[Efficacy and safety of generic azacitidine in Chinese patients with higher-risk myelodysplastic syndromes: a multicenter, prospective, single-arm study]

Objective: To evaluate the efficacy, safety, and pharmacokinetics of the generic azacitidine in Chinese patients with higher-risk myelodysplastic syndromes(MDS). Methods: Between October 2013 and 2016, 72 patients were eligible for enrollment at 9 sites from China received generic subcutaneous azacitidine 75 mg·m(-2)·d(-1) for 7 days per 28-day cycle, for ≥6 cycles. Pharmacokinetic blood samples were collected on day 1 of a single-dose. Results: For each patient at cycle 6 or at the time of study discontinuation, whichever came first, the overall response rate, which included complete remission (CR)and partial remission(PR), was 6.9%(5/72), the rate of patients who had the best effect with CR or PR during the treatment was 12.5%(9/72). Patients who were dependent on red-blood-cell transfusions and platelet transfusions at baseline became transfusion independent were 46.3%(19/41)and 41.2% (7/17), respectively. The median time of treatment was 6 cycles, and the median OS was 16.1 months (95%CI 10.9-20.6 months). For 36 patients(50%)received treatment at ≥6 cycles, and the median OS was 22.3 months(95%CI 16.1- not evaluative). Most common grade Ⅲ-Ⅳ hematologic treatment-emergent adverse events were neutropenia(55%), leukopenia(47%), and thrombocytopenia(61%). Pharmacokinetic profiles were similar for generic and original azacitidine in Chinese patients. Conclusion: Generic azacitidine treatment was favorable and safe and can be used as a standard treatment for patients with higher-risk MDS.

Correlations of LTα and NQO1 gene polymorphisms with childhood asthma

OBJECTIVE

To explore the correlation of the lymphotoxin alpha (LTα) and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase 1 (NQO1) gene polymorphisms with childhood asthma.

PATIENTS AND METHODS

A total of 102 asthma children (observation group) and 80 healthy children (control group) were enrolled. The information was collected via questionnaires and the polymorphisms of LTα rs2844484 and NQO1 rs2917666 were examined with the TaqMan-MGB probe.

RESULTS

Observation group had higher constituent ratios of contact with animal furs, personal history of infection, personal history of allergy, familial infection history and familial allergic history than those of control group (p<0.05). However, there were no differences in age, sex, passive smoking, purchase of new furniture and mask wearing between the two groups (p>0.05). The frequency of LTα rs2844484 genotype AA was significantly higher than that of genotype AG and GG (p<0.01), and NQO1 rs2917666 genotype CC showed notably higher frequency than that of genotype CG and GG (p<0.05). The frequency of LTα rs2844484 A allele was significantly higher than that of G allele (p<0.01), while NQO1 rs2917666 C allele had remarkably higher frequency than G allele (p<0.05). The comparisons of the recessive and additive modes revealed differences between the two groups (p<0.05). However, we did not observe significant difference in dominant mode between the two groups (p>0.05).

CONCLUSIONS

The risk factors for childhood asthma include the contact with animal furs, personal history of infection, personal history of allergy, familial infection history and familial allergic history. Polymorphisms of LTα and NQO1 genes are correlated with childhood asthma.

Soaking up the oil: Biological impacts of dispersants and crude oil on the sponge Halichondria panicea

Used during an oil spill to minimise the formation of an oil slick, dispersants have negative biological effects on marine model organisms. However, no study has investigated the impacts of dispersants on adult sponge individuals. Here, we examine the effects of water accommodated oil fraction (WAF - oil in seawater), chemically enhanced WAF (CEWAF - oil and dispersant in seawater) and Benzo[A]Pyrene on sponge Halichondria panicea at physiological and molecular levels. Sponge clearance rate decreased sharply when exposed to WAF and CEWAF but the oil loading at which the clearance rate was reduced by 50% (ED50) was 39-fold lower in CEWAF than in WAF. Transcriptomic analysis revealed a homogenous molecular response with the greatest number of differentially expressed genes identified in CEWAF samples (1,461 genes). Specifically, genes involved in stress responses were up-regulated. This study presents evidence that the use of dispersants should be considered carefully in areas where sponges are present.

The association of hematuria on kidney clinicopathologic features and renal outcome in patients with diabetic nephropathy: a biopsy-based study

PURPOSE

To investigate the relationships between hematuria, clinicopathological features and renal outcomes in patients with biopsy-proven diabetic nephropathy (DN).

METHODS

This cohort study included 261 patients with DN. Participants were divided into two groups according to number of red blood cells per high-power field (RBC/hpf) in urine sediment: the hematuria (-) group (≤ 3 RBC/hpf) and the hematuria (+) group (> 3 RBC/hpf). Basic clinical parameters were measured at the time of renal biopsy; relationships between hematuria and clinicopathological features and renal outcomes were analyzed.

RESULTS

Patients in the hematuria (+) group often had overt proteinuria. Interstitial inflammation was more severe in the hematuria (+) group than in the hematuria (-) group. Glomerular arteriolar hyalinosis, interstitial fibrosis and tubular atrophy were comparable between groups. For patients with early DN (eGFR ≥ 60 ml/min/1.73 m²), urinary RBC/hpf at baseline was positively correlated with glomerular classification, interstitial fibrosis/tubular atrophy scores and interstitial inflammation scores. In prognostic analysis, hematuria was associated with a higher risk of progression to end-stage renal disease. Hematuria remained an independent predictor after adjustment for confounding factors such as sex, age, duration of diabetes, serum glucose level, hypertension, cholesterol, eGFR and urine protein excretion, especially in patients with early DN and in male patients.

CONCLUSION

In this study, hematuria was associated with more severe renal pathologic lesions in patients with DN. The presence of hematuria could be an independent predictor of renal outcome in patients with early DN.

[Comparison of the curative effect of transjugular intrahepatic portosystemic shunt with expanded polytetrafluoroethylene-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal -gastric variceal bleeding in portal hypertension]

Objective: To compare the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with expanded polytetrafluoroethylene (ePTFE)-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal-gastric variceal bleeding in portal hypertension. Methods: Patients with esophageal-gastric variceal bleeding who received TIPS treatment (ePTFE covered stent) or gastroscopy for the first time as the secondary prevention for portal hypertension at Nanfang Hospital of Southern Medical University through March to July 2017 were selected. One year after the operation, liver function changes, ascites remission rates, incidence of hepatic encephalopathy, re-bleeding rate, average hospitalization frequency and expenses, survival time, as well as the TIPS patency conditions were analyzed in the two groups of patients. 2 test, Kaplan-Meier method and Mann-Whitney U test were used to analyze the data. Results: There were 74 and 66 cases in the TIPS and the drug combined gastroscopy group and the follow-up duration (14.57 ± 0.79) was 12-16 months. One year after surgery, the remission rate of ascites in the TIPS group was higher 57.1% (32/56) than that of the drug combined gastroscopy group (0), and the difference was statistically significant (χ(2) = 2 = 36.73, P < 0.01). The cumulative incidence of hepatic encephalopathy at 1, 3, 6, and 12 months after surgery in the TIPS group was 32.4% (24/74), 37.8% (28/74), 40.5% (30/74), and 40.5% (30/74), respectively. The cumulative incidence of hepatic encephalopathy in the drug combined gastroscopy group was 3.0% (2/66), 3.0% (2/66), 3.0% (2/66), and 6.1% (4/66), respectively. Kaplan-Meier analysis showed that the cumulative incidence of hepatic encephalopathy in the TIPS group was higher than that of the drug combined gastroscopy group (χ(2) = 11.29, P < 0.01). The incidence of severe hepatic encephalopathy ( grade III to IV) at 1, 3, 6, and 12 months after surgery in the TIPS group was 2.7% (2/74), 0, 0, and 0, respectively. The incidence of severe hepatic encephalopathy in drug combined gastroscopy group was 0, and there was no statistically significant difference in development of hepatic encephalopathy between the two groups (P > 0.05). The re-bleeding rates of TIPS group and drug combined gastroscopy group were 0 and 27.3% (18/66), respectively, and the difference was statistically significant (χ(2) = 22.42, P < 0.01). There was no death reported during the follow-up period between both groups. The hospitalization frequency times (1.45 ± 0.80) in TIPS group was lower than that of the drug combined gastroscopy group times (3.24 ± 1.80), and the difference was statistically significant (U = -4.52, P < 0.01). Conclusion: In the prevention of esophageal-gastric variceal bleeding, TIPS (ePTFE-covered stent) treatment has the advantages of reducing re-bleeding rate, high ascites remission rate and hospitalizations frequency. In addition, patients treated with TIPS have a higher incidence of hepatic encephalopathy than that of drugs combined with gastroscopy. However, TIPS did not exacerbate the incidence of hepatic encephalopathy, and there was no significant difference in the 1-year survival rate after TIPS and drugs combined with gastroscopy treatment.

Humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer

A relative humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer (MZI) is proposed in this paper. The MZI was made by splicing a segment of the few-mode fiber (FMF) between two segments of a no-core fiber (NCF) and two segments of a single mode fiber (SMF) located outside the two NCFs. The core and cladding of the FMF acted as interferometric arms, while the NCFs acted as couplers for splitting and recombining light due to mismatch of mode field diameter. The cladding of the FMF was corroded with hydrofluoric acid, and a layer of graphene oxide (GO) film was coated on the corroded cladding of FMF via the natural deposition method. The refractive index of GO varied upon absorption the water molecules. As a result, the phase difference of the MZI varied and the wavelength of the resonant dip shifted with a change in the ambient relative humidity (RH). High humidity sensitivity of 0.191 and 0.061 nm/%RH in the RH range of 30-55% and 55-95%, respectively, were achieved experimentally. The high sensitivity, compact size, and simple manufacturing of the proposed sensor could offer attractive applications in fields of chemical sensors and biochemical detection.

[Typical case analysis of COVID-19 cluster epidemic in Shaanxi, 2020]

Objective: By analyzed the transmission patterns of 4 out of the 51 COVID-19 cluster cases in Shaanxi province to provide evidences for the COVID-19 control and prevention. Methods: The epidemiological data of RT-PCR test-confirmed COVID-19 cases were collected. Transmission chain was drawn and the transmission process was analyzed. Results: Cluster case 1 contained 13 cases and was caused by a family of 5 who traveled by car to Wuhan and returned to Shaanxi. Cluster case 2 had 5cases and caused by initial patient who participated family get-together right after back from Wuhan while under incubation period. Cluster case 3 contained 10 cases and could be defined as nosocomial infection. Cluster case 4 contained 4 cases and occurred in work place. Conclusion: Higher contact frequency and smaller places were more likely to cause a small-scale COVID-19 cluster outbreak, with potential longer incubation period. COVID-19 control strategies should turn the attention to infection prevention and control in crowded places, management of enterprise resumption and prevention of nosocomial infection.

Adsorption behavior and mechanism of Au(III) on caffeic acid functionalized viscose staple fibers

A novel fibrous adsorbent (DAVSF-CA) was synthesized via grafting caffeic acid (CA) onto dialdehyde viscose staple fiber (DAVSF), and used to selectively adsorb Au(III) from simulated wastewater. Fourier Transform Infrared (FTIR), X-ray Photoelectron (XPS) and Nuclear Magnetic Resonance (NMR) spectra confirmed that caffeic acid was successfully grafted on DAVSF through condensation reaction. Adsorption experiments revealed that the adsorption of Au(III) on DAVSF-CA was extremely dependent on pH values and temperatures, and the maximum adsorption capacity of 3.71 mmol/g for Au(III) was obtained at pH 3.0 and 333 K according to the Langmuir fitting. High temperature was favorable for Au(III) adsorption because the adsorption of Au(III) on the DAVSF-CA was endothermic. The competitive adsorption demonstrated that DAVSF-CA had a good preference to Au(III) adsorption in the presence of some coexisting pollutants. The adsorption isotherm data of Au(III) were well-described by the Langmuir model, while the kinetic data were fitted well by the Pseudo-second-order equation. The major reaction involving the reduction of Au(III) to Au(0) was identified by XPS and XRD analysis. Namely, Au(III) was first captured on protonated functional groups via electrostatic adsorption, and then reduced to its elemental form and formed the nano-particles on the adsorbent surfaces.

Circular RNA UBAP2 contributes to tumor growth and metastasis of cervical cancer via modulating miR-361-3p/SOX4 axis

Background

Increasing researches have reported that circular RNA UBAP2 (circUBAP2) may be a potential prognosis biomarker and participate in the development of several cancers; however, the role of circUBAP2 in cervical cancer (CC) remains largely unclear.

Methods

We applied qRT-PCR and Western blot to examine expression levels of circUBAP2, miR-361-3p, SOX4, Bax, Bcl-2, Cleaved caspase 3, N-cadherin, Vimentin and E-cadherin. Cell proliferation, apoptosis, invasion and migration were analyzed by MTT assay, Flow cytometry, and Transwell assay, respectively. The interaction between miR-361-3p and circUBAP2 or SOX4 was confirmed by luciferase reporter assay and pull-down assay. Murine xenograft model was established by injecting SiHa cells which stably transfected sh-circUBAP2.

Results

CircUBAP2 was up-regulated in CC tissues and cell lines and high circUBAP2 expression predicated poor outcome. Knockdown of circUBAP2 suppressed cell proliferation, migration, invasion and EMT, while induced apoptosis in CC in vitro, and inhibited tumor growth and metastasis in vivo. MiR-361-3p directly bound to circUBAP2 or SOX4, and circUBAP2 could regulate SOX4 expression by sponging miR-361-3p in CC cells. Furthermore, rescue assay results demonstrated that the inhibitory effects of circUBAP2 knockdown on cell growth and metastasis were partially reversed by miR-361-3p down-regulation or SOX4 up-regulation in CC.

Conclusion

CircUBAP2 represents a prognostic marker and contributes to tumor growth and metastasis via modulating miR-361-3p/SOX4 axis in CC, which indicates a potential therapeutic target for CC treatment.

Whole-body magnetic resonance imaging is superior to skeletal scintigraphy for the detection of bone metastatic tumors: a meta-analysis

OBJECTIVE

The meta-analysis aims to compare the diagnostic performance of whole-body magnetic resonance imaging (MRI) and skeletal scintigraphy (SS) for the detection of skeletal metastases.

MATERIALS AND METHODS

We searched Medline, Scopus, Embase and Cochrane library databases for identifying fifteen eligible studies with a total of 1939 participants, and the quality of these studies was assessed according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. Sensitivities, specificities, diagnostic odds ratios (DOR), positive likelihood ratios (PLR), and negative likelihood ratios (NLR) were calculated. Summary receiver operating characteristic curves (sROC) were generated using bivariate models for whole-body MRI and skeletal scintigraphy.

RESULTS

Whole-body MRI had higher but comparable patient-based higher specificity compared to SS (99% vs. 95%). However, it had markedly higher sensitivity (94% vs. 80% respectively), DOR (966 vs. 82), and LPR (54.4 vs 17.1). LNR of whole-body MRI was <0.1 (0.06), while LNR of SS was >0.1 (0.22). The area under curves (AUC) for whole-body MRI and SS were 0.99 and 0.95 respectively.

