Botulinum Toxin Type A Attenuates Apoptosis in Human Dermal Microvascular Endothelial Cells Exposed to an In Vitro Model of Ischemia/Reperfusion Injury

BACKGROUND

Botulinum toxin type A (BTXA) has been reported to increase survival of critically ischemic skin flaps; however, the effect of BTXA in human dermal microvascular endothelial cells (HDMECs) remains to be investigated. This study aimed to investigate the protective effect of BTXA in HDMECs exposed to an in vitro model of ischemia/reperfusion injury.

METHODS

HDMECs were isolated from human upper eyelid tissue and were randomly divided into 3 groups: 1.

CONTROL GROUP

culture under normoxic conditions (95% air and 5% CO₂); 2. hypoxia/reoxygenation (H/R) group: culture in a hypoxic incubator (94% N₂ + 5% CO₂ + 5% O₂) for 8 hours, followed by culture in saturated aerobic culture medium for 24 hours; and 3. BTXA group: treatment with BTXA for 12 hours before exposure to hypoxic conditions. Flow cytometry was used to analyze the apoptosis of HDMECs, and western blotting was used to detect the expression of apoptosis-related proteins.

RESULTS

H/R leads to severe injury in HDMECs, as evidenced by an increase in the percentage of apoptosis and an increase in expression of apoptosis-related proteins (Bax, cleaved-caspase-3, and cytochrome C). Moreover, H/R results in a decrease in expression of anti-apoptotic protein (Bcl-2), which can be significantly attenuated with BTXA treatment.

CONCLUSION

BTXA protects against apoptosis in HDMECs exposed to an in vitro model of H/R-induced injury.

Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture

Objective

This study aims to discuss the clinical effect of balloon kyphoplasty on elderly patients with multiple osteoporotic vertebral fractures.

Methods

The observation group was treated with balloon kyphoplasty, and the control group was managed with conservative treatment. Image indices, pain degree, daily life disturbance, and occurrences of complications were compared between the two groups.

Results

In total, 116 elderly patients with multiple osteoporotic vertebral fracture admitted in our hospital from January 2016 to June 2017 were chosen and divided randomly into observation (n = 58) and control groups (n = 58). The observation group showed a significantly higher trailing edge, leading edge, and midcourt line and larger upper thoracic kyphosis compared with the control group (P < 0.05). Before the treatment, no statistically significant differences were observed between the two groups in terms of visual analog scale (VAS) score and daily life disturbance score (P > 0.05). However, the VAS score and the daily life disturbance score of the two groups decreased sharply after the treatment (P < 0.05). Moreover, the VAS score and the daily life disturbance score of the observation group were significantly lower than those of the control group (P < 0.05). The observation group showed lower occurrence rate of complications compared with the control group (P < 0.05).

Conclusions

Balloon kyphoplasty can significantly improve the image indices of patients with multiple osteoporotic vertebral fractures and relieve their pain degree and daily life disturbance. Balloon kyphoplasty exhibited a low occurrence rate of complications and high safety and is, thus, worthy of clinical applications.

6-year change in resting heart rate is associated with incident type 2 diabetes mellitus

BACKGROUND AND AIMS

Elevated resting heart rate (RHR) is associated with risk of type 2 diabetes mellitus (T2DM). However, the association of change in RHR (ΔRHR) and incident T2DM is not fully elucidated. We aimed to assess the dose-response association between 6-year ΔRHR and T2DM.

METHODS AND RESULTS

A total of 12155 non-T2DM participants ≥18 years old were enrolled during 2007-2008 and followed up during 2013-2014. ΔRHR was calculated by subtracting the baseline RHR from the RHR value at 6-year follow-up. Age-, sex-, and RHR-specific relative risks (RRs) and 95% confidence intervals (CIs) for the effect of ΔRHR on incident T2DM were calculated by using modified Poisson regression models. As compared with ΔRHR of 0 beats/min, the adjusted risk of T2DM was significantly increased with RHR increment and reduced with RHR reduction. ΔRHR was positively associated with future risk of T2DM [RR per unit increase: 1.03 (1.03-1.04)]. As compared with stable change in RHR group (-5<ΔRHR<5 beats/min), for ΔRHR ≤ -10 beats/min, -10<ΔRHR ≤ -5 beats/min, 5≤ΔRHR<10 beats/min, and ΔRHR ≥10 beats/min groups, the pooled adjusted RR (95% CI) of T2DM was 0.69 (0.55-0.86), 0.90 (0.73-1.11), 1.31 (1.07-1.61), and 1.90 (1.59-2.26), respectively. This significant association still existed on subgroup analyses based on age, sex, and baseline RHR and sensitivity analyses.

CONCLUSIONS

Dynamic RHR change was significantly associated with incident T2DM. Our study suggests that RHR may be a non-invasive clinical indicator for interventions aiming to reduce incident T2DM in the general population.

