritoneal model of endometriosis. Endometriosis-like lesions were induced in dorsal skinfold chambers of 21 female C57BL/6 mice, and in the peritoneal cavity of 15 additional animals, which were daily treated with an i.p. injection of pioglitazone (10 mg/kg, n = 12), telmisartan (10 mg/kg, n = 12) or vehicle (5% dimethyl sulfoxide (DMSO), n = 12) throughout an observation period of 14 and 28 days, respectively.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The anti-angiogenic actions of pioglitazone, a full PPAR-γ agonist, and telmisartan were firstly assessed in vitro by an aortic ring assay. Endometriosis-like lesions were induced in the dorsal skinfold chamber or peritoneal cavity and the effects of telmisartan and pioglitazone on their vascularization, immune cell content and growth were studied by intravital fluorescence microscopy, high-resolution ultrasound imaging as well as histological, immunohistochemical and immunofluorescent analyses. Additional quantitative real-time polymerase chain reaction (qRT-PCR) arrays served for gene expression profiling of the lesions. To limit the role of chance, the experiments were conducted under standardized laboratory conditions with appropriate vehicle-treated controls. Statistical significance was accepted for a value of P < 0.05.

MAIN RESULTS AND THE ROLE OF CHANCE

Telmisartan inhibited vascular sprout formation of aortic rings more effectively than pioglitazone. Accordingly, endometriosis-like lesions in dorsal skinfold chambers of telmisartan-treated animals exhibited a markedly lower functional microvessel density and blood perfusion. High-resolution ultrasound analyses of peritoneal endometriosis-like lesions revealed that the compound inhibited the stromal tissue growth, resulting in a significantly reduced final lesion volume. In contrast, the development of cysts did not differ between the groups. Moreover, telmisartan induced an up-regulation of PPAR-γ and a down-regulation of AT1R proteins in endometriosis-like lesions, which was associated with a decreased density of CD31-positive microvessels, a reduced immune cell content and a lower number of Ki67-positive proliferating cells. qRT-PCR arrays further demonstrated an inhibitory action of telmisartan on the expression of several angiogenic and inflammatory genes.

LIMITATIONS, REASONS FOR CAUTION

Endometriosis-like lesions were induced by syngeneic tissue transplantation into recipient mice without the use of pathological endometriotic tissue of human nature. Therefore, the results obtained in this study may not fully relate to human patients with endometriosis.

WIDER IMPLICATIONS OF THE FINDINGS

This study demonstrates that telmisartan inhibits vascularization, immune cell content and growth of endometriosis-like lesions. Accordingly, the combined blockade of AT1R and activation of PPAR-γ represents a promising new concept in the development of novel compounds for the treatment of endometriosis.

STUDY FUNDING/COMPETING INTEREST(S)

There was no specific funding of this study. The authors have no conflicts of interest to declare.

HER2, MET and FGFR2 oncogenic driver alterations define distinct molecular segments for targeted therapies in gastric carcinoma

Background:

Gastric cancer (GC) is a leading cause of cancer deaths worldwide. Since the approval of trastuzumab, targeted therapies are emerging as promising treatment options for the disease. This study aimed to explore the molecular segmentation of several known therapeutics targets, human epidermal growth factor receptor 2 (HER2), MET and fibroblast growth factor receptor 2 (FGFR2), within GC using clinically approved or investigational kits and scoring criteria. Knowledge of how these markers are segmented in the same cohort of GC patients could improve future clinical trial designs.

Methods:

Using immunohistochemistry (IHC) and FISH methods, overexpression and amplification of HER2, FGFR2 and MET were profiled in a cohort of Chinese GC samples. The correlations between anti-tumour sensitivity and the molecular segments of HER2, MET and FGFR2 alterations were further tested in a panel of GC cell lines and the patient-derived GC xenograft (PDGCX) model using the targeted inhibitors.