CONCLUSIONS

We demonstrate that both whole-body MRI and SS have good diagnostic performance. However, MRI is superior for diagnostics of bone metastases, as it has higher sensitivity, higher diagnostic accuracy, and can be used for both confirmation and exclusion of metastatic bone disease.

pH-Responsive Antibacterial Resin Adhesives for Secondary Caries Inhibition

Secondary caries caused by dental plaque is one of the major reasons for the high failure rate of resin composite restoration. Although antimicrobial agent-modified dental restoration systems have been researched for years, few reported intelligent anticaries materials could respond to the change of the oral environment and help keep oral eubiosis. Herein, we report tertiary amine (TA)-modified resin adhesives (TA@RAs) with pH-responsive antibacterial effect to reduce the occurrence of secondary caries. Two kinds of newly designed TA monomers were synthesized: DMAEM (dodecylmethylaminoethyl methacrylate) and HMAEM (hexadecylmethylaminoethyl methacrylate). In the minimum inhibitory concentration and minimum bactericidal concentration test against Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii, they exhibited antibacterial effect only in acidic medium, which preliminarily verified the acid-activated effect of TAs. Then DMAEM and HMAEM were incorporated into adhesive resin at the mass fraction of 5%, yielding TA@RAs. In vivo and in vitro tests showed that the mechanical properties and biocompatibility of the adhesive were not affected. A S. mutans biofilm model in acidic and neutral medium was used and confirmed that TA@RAs could respond to the critical pH value of de-/remineralization and acquire reversible antibiofilm effect via the protonation and deprotonation of TAs. Meanwhile, the stability of antibacterial effect was confirmed via a 5-d pH-cycling experiment and a saliva-derived biofilm aging model. Furthermore, 16S rRNA gene sequencing showed that TA@RAs could increase the diversity of the saliva-derived biofilms, which implied that the novel materials could help regulate the microbial community to a healthy one. Finally, an in vitro demineralization model and in vivo secondary caries model were applied and demonstrated that TA@RAs could prevent secondary dental caries effectively. In summary, the reversible pH-responsive and non-drug release antibacterial resin adhesives ingeniously overcome the defect of the present materials and hold great promise for clinical application.

Core-shell nanowires of NiCo2O4@α-Co(OH)2 on Ni foam with enhanced performances for supercapacitors

The composites of NiCo₂O₄ with unique structures are extensively explored as promising electrodes. In this work, core-shell structured nanowires anchored on nickel foam are synthesized by the hydrothermal synthesis of NiCo₂O₄ as core and subsequent electrodeposition of α-Co(OH)₂ as shell. The core-shell composites exhibit enhanced electrochemical performances ascribing to the synergistic reactions from both materials, showing higher specific capacitance than any single component. By changing the deposition time, the mass loading of α-Co(OH)₂ can be easily controlled. The electrochemical performances of the hybrid electrodes are diverse with the mass loading of Co(OH)₂. The optimized hybrid electrode with 3 mins electrodeposition exhibits the highest specific capacitance (1298 F g^-1 at 1 A g^-1) among all electrodes. The redox reaction is a main contributor to the total specific capacitance through electrochemical kinetics analysis. An asymmetric supercapacitor assembled by the optimized material as positive electrode and activated carbon as negative electrode can achieve a relatively high energy density of 39.7 Wh kg^-1 at a power density of 387.5 W kg^-1 (at 0.5 A g^-1) in a voltage of 1.55 V.

THU0036 FIRST-IN-HUMAN TRIAL OF BCMA-CD19 COMPOUND CAR IN THE TREATMENT OF AUTOANTIBODY MEDIATED DISORDERS

Background:

Donor-specific anti-HLA antibodies (DSAs) are antibodies in the recipient directed against donor class I/II HLA antigens. The existence of DSAs before allogenic hematopoietic stem cell transplantation (AHSCT) are known to cause primary graft failure. Currently there’s no established method of DSA desensitization due to the long half-life of plasma cells.

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease involving in multiple organ systems mediated by numerous autoantibodies. Recent results have shown that depletion of B cells by CD19 CAR-T cells effectively reversed some manifestations in two SLE mouse models. However, plasma cells could be spared with single CD19 CAR-T cells, and peripheral circulating anti-DNA IgG and IgM autoantibodies remain elevated or increased in treated mice.

Objectives:

We present the efficacy of BCMA-CD19 compound CAR (cCAR), which target on antibody- producing “root”, both B cells and plasma cells in preclinical study and in our first-in-human phase 1 clinical trial.

Methods:

We constructed a BCMA-CD19 cCAR composed of a complete BCMA-CAR fused to a complete CD19 CAR, separated by a self-cleaving P2A peptide. We assessed the functional activity of cCAR in co-culture assay with multiple cell lines. We also verified cCAR efficacy with two mouse models, injected with either BCMA-expressing MM.1S cells or CD19-expressing REH cells. In our phase 1 clinical trial, we enrolled patients with hematologic malignancies with antibody mediated disorders.

Results:

BCMA-CD19 cCAR exhibited robust cytotoxic activity against the K562 cells engineered to express either CD19 or BCMA in co-culture assays, indicating the ability of each complete CAR domain to specifically lyse target cells. In mouse model study, cCAR-T cells were able to eliminate tumor cells in mice injected with MM.1S cells and REH cells, indicating that both BCMA and CD19 are specifically and equally lysing B cells and plasma cells in vivo, making BCMA-CD19 cCAR a candidate for clinical use.

In our first-in-human clinical trial, the first case is a 48-year-old female patient having resistant B-ALL with high DSA titers. She exhibited complete remission of B-ALL at day 14 post-CAR T treatment. MFI of DSA dropped from 7800 to 1400 at 8 weeks post cCAR treatment, the reduction percentage was approximately 80% (Figure 1). The patient had no CRS, and no neurotoxicity was observed.

Figure 1.

1. A) MFI of DSA and other HLA antibodies before and at different time points after cCAR T infusion. B) the percent reduction post-transfusion of cCAR T cells at different time points.

The second case is a 41-year-old female patient having a refractory diffuse large B cell lymphoma with bone marrow (BM) involvement. Furthermore, she has a 20 years of SLE, with manifestation of fever dependent of corticosteroids. On day 28 after cCAR treatment, PET/CT scan showed CR, and BM turned negative. In addition, she is independent of steroids, has no fever and other manifestations, C3/C4 are within normal ranges, and all the ANA dropped significantly, especially the nuclear type ANA, which turned from> 1:1000 to be negative at day 64. She had Grade 1 CRS but with no neurotoxicity observed. The absence of B cells and plasma cells persisted more than 5 months post CAR therapy.

Conclusion:

Our first in human clinical trial on BCMA-CD19 cCAR demonstrated profound efficacy in reducing DSA levels in an AHSCT candidate and ANA titer in a SLE patient. There was strong clinical evidence of depletion of antibody-producing roots, B-cells and plasma cells in both patients. Our results further suggested that BCMA-CD19 cCAR has the potential to benefit patients receiving solid organ transplants or those with other antibody-mediated diseases.

Figure 2.

Reduction of different type of ANA titer at different time points.

Acknowledgments:

patients and their families

Disclosure of Interests:

Fang liu: None declared, Hongyu Zhang: None declared, Xiao Wang: None declared, Jia Feng: None declared, Yuanzhen cao Employee of: Employee of iCell Gene Therapeutics LLC, Yi Su: None declared, Masayuki Wada Employee of: employee of iCell Gene Therapeutics LLC, Yu Ma Employee of: employee of iCAR Bio Therapeutics Ltd, Yupo Ma Shareholder of: shareholder of iCell Gene Therapeutics LLC

AB0425 PRELIMINARY EVALUATION OF THE SURAL NERVE USING 24-MHZ ULTRASOUND: A NEW APPROACH TO EVALUATE SURAL NEUROPATHY OF SJOGREN’S SYNDROME PATIENTS

Background:

Peripheral neuropathy is one of the most frequent extraglandular manifestations of primary Sjögren’s syndrome (pSS). The diagnosis of peripheral neuropathy complications of pSS is based primarily on careful neurologic examination and electrodiagnostic tests. The value of ultrasound in peripheral nerve has been recognized. However, little clinical researches have focused specifically on cutaneous nerve of pSS.

Objectives:

To evaluate the morphological changes of sural nerve in patients with pSS by high-frequency ultrasound.

Methods:

The prospective study subjects consisted of 31 consecutive pSS patients underwent sural nerve biopsy and 30 healthy volunteers as controls. The ultrasonic presentations of the fascicle, perineurium, epineurium of sural nerve were observed, and the cross-sectional areas (CSA) of the sural nerves was measured.

Results:

Among the 21 sural nerves confirmed by pathology, all showed the thickening of the perineurium and epineurium (Figure 1-2), and abnormal blood flow signal in perineurium or epineurium in 14 cases (Figure 2). The mean CSAs were (1.41±0.44) mm2 for the control group, and (1.58±0.48) mm2 for the case group (P>0.05). In addition, the abnormal blood flow signal in sural nerve correlated with disease activity.

Conclusion:

This study indicated that high-frequency ultrasound may be a valuable tool for evaluating cutaneous nerve neuropathy of Sjogren’s syndrome patients.

References:

[1]Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis. 2002;61(6):554-8.

[2]Terrier B, Lacroix C, Guillevin L, Hatron PY, Dhote R, Maillot F, et al. Diagnostic and prognostic relevance of neuromuscular biopsy in primary Sjögren’s syndrome-related neuropathy. Arthritis Rheum.2007;57(8):1520-9.

[3]McCoy SS, Baer AN. Neurological Complications of Sjögren’s Syndrome: Diagnosis and Management. Curr Treatm Opt Rheumatol. 2017;3(4):275-88.

[4]Carvajal Alegria G, Guellec D, Devauchelle-Pensec V, Saraux A. Is there specific neurological disorders of primary Sjögren’s syndrome? Joint Bone Spine. 2015;82(2):86-9.

Figure 1.

Transverse sonograms of the sural nerve (arrows) V: indicates lesser saphenous vein

Figure 2.

Longitudinal sonograms of the sural nerve (arrows) The sonogram of sural nerve showed abnormal blood flow signal. V indicates lesser saphenous vein.

Acknowledgments:

This work was partly supported by National Natural Science Foundation of China (No. 81701712).

Disclosure of Interests: :

None declared

SAT0560 THE PROGNOSTIC VALUE OF ULTRASONOGRAPHIC FINDINGS IN INDIVIDUALS WITH ASYMPTOMATIC HYPERURICEMIA

Background:

Chronic and steady asymptomatic hyperuricemia (AHU) can eventually lead to the deposition of monosodium urate crystals in joints and soft tissues. The rate of progression from AHU to clinically evident gout varies and mainly depends on serum uric acid levels. However, little is known about the prognostic value of ultrasonographic findings in individuals with AHU in detail.

Objectives:

To explore the prognostic value of ultrasonographic findings in individuals with asymptomatic hyperuricemia.

Methods:

We analyzed the ultrasonographic findings (snowstorm sign, double-contour (DC) sign, tophi, bone erosion, and abnormal blood flow) of bilateral knees, ankles and the first metatarsal-phalangeal joints (1st MTP) of individuals with AHU at Peking University People’s hospital between June 2014 and May 2016. All individuals were followed up for two years.

Results:

Among 218 individuals with AHU, the prevalence of snowstorm sign, DC sign, tophi, bone erosion and abnormal blood flow was 41%, 23%, 4%, 9% and 13%, respectively. Gout attacked in 36 patients during 2-year follow-up with 4.5 years of HU duration. The first attack affected the 1st MTP in 60%, the ankle in 31%, and the knee in 11% of the patients with gout. Patients with gout attack has longer hyperuricemia duration compared with individuals with AHU without gout attack. DC sign, tophi, and bone erosion on ultrasound were more frequently presented in patients with gout attack compared with individuals with AHU without gout attack. However, the prevalence of snowstorm sign and and abnormal blood flow on ultrasound has no significant differences between patients with gout attack and individuals with AHU without gout attack.

Conclusion:

Longer hyperuricemia duration, DC sign, tophi, and bone erosion on ultrasound in individuals with AHU could be associated with gout attack.

References:

[1]Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74(10):1789-98.

[2]Estevez-Garcia IO, Gallegos-Nava S, Vera-Pérez E, Silveira LH, Ventura-Ríos L, Vancini G, et al. Levels of cytokines and MicroRNAs in individuals with asymptomatic hyperuricemia and ultrasonographic findings of gout: A Bench-to-Bedside Approach. Arthritis Care Res. 2018;70(12):1814-21.

[3]Elsaman AM, Muhammad EM, Pessler F. Sonographic findings in gouty arthritis: diagnostic value and association with disease duration. Ultrasound Med Biol. 2016;42(6):1330-6.

[4]Joosten LAB, Crişan TO, Bjornstad P, Johnson RJ. Asymptomatic hyperuricaemia: a silent activator of the innate immune system. Nat Rev Rheumatol. 2020;16(2):75-86.

Acknowledgments:

This work was supported by National Natural Science Foundation of China (No. 81571684 to Jiaan Zhu), Peking University People’s Hospital Research and Development Funds (RDC2014-02 to Wenting Fan).

Disclosure of Interests:

None declared

[A pathological report of three COVID-19 cases by minimal invasive autopsies]

Objective: To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19). Methods: Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV. Results: Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs. Conclusions: The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.

[Efficacy of minimally invasive pulmonary surfactant administration in preterm infants with neonatal respiratory distress syndrome: a multicenter clinical trial]

Objective: To explore the feasibility and safety of minimally invasive surfactant administration (MISA) in preterm neonates with respiratory distress syndrome (NRDS). Methods: In this multicenter prospective randomized controlled trial, 92 preterm infants with gestation age ≤30 weeks and diagnosed with NRDS were enrolled in 8 level Ⅲ neonatal intensive care units (NICU) in Beijing-Tianjin-Hebei Region from 1(st) July 2017 to 31(st) December 2018. They were randomly assigned to minimally invasive surfactant administration (MISA) group or endotracheal intubation surfactant administration (EISA) group according to random number generated by computer. Infants in both groups received calf pulmonary surfactant preparation at a dose of 70-100 mg/kg. The data of demography, perinatal situation, medication administration, complications, clinical outcomes in the two groups were compared with Chi-square test, Student's t-test, Mann-Whitney U test or Fisher's exact test. Results: Among the 92 preterm infants, 53 were males, 39 were females; 47 were in the MISA group (25 males), and 45 were in the EISA group (28 males). The gestational age and birth weight were (29.5±1.2) weeks and (1 271±242) g in all patients, (29.5±1.4) weeks and (1 285±256) g in the MISA group, and (29.6±0.9) weeks and (1 255±227) g in the EISA group. The duration of surfactant infusion and the length of whole procedure in the MISA group were significantly longer than that in the EISA group (60 (18, 270) s vs. 50 (30, 60) s, Z=3.009, P=0.003; 90 (60, 300) s vs. 60 (44, 270) s, Z=3.365, P=0.001). For the outcomes, the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and bronchopulmonary dysplasia (BPD) were lower in the MISA group than in the EISA group (36% (17/47) vs. 67% (30/45), χ(2)=8.556, P=0.003; 26% (12/47) vs. 47% (21/45), χ(2)=4.464, P=0.035). Conclusions: Minimally invasive surfactant administration is applicable in preterm infants ≤30 weeks gestational age with NRDS. Although the length of whole procedure is longer than route endotracheal administration, the benefit of decreasing the incidences of hsPDA and BPD outweighs this demerit.