Results:

Of 172 GC patients, positivity for HER2, MET and FGFR2 alternations was found in 23 (13.4%), 21 (12.2%) and 9 (5.2%) patients, respectively. Positivity for MET was found in 3 of 23 HER2-positive GC patients. Co-positivity for FGFR2 and MET was found in 1 GC patient, and amplification of the two genes was found in different tumour cells. Our study in a panel of GC cell lines showed that in most cell lines, amplification or high expression of a particular molecular marker was mutually exclusive and in vitro sensitivity to the targeted agents lapatinib, PD173074 and crizotinib was only observed in cell lines with the corresponding high expression of the drugs' target protein. SGC031, an MET-positive PDGCX mouse model, responded to crizotinib but not to lapatinib or PD173074.

Conclusions:

Human epidermal growth factor receptor 2, MET and FGFR2 oncogenic driver alterations (gene amplification and overexpression) occur in three largely distinct molecular segments in GC. A significant proportion of HER2-negative patients may potentially benefit from MET- or FGFR2-targeted therapies.

Autotransplantation of mesiodens for missing maxillary lateral incisor with cone-beam CT-fabricated model and orthodontics

AIM

Autotransplantation is a viable treatment option for a missing tooth when there is a suitable donor, especially in adolescents with remaining facial growth. This report presents the aesthetic restoration of a missing maxillary lateral incisor through orthodontic treatment and autotransplantation of a mesiodens using a CBCT-fabricated rapid-prototyping model.

SUMMARY

A 14-year-old male patient with a congenitally missing maxillary lateral incisor was referred from the Department of Orthodontics. The teeth were moved orthodontically to regain space for the missing lateral incisor and to close the space of the mesiodens after transplantation. A replica of the donor tooth was fabricated from a cone-beam computed tomography scan through a rapid-prototyping machine before autotransplantation surgery. The model was used to create a socket for the graft tooth, thereby shortening the extra-oral time and minimizing the damage to the root surface. After transplantation and orthodontic tooth movement, the mesiodens was finally restored with an aesthetic laminate restoration. Over 3 years, the aesthetics remained excellent, and the transplant functioned normally without any signs or symptoms of root resorption.

KEY LEARNING POINT

Missing anterior teeth may be replaced through a combination of orthodontics, autotransplantation with a rapid-prototyping model and prosthodontic restoration, in growing patients.

MRI appearances of stage IE/IIE extranodal NK/T-cell lymphoma, nasal type, in the upper aerodigestive tract

BACKGROUND

The clinical symptoms of NK/T-cell lymphoma at presentation are nonspecific and may mimic those of other benign nasal diseases such as rhinitis and nasal polypus. However, radiologic studies regarding this aggressive clinical course entity are limited.

AIM

To review 123 newly diagnosed MRI appearances in patients with extra-nodal NK/T-cell lymphoma, nasal type, in a large cohort and determine the characteristic imaging findings.

SUBJECTS AND METHODS

We investigated the magnetic resonance imaging (MRI) findings of patients with newly diagnosed stage IE/IIE extranodal NK/T-cell lymphoma, nasal type, in the upper aerodigestive tract.

RESULTS

Most nasal cavity patients (63.4%) showed extra nasal cavity involvements. The polypoid pattern was most frequently seen (55.3%), followed by the infiltrative (27.6%) and combined (17.1%) patterns. The polypoid pattern tended to develop in the nasal cavity group, while the infiltration pattern was more common in the non-nasal cavity group (63.4% vs. 60.0%, p < 0.001). Homogeneous iso-intensity was seen in 97.6%, 88.6% and 56.1% of cases on T1-, T2-weighted images and post-contrast images, respectively. Bone destruction and necrosis were observed in 44.7% and 56.3% of patients. Both tumour necrosis and bone destruction were related to tumour size (p = 0.008, 0.001). Only 12.2% of patients had cervical lymphadenopathy Multi-region involvement, irregular growth pattern, predisposition to necrosis and bone destruction, and little lymphadenopathy are valuable for diagnosis and can be used to differentiate these tumours from other malignant tumours.

CONCLUSIONS

Our large cohort study of MRI of NK/T cell lymphoma, nasal type, revealed the features of this lymphoma on MRI including some radiologic signs never reported earlier; these findings are invaluable for early diagnosis and may aid future studies aiming to predict the prognosis and response to therapy.