[Evaluation of human milk feeding in hospitalized very low and extremely low birth weight infants]

Objective: To investigate the current situation of human milk (HM) feeding in hospitalized very low and extremely low birth weight infants. Methods: The study retrospectively extracted the data of 601 infants with birth weight <1 500 g, and admitted within 24 hours after birth to the Neonatal Intensive Care Unit of Nanjing Maternity and Child Health Care Hospital from January 2016 to December 2018. The infants were grouped into exclusive mother's-own-milk (MOM) group, donor human milk (DHM) group (partial or none MOM), and mixed (HM and formula) feeding group according to the feeding strategy. Qualitative and quantitative variables in the three groups were compared with One-way ANOVA, Kruskal-Wallis test, Chi-square test or Fisher exact test. Kappa and McNemar test were used for consistency testing. Results: Among the 601 infants (309 boys and 292 girls), 6 (1.0%) infants had never been fed with MOM. The gestational age and birth weight were (29.3±1.9) weeks and 1 260(1 115, 1 400) g in 601 infants. A total of 8 (1.3%) infants were grouped into MOM group, 542 (90.2%) were grouped into DHM group, and 51 (8.5%) were grouped into mixed feeding group. The percentage of enteral feedings with MOM in the stage of hospitalization 1-7 d, 8-14 d and 15-28 d were 73.6% (42.9%, 86.7%), 97.5% (78.6%, 100.0%) and 99.3% (93.0%, 100.0%), respectively (H=414.95, P<0.01), and the pairwise comparison suggested that the stage of hospitalization 1-7 d was the lowest (adjusted both P<0.05). The average weight adjusted daily dose of MOM were 9.7 (4.3, 18.2), 59.1 (26.5, 93.5) and 116.0 (60.3, 142.6) ml/(kg·d) in the stage of hospitalization 1-7 d, 8-14 d and 15-28 d, respectively (H=759.75, P<0.01), and the pairwise comparison suggested that the stage of hospitalization 1-7 d was the lowest (adjusted both P<0.05). The weight adjusted daily dose of MOM in exclusive MOM group, DHM and Mixed feeding group were 95.2 (40.0, 117.2), 82.9(53.6, 103.1) and 55.7 (16.6, 97.5) ml/(kg·d), respectively (H=10.78, P=0.005).Additionally, the percentage and weight adjusted daily dose of MOM showed a general consistency of 0.703 (P>0.05, Kappa=0.408). Conclusions: The rate of exclusive MOM feeding is low, especially during the first 7 days of hospitalization. The percentage of total enteral feedings with MOM and the average weight adjusted daily dose of MOM can well evaluate the situation of HM feeding during hospitalization quantitively.

First Measurement of Λ_{c} Baryon Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of the charmed baryon Λ_{c}^{±} production at midrapidity (|y|<1) in Au+Au collisions at sqrt[s_{NN}]=200  GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider. The Λ_{c}/D^{0} [denoting (Λ_{c}^{+}+Λ_{c}^{-})/(D^{0}+D[over ¯]^{0})] yield ratio is measured to be 1.08±0.16  (stat)±0.26  (sys) in the 0%-20% most central Au+Au collisions for the transverse momentum (p_{T}) range 3<p_{T}<6  GeV/c. This is significantly larger than the pythia model calculations for p+p collisions. The measured Λ_{c}/D^{0} ratio, as a function of p_{T} and collision centrality, is comparable to the baryon-to-meson ratios for light and strange hadrons in Au+Au collisions. Model calculations including coalescence hadronization for charmed baryon and meson formation reproduce the features of our measured Λ_{c}/D^{0} ratio.

Sdccag3 Promotes Implant Osseointegration during Experimental Hyperlipidemia

Hyperlipidemia adversely affects bone metabolism, often resulting in compromised osseointegration and implant loss. In addition, genetic networks associated with osseointegration have been proposed. Serologically defined colon cancer antigen 3 (Sdccag3) is a novel endosomal protein that functions in actin cytoskeleton remodeling, protein trafficking and secretion, cytokinesis, and apoptosis, but its roles in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and in implant osseointegration under hyperlipidemic conditions have not been uncovered. Here, we performed microarray and RNA sequencing analysis to determine the differential expression of the Sdccag3 gene and related noncoding RNAs (ncRNAs) and to assess the long noncoding RNA (lncRNA) MSTRG.97162.4-miR-193a-3p-Sdccag3 coexpression network in bone tissues within the region 0.5 mm around implants in hyperlipidemic rats. In this experiment, we found that Sdccag3 and the previously uncharacterized lncRNA-MSTRG.97162.4 were downregulated during hyperlipidemia, while miR-193a-3p was upregulated. Sdccag3 overexpression increased new trabecular formation, the bone volume/total volume (BV/TV) (1.24-fold), and bone-implant combination ratio (BIC%) (1.26-fold). An RNA pulldown experiment revealed that Sdccag3 protein targeted lncRNA-MSTRG.97162.4 nucleotides 361 to 389. In addition, lncRNA-MSTRG.97162.4 overexpression significantly enhanced Sdccag3 (2.78-fold) expression and increased BV/TV (1.45-fold) and BIC% (1.07-fold) at the bone-implant interface. Taken together, these findings indicate that Sdccag3 overexpression enhances implant osseointegration under hyperlipidemic conditions by binding to lncRNA-MSTRG.97162.4. Furthermore, miR-193a-3p overexpression inhibited lncRNA-MSTRG.97162.4 (0.63-fold) and Sdccag3 (0.88-fold) expression and induced poor implant osseointegration (BV/TV, 0.86-fold; BIC%, 0.82-fold), while miR-193a-3p downregulation produced the opposite results (lncRNA-MSTRG.97162.4, 10.69-fold; Sdccag3, 6.96-fold; BV/TV, 1.20-fold; BIC%, 1.26-fold). Therefore, our findings show that Sdccag3 promotes implant osseointegration, and its related lncRNA-MSTRG.97162.4 and miR-193a-3p play an important role in osseointegration during hyperlipidemia, which might be a promising therapeutic target for improving dental implantation success rates.

[Effect of free medial plantar perforator flap in repairing deep burn wound on palm with the assistance of three dimensional computed tomography angiography]

Objective: To explore the effect of free medial plantar perforator flap in repairing deep burn wound on palm with assistance of three dimensional computed tomography angiography (CTA). Methods: From March 2015 to January 2018, 11 patients with deep burn wounds of palm were admitted to the Department of Burns and Plastic Surgery of Yidu Central Hospital of Weifang City, including 6 males and 5 females, aged 19-53 years. The wound area after debridement was 3.0 cm×2.5 cm-8.0 cm×6.0 cm. Before the operation, CTA of the foot was performed, and the three dimensional digital model was reconstructed by computer software to observe the initial position, course, and distribution of the arteries and veins in the donor site. The medial plantar perforator flap was designed according to the area and shape of the wound, with area of 3.5 cm×3.0 cm-8.5 cm×6.5 cm. After the wound was covered by the flap, the perforating branch of the medial plantar artery was anastomosed end to end with the carpal epithelial branch of the ulnar artery, the accompanying vein or the branch of the great saphenous vein was anastomosed end to end with the accompanying vein of the carpal epithelial branch of the ulnar artery, and the terminal branch of the saphenous nerve or the medial dorsal cutaneous nerve was anastomosed end to end with the superficial palmar branch of the ulnar nerve. The wound of donor site was covered with full-thickness skin graft from the outer thigh of the same side. The perforators of the medial plantar artery observed during the operation were compared with the reconstructed three dimensional CTA images. The survival of flap was observed, and the appearance and function of the flap were followed up and evaluated with trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. Results: The initial position, course, and distribution of the perforator of the medial plantar artery during the operation were basically the same as those of the reconstructed three dimensional CTA images before the operation. All the flaps of patients survived after the operation. During the 6 months to 1 year follow-up, the appearance of flap was good, with no obvious swelling or pigmentation, but with good elasticity. The discrimination distance between the two points was 5.0-8.0 mm, and the flaps were evaluated as excellent in 4 cases, good in 6 cases, and fair in 1 case. Conclusions: The free medial plantar perforator flap is an ideal choice for repair of the deep burn wound on palm. Three dimensional CTA before the operation can detect condition of vascular variation, with high accuracy of vascular anastomosis during operation.

ICRP Publication 142: Radiological Protection from Naturally Occurring Radioactive Material (NORM) in Industrial Processes

The purpose of this publication is to provide guidance on radiological protection in industries involving naturally occurring radioactive material (NORM). These industries may give rise to multiple hazards and the radiological hazard is not necessarily dominant. The industries are diverse and may involve exposure of people and the environment where protective actions need to be considered. In some cases, there is a potential for significant routine exposure of workers and members of the public if suitable control measures are not considered. Releases of large volumes of NORM may also result in detrimental effects on the environment from radiological and non-radiological constituents. However, NORM industries present no real prospect of a radiological emergency leading to tissue reactions or immediate danger for life. Radiological protection in industries involving NORM can be appropriately addressed on the basis of the principles of justification of the actions taken and optimisation of protection using reference levels. An integrated and graded approach is recommended for the protection of workers, the public, and the environment, where consideration of non-radiological hazards is integrated with radiological hazards, and the approach to protection is optimised (graded) so that the use of various radiological protection programme elements is consistent with the hazards while not imposing unnecessary burdens. For workers, the approach starts with characterisation of the exposure situation, and integration, as necessary, of specific radiological protective actions to complement the protection strategy already in place or planned to manage other workplace hazards. According to the characteristics of the exposure situation and the magnitude of the hazards, a relevant reference level should be selected and appropriate collective or individual protective actions taken. Exposure to radon is also treated using a graded approach, based first on application of typical radon prevention and mitigation techniques, as described in <italic>Publication 126</italic>. A similar approach should be implemented for public exposure through the control of discharges, wastes, and residues after characterisation of the situation. If the protection of non-human species is warranted, it should be dealt with after an assessment of radiological exposure appropriate for the circumstances, taking into account all hazards and impacts. This should include identification of exposed organisms in the environment, and use relevant derived consideration reference levels to inform decisions on options for control of exposure.

[Analysis of trends on smoking prevalence and its risk factors in Shaanxi province 2007-2015]

Objective: To analyze the trend of smoking prevalence and its risk factors among adults in Shaanxi province from 2007 to 2015. Methods: We used data from China Chronic Disease and Risk Factor Surveillance in 2007, 2010, 2013 and 2015. The current smoking prevalence and trends of the four surveys were calculated. Its risk factors were analyzed by multivariate logistic regression from each survey and then from all pooled data of the three surveys. Results: The number of participants in 2007, 2010, 2013 and 2015 was 1 542, 3 000, 10 166 and 6 330, respectively. The current smoking prevalence dropped from 34.34% in 2007 to 26.22% in 2013, but increased to 28.33% in 2015 (trend χ(2) test: Z=2.53, P=0.01). The results from four pooled data showed that the current smoking prevalence of men was higher than that of women (OR=75.03, 95%CI: 63.57-88.55). The current smoking prevalence of people aged 45-59 was higher than that of people aged 18-44 (OR=1.28, 95%CI: 1.15-1.41). In addition, the current smoking prevalence of those who were educated for 7-9 years and more than 9 years were higher than those who were educated for less than 6 years (people with education for 7-9 years OR=1.44, 95%CI: 1.29-1.61; people with education >9 years OR=1.43, 95%CI: 1.26-1.63). The current smoking prevalence of the single was lower than those of married/cohabitants (OR=0.54, 95%CI: 0.37-0.77). The current smoking prevalence of retirees were lower than those of employees (OR=0.46, 95%CI: 0.38-0.57) and smoking prevalence of alcohol drinkers were higher than those of non-drinkers (OR=2.92, 95%CI: 2.67-3.19). Conclusion: From 2007 to 2015, the current smoking prevalence of Shaanxi population was high and the trends remained stable. It is necessary to strengthen smoking control and health education for men, people over 45 years old, people with education level 7 years and above, and working personnel in Shaanxi province.

Cost-effectiveness of bivalent versus monovalent vaccines against hand, foot and mouth disease

OBJECTIVES

Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) were responsible for 43.3% (235 123/543 243) and 24.8% (134 607/543 243) of all laboratory-confirmed hand, foot and mouth disease (HFMD) cases during 2010-2015 in China. Three monovalent EV71 vaccines have been licensed in China while bivalent EV71/CA16 vaccines are under development. A comparative cost-effectiveness analysis of bivalent EV71/CA16 versus monovalent EV71 vaccination would be useful for informing the additional value of bivalent HFMD vaccines in China.

METHODS

We used a static model parameterized with the national HFMD surveillance data during 2010-2013, virological HFMD surveillance records from all 31 provinces in mainland China during 2010-2013 and caregiver survey data of costs and health quality of life during 2012-2013. We estimated the threshold vaccine cost (TVC), defined as the maximum additional cost that could be paid for a cost-effective bivalent EV71/CA16 vaccine over a monovalent EV71 vaccine, as the outcome. The base case analysis was performed from a societal perspective. Several sensitivity analyses were conducted by varying assumptions governing HFMD risk, costs, discounting and vaccine efficacy.

RESULTS

In the base case, choosing the bivalent EV71/CA16 over monovalent EV71 vaccination would be cost-effective only if the additional cost of the bivalent EV71/CA16 compared with the monovalent EV71 vaccine is less than €4.7 (95% CI 4.2-5.2). Compared with the TVC in the base case, TVC increased by up to €8.9 if all the test-negative cases were CA16-HFMD; decreased by €1.1 with an annual discount rate of 6% and exclusion of the productivity loss; and increased by €0.14 and €0.3 with every 1% increase in bivalent vaccine efficacy against CA16-HFMD and differential vaccine efficacy against EV71-HFMD, respectively.

CONCLUSIONS

Bivalent EV71/CA16 vaccines can be cost-effective compared with monovalent EV71 vaccines, if suitably priced. Our study provides further evidence for determining the optimal use of HFMD vaccines in routine paediatric vaccination programme in China.

Government regulation and consumer evaluation after dairy products scandal in China

With the continuous expansion of the global dairy trade market, the quality and safety of the Chinese dairy market have a wide and far-reaching impact on the world. Based on the development of the dairy scandal in the past few years in China, this study illustrates the serious damage of melamine on human health and the negative impact on the dairy industry in China.

This study shows that the lack of effective government regulations is a key reason for dairy market failure. Consumers are lacking confidence in the quality of Chinese dairy products and the government's market regulations. The Chinese dairy market will continue to rely on imported dairy products. By analyzing the typical cases of the dairy market in China, this study aims to provide a guide for dairy industries in other countries.