Ageing and type 2 diabetes in an elderly Chinese population: the role of insulin resistance and beta cell dysfunction

OBJECTIVE

The aim of this longitudinal study was to examine the effects of ageing on glucose regulation in elderly Chinese men and women.

SUBJECTS AND METHODS

A total of 4,566 older Chinese men and women (mean age: 70.4 ± 6.7 years) were enrolled in the study. Oral glucose tolerance tests were performed in all participants at baseline and in 3,174 individuals (69.5%) after 3 years of follow-up. Insulin resistance and beta cell function were estimated by the homeostasis model assessment for insulin resistance (HOMA-IR) and beta function (HOMA%-b), respectively.

RESULTS

At baseline, 1,143 had type 2 diabetes (T2D), 517 had prediabetes and 2,906 had normal glucose tolerance (NGT). After 3 years of follow-up, 769 (42.2%) of 1,821 individuals with NGT at baseline progressed to prediabetes and 153 (8.4%) progressed to T2D. Of individuals with prediabetes at baseline, 17.3% progressed to T2D. In individuals who maintained NGT during follow-up ageing was associated with increased insulin resistance (p ≤ 0.001) and a compensatory increase in beta function (p ≤ 0.001). Individuals with NGT or prediabetes who progressed to T2D during follow-up had a significantly increased insulin resistance and a decreased beta cell function (p < 0.01). In contrast, individuals who regressed from prediabetes to NGT increased both insulin resistance and beta cell function (p < 0.01).

CONCLUSIONS

Ageing is associated with development of insulin resistance in an Elderly Chinese population. Therefore, maintenance of normal glucose regulation depends on the ability to compensatory increase of the beta cell function.

CRM1 inhibition induces tumor cell cytotoxicity and impairs osteoclastogenesis in multiple myeloma: molecular mechanisms and therapeutic implications

The key nuclear export protein CRM1/XPO1 may represent a promising novel therapeutic target in human multiple myeloma (MM). Here we showed that chromosome region maintenance 1 (CRM1) is highly expressed in patients with MM, plasma cell leukemia cells and increased in patient cells resistant to bortezomib treatment. CRM1 expression also correlates with increased lytic bone and shorter survival. Importantly, CRM1 knockdown inhibits MM cell viability. Novel, oral, irreversible selective inhibitors of nuclear export (SINEs) targeting CRM1 (KPT-185, KPT-330) induce cytotoxicity against MM cells (ED50<200 nM), alone and cocultured with bone marrow stromal cells (BMSCs) or osteoclasts (OC). SINEs trigger nuclear accumulation of multiple CRM1 cargo tumor suppressor proteins followed by growth arrest and apoptosis in MM cells. They further block c-myc, Mcl-1, and nuclear factor κB (NF-κB) activity. SINEs induce proteasome-dependent CRM1 protein degradation; concurrently, they upregulate CRM1, p53-targeted, apoptosis-related, anti-inflammatory and stress-related gene transcripts in MM cells. In SCID mice with diffuse human MM bone lesions, SINEs show strong anti-MM activity, inhibit MM-induced bone lysis and prolong survival. Moreover, SINEs directly impair osteoclastogenesis and bone resorption via blockade of RANKL-induced NF-κB and NFATc1, with minimal impact on osteoblasts and BMSCs. These results support clinical development of SINE CRM1 antagonists to improve patient outcome in MM.

1,25(OH)2D3 suppresses COX-2 up-regulation and thromboxane production in placental trophoblast cells in response to hypoxic stimulation

In this study, we determined if vitamin D could inhibit oxidative stress-induced thromboxane production by placental trophoblasts. Trophoblast isolated from normal placentas were stimulated with CoCl2, a hypoxic mimicking agent, with or without pretreatment of 1,25(OH)2D3. Soluble phospholipase-A2, metabolites of thromboxane-A2 and prostacyclin, and 8-isoprostane were measured. Expression of cyclooxygenase-1 (COX-1), COX-2, and heme oxygenase-1 (HO-1) were determined. We found that pretreatment of trophoblasts with 1,25(OH)2D3 significantly reduced 8-isoprostane and the ratio of thromboxane-A2 to prostacyclin production, and blocked COX-2 expression induced by CoCl2. These results provide evidence of the beneficial effects of vitamin D on placental trophoblasts.