Effect of Application Rate and Timing on Residual Efficacy of Pyraclostrobin in the Control of Pepper Anthracnose

Anthracnose is a devastating disease that seriously affects pepper production worldwide. Anthracnose management is currently a major problem because of the widespread and long period of infection of this disease. Therefore, determination of the optimal fungicide application timing is important for controlling anthracnose in a timely manner . In vitro sensitivity tests showed no significant difference in the pyraclostrobin sensitivity of Colletotrichum scovillei collected from 2016 and 2017, with mean half maximal effective concentration values of 0.349 to 0.542 and 0.0475 to 0.0639 mg/liter for the inhibition of mycelial growth and spore germination, respectively. Fungicide application initiated at the full-bloom stage could significantly delay anthracnose disease onset, decrease anthracnose incidence and development (23.67 to 89.80%), and increase pepper yield by 10.7 to 29.2%. In addition, the application dosage was decreased by >50%. BF-500-3, the main metabolite of pyraclostrobin, was detected in pepper fruit and exhibited high inhibitory activity against C. scovillei. The final residues of all fungicides at different application timing were below maximum residue limits. Moreover, structural equation modeling indicated that application timing plays the most important role in anthracnose disease inhibition. The tank mixtures of pyraclostrobin with tebuconazole and fludioxonil showed more satisfactory efficacy (69.87 to 78.36%) against anthracnose than did pyraclostrobin alone under field conditions. This study is the first to determine the best fungicide application timing for anthracnose management. These results establish the basis for sustainable development of the pepper industry.

[Clinicopathological features of T-lymphoblastic lymphoma with Langerhans cell histiocytosis in the same lymph node]

Objective: To investigate the clinicopathological features, immunophenotypes, genetics and prognosis of T-lymphocyte lymphoma/myeloid sarcoma combined with Langerhans cell histiocytyosis (coexistence of T-LBL/MS and LCH). Methods: Clinical and pathological data of the 6 patients with coexistence of T-LBL/MS and LCH were analyzed, who were diagnosed at the Foshan Hospital of Sun Yat-sen University and the Friendship Hospital of Capital Medical University, from December 2013 to April 2019. The hematoxylin and eosin stain, immunohitochemistry (EnVision) and in situ hybridization were used. Related literatures were reviewed. Results: Four patients were T-LBL combined with LCH, 1 was T-LBL/MS combined with LCH, and 1 was MS combined with LCH. There were 2 male and 4 female patients, with age ranged from 5 to 77 years old (median, 59 years old). Three patients represented with only multiple lymph node swelling. The other 3 displayed both multiple lymph node swelling, and skin/liver or spleen lesions. Lymph node structure was destroyed in 5 cases, while 3 cases had several residual atrophic follicles. Histologically, there were two types of tumor cells: one type of the abnormal lymphoid-cells exhibited small to medium-sized blast cells, typically showing a nested distribution, and these cells were mainly identified in residual follicles and paracortical areas; the other type of histiocytoid cells had a large cell size and abundant pale or dichromatic cytoplasm. Their nuclei were irregularly shaped, showing folded appearance and nuclear grooves. These cells were mainly present in marginal sinus, medullary sinus and interstitial area between follicles. Eosinophil infiltration in the background was not evident in any of the cases. The lymphoid-cells of medium size showed TdT+/CD99+/CD7+, with variable expression of CD34/MPO/CD2/CD3. Ki-67 index was mostly 30%-50%. However, the histiocytoid cells showed phenotype of CD1a+/S-100+/Langerin+/-, while CD163/CD68 were positive in some degree. These cells did not express any T or B cell markers. The Ki-67 index mostly ranged between 10%-20%. None of the cases had Epstin-Barr viral infection. Among the 6 patients, 4 patients were followed up (6-63 months, median time, 18.5 months), of whom 1 patient died of the disease and 3 patients were alive at the end of follow-up. Conclusions: T-LBL/MS combined with LCH is a rare mixed type of immature hematopoietic disease, and mainly occurs in lymph node and skin. The clinical course is overall aggressive. Therefore, it is helpful to recognize and identify the two pathologic components in the same tissue for accurate diagnosis and proper treatment.

Effect of Pyrisoxazole on Colletotrichum scovillei Infection and Anthracnose on Chili

Anthracnose caused by Colletotrichum scovillei is one of the most destructive diseases affecting chili production. Disease control mainly relies on conventional fungicides, and repeated exposure to single-site mode-of-action fungicides may pose a risk for the development of resistant isolates within the population. Our previous study suggested that pyrisoxazole has strong inhibitory activity against C. scovillei in vitro. However, the effects of pyrisoxazole on the C. scovillei infection process and the performance of pyrisoxazole in the field remain unclear. In this study, pyrisoxazole exhibited strong inhibitory activity against the mycelial growth, appressorium formation, and appressorium diameter of C. scovillei, with half maximal effective concentration values of 0.1986, 0.0147, and 0.0269 μg/ml, respectively, but had no effect on sporulation, even at the highest concentration of 1.6 μg/ml. The baseline sensitivity curves were unimodal with a long right-hand tail. The in vivo data showed that pyrisoxazole provided both preventive and curative activity against anthracnose on chili. Pyrisoxazole decreased the incidence of anthracnose and reduced disease progress. The results of electron microscopy showed that pyrisoxazole can affect the C. scovillei infection process by altering mycelial morphology, degrading conidia and germ tubes, suppressing conidial germination and appressorium formation, and enhancing conidiophore production. Pyrisoxazole can be used to effectively control anthracnose under field conditions and increase chili yield; moreover, no phytotoxicity symptoms were observed after treatment. These results provide new insight into the mechanisms by which pyrisoxazole controls disease and suggest that pyrisoxazole is a feasible alternative for the management of anthracnose in chili.

Stitching the synapse: Cross-linking mass spectrometry into resolving synaptic protein interactions

Synaptic transmission is the predominant form of communication in the brain. It requires functionally specialized molecular machineries constituted by thousands of interacting synaptic proteins. Here, we made use of recent advances in cross-linking mass spectrometry (XL-MS) in combination with biochemical and computational approaches to reveal the architecture and assembly of synaptic protein complexes from mouse brain hippocampus and cerebellum. We obtained 11,999 unique lysine-lysine cross-links, comprising connections within and between 2362 proteins. This extensive collection was the basis to identify novel protein partners, to model protein conformational dynamics, and to delineate within and between protein interactions of main synaptic constituents, such as Camk2, the AMPA-type glutamate receptor, and associated proteins. Using XL-MS, we generated a protein interaction resource that we made easily accessible via a web-based platform (http://xlink.cncr.nl) to provide new entries into exploration of all protein interactions identified.

Adsorptive recovery of Au(III) from aqueous solution using crosslinked polyethyleneimine resins

Resin adsorption is considered as a promising method to recover gold ions from wastewater, but further reduction reaction is required to convert gold ions into particles. In this study, a crosslinked polyethyleneimine resin (CPEIR) was developed via a suspension polymerization of polyethyleneimine (PEI) and ethylene glycol diglycidyl ether (EGDE) for gold recovery. The Au(III) adsorption capacities of CPEIR were significantly impacted by solution pH and initial Au(III) concentrations but unaffected by co-existing metal ions. Compared with commercial anion-exchange resin IRA400, the CPEIR exhibited higher sorption amount and selectivity for Au(III) due to its high density of amine and hydroxyl groups on the surfaces. The adsorption isotherm of Au(III) on CPEIR was well described by the Langmuir equation, and the maximum uptake amount of Au(III) was high up to 943.5 mg/g, much higher than the reported sorbents. The adsorption kinetic data on the CPEIR were fitted well by the Pseudo-second-order equation, and the intraparticle diffusion was found to be the rate-controlling process of Au(III) adsorption. X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) analysis confirmed that Au(III) ions were adsorbed on the CPEIR via electrostatic attraction and chelating interaction, and subsequently the partial loaded Au(III) ions were reduced to elemental gold whereas the hydroxyl groups of CPEIR were oxidized to carbonyl groups.