Abstract P4-03-08: Pathological analysis of intraductal papillary lesions in 3690 patients

Background:Papillary lesions of the breast (PL) account for 1 - 2% in breast tumors and 10% in benign tumors. Ductoscopy due to its high rate (60 times) amplification and visualization of lesions, which makes it possible to directly visualize the duct from the orifice of the duct well into the periphery. It could not only find abnormities which other tests could not provide, but also predict histological diagnosis.However, ductoscopy findings and pathological results are not always consistent. Ductoscopy examine is limited by many factors such as complicated anatomical structure of breast and ductal obstruction, so in some cases it may have missed diagnosis. Lesions could be missed due to extrusion and shedding during ductoscopy examine procedure and preparation of pathological section.

Methods:In this study, we retrospectively studied on 4170 papillary lesions diagnosed by ductoscopy in 3690 patients from April 23, 2008 to October 31st, 2012 and compared incidence of each disease. These cases were evaluated by final histopathology(42.2% solitary papillary lesion, 32.5% multiple papillomatosis, 13.0% premalignant or malignant lesions, 6.5% mammary duct or plasma cell mastitis, 5.7% epithelial hyperplasia). The sensitivity of ductoscopy for PL in this study was 87.8%, and specificity was 89.2%.

Results and Discussion:Spontaneous nipple discharge(SND) is the third third most common presenting symptom of breast disease accounting for 3∼8% of breast symptoms. But in our experience, not all of the intraductal lesions would have SND, especially in those cases which localized more distally. Besides, intraductal lesions in premalignant or malignant lesions cases would have more incidence to localize distally than their benign papilloma. Thus, if we only take ductoscopy on patients who suffer SND, we might have some missed diagnosis for those people who did not suffer SND including malignant lesions.At present, although ductoscopy is not routine examination for breast cancer screening, we consider that for people who share a high-risk of developping breast cancer, although she might not have SND, ductoscopy could be a selective screen tool.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-03-08.

Abstract P4-04-11: Correlation study of gene polymorphisms on 19p13.1 with triple negative breast cancer

Objective:The aim of this study was to investigate the association between triple negative breast cancer (TNBC) susceptibility and single nucleotide polymorphisms (SNPs) of MERIT40(c19orf62)and ANKLE1 genes located in 19p13.1, so as to find the clinical helpful molecular markers and therapeutic targets to the early detection and to guide individualized treatment.

Materials and Methods:Totally 252 patients with breast cancer diagnosed and treated in Breast Surgery Department of China-Japan Union Hospital affiliated to Jilin University were taken into the study, Among them,there were 124 cases identified as TNBC by using IHC technique, and others there were 128 cases as non-TNBC. Using common PCR assay and DNA sequencing to detect the SNPs of candidate genes. Finally, the association was analyzed between triple negative breast cancer group and non-triple negative breast cancer group with incidence and impact factors.

Results:Three genotypes were detected in rs8170,a SNP of MERIT40 gene located in 19p13.1.The frequencies of CC, CT and TT genotype in the triple negative breast cancer group and non-triple negative breast cancer group were 52.9% vs 93.5%, 41.2% vs 6.5% and 5.9% vs 0.0%.The difference of the distribution of genotypes between two groups was statistically significant (P = 0.004).Three genotypes were detected in rs2363956,a SNP of ANKLE1 gene also located in 19p13.1. The frequencies of TT, GT and GG genotype in the triple negative breast cancer group and non-triple negative breast cancer group were 35.7% vs 38.5%, 42.9% vs 53.8%and 21.4%vs7.7%.The difference of the distribution of genotypes between tow groups was no significant correlation (P = 0.464).Rs2363956 genotypes had obvious correlation with clinical stage (P = 0.005) and lymph node metastasis (P = 0.029) in non-triple negative breast cancer group, but not in triple negative breast cancer group(P = 0.323, P = 0.510).Neither rs8170 nor rs2363956 genotypes had obvious correlation with breast cancer-related immune group, such as EGFR,P53(P&gt;0.05). Logistic regression analysis showed that TT genotype of rs8170 would increase the risk of in TNBC patients (OR = 1.426,95% CI = 1.266-2.872 P = 0.024).There was no significant association between the risk of incidence and the SNPs of ANKLE1 genes. Multivariate Logistic regression analysis showed that the polymorphism of ANKLE1 rs2363956 was an independent prognostic factor with lymph node metastasis and high clinical installments in for non-triple negative breast cancer (OR = 1.228, 95%CI = 1. 104-1.908 P = 0.045), but not for triple negative breast cancer.

Conclusions :The rate of incidence is comparatively higher in TNBC patients with TT genotype of MERIT40 rs8170, which may be an important molecular markers to predict the incidence of triple negative breast cancer.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-04-11.

Deficiency of antithrombin and protein C gene in 202 Chinese venous thromboembolism patients

INTRODUCTION

Antithrombin and protein C gene deficiencies are commonly inherited risk factors for VTE patients. We aim to investigate the deficiency of these two gene in 202 Chinese patients with venous thromboembolism (VTE).

METHODS

Antithrombin activity (AT: A) and protein C activity (PC: A) were measured in 202 VTE patients, and for those with unexplainable low results, PCR and direct sequencing of the related genes were carried out.

RESULTS

Deficiency levels of antithrombin and protein C gene were found to be 2% and 8%, respectively. AT or PC hereditary deficiency can be found in 10% patients with VTE.

CONCLUSION

Protein C gene deficiency might be more prevalent than AT gene deficiency in Chinese VTE patients. Functional assay combined with genetic analysis is useful in the diagnosis of inherited defects in VTE patients.

Efficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised, double-blind, placebo-controlled trials

OBJECTIVE

To determine the efficacies of different preparations of glucosamine for the treatment of osteoarthritis (OA).

METHODS

Systematic searches of the bibliographic databases Medline, Embase, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews for randomised, double-blind, placebo-controlled trials (RCTs) concerning glucosamine treatment of OA. Effect size (ES) was estimated using Cohen's standardised mean difference. Consistency was evaluated via the I(2) index.

RESULTS

Nineteen trials (3159 patients) contributed to the meta-analysis, revealing a large degree of inconsistency among the trials in terms of pain-reduction outcome: the combined ES in glucosamine sulphate (GS) trials was -0.22 [95% confidence intervals (CI) -0.48, 0.04], I(2) was 82.3%. The combined ES in glucosamine hydrochloride (GH) trials was -0.03 (95% CI -0.14, 0.08), with an absence of heterogeneity. No treatment ES was observed [-0.38 (95% CI -0.99, 0.23)] favouring GS in trials of less than 24 weeks duration and the I(2) remained high (I(2) = 88.5%). No significant treatment ES -0.09 (95% CI -0.21, 0.03) was observed in trials of more than 24 weeks duration compared with placebo, with a heterogeneity of zero. In terms of function-modifying outcomes, GS showed no significant effect on Lequesne Index reduction vs. placebo in trials of less than 24 weeks duration (ES -0.55 (95% CI -1.22, 0.11)) with a high degree of heterogeneity (I(2) = 92.9%). Pooling data from studies with durations of more than 24 weeks presented a significant combined ES of -0.36 (95% CI: -0.56, -0.17) with an absence of heterogeneity. No risk of publication bias could be detected using Egger test.

CONCLUSIONS

GH is ineffective for pain reduction in patients with knee OA. GS may have function-modifying effects in patients with knee OA when administered for more than 6 months. However, it showed no pain-reduction benefits after 6 months of therapy.

Noninvasive identification and assessment of functional brown adipose tissue in rodents using hyperpolarized ¹³C imaging

OBJECTIVE

The recent identification of functional depots of brown adipose tissue (BAT) in adult humans has potential implications for the treatment of obesity. In order to evaluate new therapies aimed at inducing the production of more BAT or activating BAT in humans, it will be important to develop noninvasive methods to assess the functional state of the tissue in vivo. In this study, we investigate the feasibility of using hyperpolarized (13)C imaging to noninvasively identify functional, activated BAT in an in vivo rodent model, in less than 1 min, following an infusion of pre-polarized [1-(13)C] pyruvate.