[Comparison of keratometric measurements obtained by the Verion image guided system with the IOLMaster and the Pentacam before cataract extraction surgery]

Objective: To compare the keratometric measurements of the Verion image guided system with the partial coherence interferometry (IOLMaster700) and the scheimpflug corneal topography (Pentacam). Methods: In this cross-sectional study, 146 eyes of 88 patients [mean age, (69±10) years; 62 eyes of male patients and 84 eyes of female patients] with cataract were examined before cataract extraction and IOL implantation surgery in the Tenth People's Hospital Affiliated to Tongji University from January 2016 to March 2017. Corneal curvature values acquired by the Verion optical imaging system were compared with the IOLMaster700 and the Pentacam. Keratometric data, magnitude of astigmatism, and steep astigmatic axis measurements from all three instruments were also compared. According to the steep axis of astigmatism, the eyes were divided into groups of with the rule (WTR), against the rule (ATR), and oblique astigmatism. The parameter differences between the Verion and the other devices in the three groups were analyzed. The data were evaluated using repeated measures analysis of variance and Bland-Altman plots. Results: The values of steep keratometry (Ks) of the Verion, IOLMaster700, and Pentacam were (44.60±1.32), (44.73±1.37), (44.43±1.35) D, respectively. The values of flat keratometry (Kf) of the Verion, IOLMaster700, and Pentacam were (43.51±1.41), (43.51±1.52), (43.40±1.45) D, respectively. The values of mean keratometry (Km) of the Verion, IOLMaster700, and Pentacam were (44.60±1.32), (44.12±1.35), (43.92±1.34) D, respectively. The values of astigmatism magnitude were (1.09±0.87), (1.24±1.02), (1.04±0.80) D, respectively. The F values were 1.81, 0.31, 0.93 and 2.22 in relation to Ks, Kf, Km and corneal astigmatism magnitude among the three instruments, respectively (all P>0.05). The 95% confidence intervals of Kf, Ks and astigmatism magnitude between the Verion and the other two devices were -1.10 to 0.80 D, -0.55 to 0.88 D; -1.10 D to 1.10 D, -0.80 to 1.04 D; -1.21 to 0.90 D, -0.92 to 1.02 D. The outcomes were considered acceptable. There were no statistically differences in steep astigmatic axis measurements between the Verion and the other two instruments among the WTR (62 eyes), ATR (45 eyes) and oblique (15 eyes) groups (F=0.63, 0.37; P=0.54, 0.72, respectively). Conclusions: The Verion image guided system is a reliable system for the measurement of keratometry values and astigmatism. The keratometric power, magnitude and steep axis of astigmatism have no significant difference, and there is a good agreement among the Verion, IOL Master 700, and Pentacam. (Chin J Ophthalmol, 2020, 56: 47-52).

[Expression of myocyte enhancer factor 2B in mantle cell lymphoma and its clinical significance]

Objective: To investigate the expression of myocyte enhancer factor 2B (MEF2B) in mantle cell lymphomas (MCL), and to analyze the correlation between the expression of MEF2B and pathological subtypes, structural subtypes, SOX11 expression and its clinical significance. Methods: Paraffin-embedded tissues were stained with HE, immunohistochemistry (EnVision method) and fluorescence in situ hybridization (FISH) , in addition, the clinical and pathological data of 60 cases of MCL were collected at Sun Yat-sen University Foshan Hospital and Sun Yat-sen University Cancer Center from January,2002 to May, 2019 for analysis. Results: Of the 60 MCLs, males is predominant (M∶F=3∶1). Histologically, the typical MCL is the majority (classical MCL: variant type MCL=48 cases:12 cases) . Fifty cases were classified into non-complete FDC meshwork type MCL, and the remaining 10 cases were classified into the complete-FDC meshwork type MCL group. Patients with classical MCL were more than 60 years old. The coexistent lesion sites both node and extranode in pathological subtype or structural subtype was the most common lesion sites. SOX11(+) MCL was common in classical MCL (P=0.040) and tended to be complete-FDC meshwork type MCL (P=0.086). The expression rate of MEF2B in MCL was 60.0%(36/60). This rate of MEF2B in classical type, complete-FDC meshwork type and SOX11(+) MCL was significantly higher than that variant type, no complete-FDC meshwork type, SOX11(-)MCL (P<0.05), respectively. There was no difference in clinical characteristics of MCL between MEF2B positive and negative groups. Compared with SOX11(-)MCL, the percentage of MEF2B expressed in tumor cells of SOX11(+)MCL was significantly higher (P=0.027). The expression of MEF2B was not related to the proliferation of tumor cells (P=0.341). There was no significant difference in the survival rate between different expression groups of MEF2B and SOX11 (P=0.304 and P=0.819, respectively). Only the mortality of variant type (blastoid/pleomorphic) MCL within 2 years was significantly higher than that of classical type MCL (P<0.05). Conclusions: The expression of MEF2B in MCL is related to the pathological subtypes, structural subtypes and the expression of SOX11, but not to the proliferation and prognosis. The high mortality rate within 2 years is only found in variant MCL. However, the role of MEF2B in MCL needs to be further studied.

[Malfunction of autophagy in tibial growth plate chondrocytes causes increased apoptosis rate in chronic renal insufficiency rats]

Objective: To observe the effect of autophagy of tibial growth plate chondrocyte on apoptosis in chronic renal insufficiency (CRI) rats. Methods: Male 4-week-old SD rats were randomly divided into two groups: (1) Sham group: only the left ureter was exposed (n=10); (2) CRI group: the left ureter was ligated to cause CRI (n=10). The urine from all the rats was collected 6 weeks after the operation and the total protein content was measured. Then all the rats were sacrificed and the concentrations of creatinine and urea nitrogen in intracardiac blood were detected. The proximal tibia were fixed and decalcified to prepare histological sections, and the number of chondrocytes of column cells in the proliferative area of tibia growth plate was observed by saffron O staining. The expression rate of protein Light Chain-3, an autophagy marker of chondrocytes, was detected by immunofluorescence. The apoptosis rate of chondrocytes was detected by the method of TUNEL assay. The level of glycogenin-1, a glycogen formation marker of chondrocyte was detected by immunohistochemistry in chondrocytes. Results: The 24 h urine total protein was higher in CRI group [(163.5±11.3) mg vs (38.6±9.8) mg, t=25.620, P<0.001]. The levels of blood creatinine [(67.3±16.2) μmol/L vs (28.4±11.5) μmol/L, t=5.974, P<0.001] and urea nitrogen [(16.4±6.4) mmol/L vs (4.8±2.0) mmol/L, t=5.198, P<0.001] were higher in CRI group. The number of chondrocytes of column cells in the proliferating area of tibia growth plate was lower in CRI group (4.2±2.1 vs 9.1±3.8, t=3.109, P=0.006). The expression rate of LC-3 protein in chondrocytes of CRI group was lower [(27.2±12.6)% vs (51.4±18.2)%, t=3.457, P=0.003]. The level of glycogenin-1 of chondrocytes in CRI group increased significantly (6.1±2.5 vs 3.5±1.8, t=2.669, P=0.016). The apoptosis rate of chondrocytes in CRI group also increased [(17.2±4.8)% vs (5.1±3.4)%, t=6.505, P<0.001]. Conclusion: Malfunction of autophagy in tibial growth plate chondrocytes causes increased apoptosis rate in CRI rats, which might be caused by the failure of glycogen degradation in chondrocytes.