DESIGN

Hyperpolarized (13)C imaging was used to monitor BAT metabolic conversion of pre-polarized [1-(13)C] pyruvate in rats during baseline and norepinephrine (NE)-stimulated conditions.

RESULTS

Activated BAT, stimulated by NE injection, can be detected in rats by increased conversion of pre-polarized [1-(13)C] pyruvate into its downstream products (13)C bicarbonate and [1-(13)C] lactate. The colocalization of the (13)C signal to interscapular BAT was validated using hematoxylin-eosin histological staining.

CONCLUSION

The radiation-free nature and recent translation into the clinic of the hyperpolarized (13)C-imaging test may potentially facilitate trials of therapeutics targeting BAT activation in humans.

Serum microRNAs as potential biomarkers of mandibular prognathism

OBJECTIVES

The aim of the study was to determine whether the expression levels of specific circulating serum microRNAs (miRNAs) are associated with mandibular prognathism (MP).

METHODS

Sixty subjects in the early permanent dentition stage and 23 in the mixed dentition stage with MP were identified. Sixty-eight normal control subjects in the early permanent dentition stage and 24 in the mixed dentition stage were recruited for comparison. According to the microarray-based expression profiling, four serum miRNAs (let-7i-3p, miR-595, miR-16-2-3p, and miR-367-5p) were validated.

RESULTS

In the MP groups, let-7i-3p was significantly over-expressed in subjects in the early permanent (P < 0.0005) and mixed (P < 0.001) dentitions, and miR-595 was significantly under-expressed (P < 0.004) in subjects in the early permanent (P < 0.004) and mixed (P < 0.0005) dentitions, compared with normal control groups. Multiple logistic regression analysis and receiver operating characteristic curve analysis revealed that let-7i-3p and miR-595 were able to significantly discriminate MP subjects from normal controls.

CONCLUSION

Let-7i-3p and miR-595 could be potential, non-invasive biomarkers for the accurate early detection and diagnosis of MP, which may result in improved clinical management.

Posterior approach for accessory-suprascapular nerve transfer: an electrophysiological outcomes study

The aim of this study was to retrospectively investigate the electrophysiological results obtained after employing the posterior approach for spinal accessory nerve-suprascapular nerve (SAN-SSN) transfer, and to compare this with the traditional anterior approach. SAN-SSN transfer was performed in 74 patients with brachial plexus injury. The posterior approach was used in 35 patients and the anterior approach was used in 39 patients. Electrophysiological examination was conducted and analyzed postoperatively. There was no significant difference between approaches in the time it took for the infraspinatus to show low-incidence motor unit action potentials (MUAPs) and an incomplete interference pattern. In addition, the final ratio of patients that showed regeneration potential of the infraspinatus was not significantly different between the approaches. Furthermore, latency and wave amplitude showed a linear regression with post-operative time in the posterior approach group. In the posterior approach group, the final abduction of the shoulder was positively correlated with the amplitude. The posterior approach for SAN-SSN is an effective potential alternative technique that may be appropriate for some clinical situations.

Radiological and clinical features of adult non-puerperal mastitis

OBJECTIVE

To describe the radiological and clinical features of adult non-puerperal mastitis and to determine the most accurate method of preventing unnecessary surgical procedures.

METHODS

Clinical and imaging findings were retrospectively reviewed in 51 females with non-puerperal mastitis, which was confirmed by biopsy/surgical pathology. All 51 patients had pre-operative MRI; 45 patients also had sonograms and 25 also had mammograms, pre-operatively.

RESULTS

Of the 51 cases with non-puerperal mastitis, 94.1% (48/51) were confirmed as having acute or chronic inflammation, and the other 3 had plasma cell mastitis; areola papillaris inflammation was found in 39.2% (20/51) of the cases. Overall, 6 of the 25 cases that were examined with mammography and 2 of the 45 cases that were examined with sonography appeared normal, but all 51 lesions were positively identified on MRI. Asymmetrical density (12/25) on mammograms and solitary or separated/contiguous, clustered, hypoechoic mass-like lesions (31/45) on ultrasound were the most common signs of non-puerperal mastitis. On enhanced MRI, 90.2% (46/51) of patients showed non-mass-like enhanced lesions. Multiple regional enhancements in the pattern of distribution (32/46) and separated or contiguous, clustered, rim-like enhancements in the pattern of internal enhancement (29/46) were the most common manifestations in non-mass-like enhanced lesions. Of the 51 patients, mastitis Type 1 and Type 2 in the time-signal intensity curve were detected in 47.1% and 51.0% of the patients, respectively. The breast imaging reporting and data system categories with the highest number of patients were Category 0 (9/25) on mammography, Category 4a on sonography (18/45) and Category 4a on MRI (29/51).

CONCLUSION

The findings from mammography and ultrasound are non-specific; therefore, using MR can be helpful in the diagnosis, especially in the presence of non-mass-like enhancements that are multiple, regional, separated, or contiguous, clustered and rim-like.

ADVANCES IN KNOWLEDGE

Mastitis is often neglected because of the lack of typical clinical signs and symptoms. This study has assessed and described the clinical features and imaging findings of adult non-puerperal mastitis on mammograms, sonograms and MRI and found that MRI is more specific in the diagnosis of disease.

Effects of vascular endothelial cells on osteogenic differentiation of noncontact co-cultured periodontal ligament stem cells under hypoxia

BACKGROUND AND OBJECTIVE

During periodontitis or orthodontic tooth movement, the periodontal vasculature is severely impaired by chronic inflammation or excessive mechanical force. This leads to a hypoxic microenvironment of the periodontal cells and enhances the expression of various cytokines and growth factors that may regulate angiogenesis and alveolar bone remodeling. However, the role of hypoxia in regulating the communication between endothelial cells (ECs) and osteoblast progenitors during the remodeling and repair of periodontal tissue is still poorly defined. The aim of this study was to investigate the effects of vascular ECs on osteogenic differentiation, mineralization and the paracrine function of noncontact co-cultured periodontal ligament stem cells (PDLSCs) under hypoxia, and further reveal the involvement of MEK/ERK and p38 MAPK pathways in the process.

MATERIAL AND METHODS

First, PDLSCs were obtained and a noncontact co-culture system of PDLSCs and human umbilical vein endothelial cells was established. Second, the effects of different time-periods of hypoxia (2% O(2) ) on the osteogenic potential, mineralization and paracrine function of co-cultured PDLSCs were investigated. Third, ERK1/2 and p38 MAPK activities of PDLSCs under hypoxia were measured by western blotting. Finally, we employed specific MAPK inhibitors (PD98059 and SB20350) to investigate the involvement of ERK1/2 and p38 MAPK in PDLSC osteogenesis under hypoxia.

RESULTS

We observed further increased osteogenic differentiation of co-cultured PDLSCs, manifested by markedly enhanced alkaline phosphatase (ALP) activity and prostaglandin E(2) (PGE(2)) levels, vascular endothelial growth factor (VEGF) release, runt-related transcription factor 2 (Runx2) and Sp7 transcriptional and protein levels and mineralized nodule formation, compared with PDLSCs cultured alone. ERK1/2 was phosphorylated in a rapid but transient manner, whereas p38 MAPK was activated in a slow and sustained way under hypoxia. Furthermore, hypoxia-stimulated transcription and expression of osteogenic regulators (hypoxia-inducible factor-1α, ALP, Runx2, Sp7, PGE(2) and VEGF) were also inhibited by PD98059 and SB203580 to different degrees.

CONCLUSION

Further increased osteogenic differentiation and mineralization of co-cultured PDLSCs under hypoxia were regulated by MEK/ERK and p38 MAPK pathways. And the ECs-mediated paracrine of PGE(2) and VEGF may facilitate the unidirectional PDLSC-EC communication and promote PDLSCs osteogenesis.