[Construction and in vitro verification of a new humanized anti-CD19 CAR-T cells with high affinity]

目的

构建人源化抗CD19嵌合抗原受体T细胞（CAR-T），通过体外实验验证其杀伤白血病细胞的能力。

方法

将人CD19的鼠源抗体（FMC63）进行了人源化改造，获得高亲和力的人源化CD19抗体；构建携带人源化CD19 CAR慢病毒载体，感染T细胞获得人源化CD19 CAR-T细胞（hCART19）；按不同效靶比将效应细胞[hCART19、未转染的T细胞（阴性组）及对照病毒转染的T细胞（对照组）]及靶细胞（CHO-K1-CD19及Raji细胞）混合培养，LDH释放实验及ELISA法检测hCART19杀伤白血病细胞的能力及细胞因子释放水平；白血病小鼠模型检测hCART19的杀瘤效果。

结果

LDH释放实验证实随着效靶比的不断增加，对靶细胞的杀伤率逐渐增加，当效靶比为10∶1时hCART19组的杀伤率最大，在Raji细胞中为（87.56±1.99）%，明显高于阴性组[（19.31±1.16）%]及对照组[（21.35±1.19）%]（P值均<0.001）。ELISA法检测显示Raji细胞作为靶细胞时，hCART19组IL-2水平[（10.56±0.88）pg/ml]及IFN-γ[（199.02±12.66）pg/ml]较阴性组[IL-2：（3.55±0.26）pg/ml；IFN-γ：（37.63±0.85）pg/ml]及对照组[IL-2：（2.92±0.32）pg/ml；IFN-γ：（52.07±3.33）pg/ml]明显升高（P值均<0.001）。以上实验在CHO-K1-CD19细胞作为靶细胞时也出现了相似的结果。给予白血病小鼠模型尾静脉分别注射hCART19、对照病毒转染的T细胞及未转染的T细胞，结果显示hCART19组小鼠存活时间>40 d，另外两组小鼠在20~30 d全部死亡，差异有统计学意义（χ²=11.73，P=0.008）。

结论

成功构建了具有抗白血病活性的人源化CD19 CAR-T细胞，为下一步的临床研究奠定了基础。

Abstract PD4-11: [18F]Fluciclovine PET tracks cellular glutamine pool size in breast cancer and changes in response to metabolic inhibition

Background: Some forms of triple negative breast cancer (TNBC) rely on glutamine (Gln) metabolism for survival and growth (1), therefore, targeting this metabolic pathway provides a viable strategy for managing TNBC. Drugs that inhibit glutaminase (GLS), a key enzyme of glutaminolysis, are being developed (1,2). [18F]Fluciclovine is a PET imaging agent that enters/exits cells via glutamine transporters and undergoes minimal metabolism. Therefore, we hypothesize, that akin to our prior work with [18F]fluoroglutamine (3), the distribution volume (VT) of fluciclovine obtained from dynamic PET can be used to estimate the cellular glutamine level (pool size) and to mark the effect of pharmacological inhibitors of tumor glutaminase (GLS). We tested this hypothesis in human TNBC and ER+ breast cancer xenograft exhibiting a high and low GLS activity, respectively.

Methods: To make [18F]fluciclovine preparation suitable for mouse imaging, citrate in the formulation was removed and replaced with PBS by eluting through a column (Bio-Rad). Cellular uptake was performed in the presence and absence of Gln transporter inhibitors and GLS inhibitor. In vivo dynamic PET imaging were performed on mice bearing HCC1806 (TNBC) and MCF-7 (ER+ BC) xenografts. Dynamic PET images were analyzed by Logan Plot (PMOD) to estimate VT.

Results: Cellular uptake of [18F]fluciclovine in HCC1806 and MCF-7 cells were sensitively inhibited by cold glutamine (Gln) and GPNA (a pharmacologic inhibitor of ASCT-2), confirming that the uptake is mediated by Gln transporters. The peak uptake in MCF-7 cells was 5-fold higher than HCC1806. In mouse models, VT from in vivo [18F]Fluciclovine PET in MCF-7 tumor is 1.4-fold of HCC1806. These data are consistent with a higher cellular Gln pool size in MCF-7 as the result of its lower GLS activity. After inhibition of tumor GLS activity, VT of [18F]fluciclovine in HCC-1806 tumors was increased by 56% from baseline values (n=2), whereas VT in MCF-7 tumors decreased 1% after treatment (n=2). Only a small change of FDG PET signal (5% decrease, n=5) was detected in TNBC tumors after GLS inhibitor treatment.

Discussions: These data suggest that VT obtained from [18F]fluciclovine PET is sensitive to changes of the Gln pool size induced by GLS inhibition whereas FDG PET is not. Since the Gln pool size is inversely related to the GLS activity, increased VT is consistent with the increased intracellular Gln level when metabolic conversion of Gln to glutamate by GLS is inhibited. Our results suggest that [18F]fluciclovine, an imaging agent approved for prostate cancer imaging, may be useful for assessing glutamine pool size in breast cancer and changes in response to GLS inhibition

Support: R21CA198563, R01CA211337, and Komen SAC130060. We thank Blue Earth Diagnostics for supplies of [18F]fluciclovine.

1.Gross MI, Demo SD, Dennison JB, et al. Mol Cancer Ther 2014;13(4):890-901.

2.Le A, Lane AN, Hamaker M, et al. Cell Metab 2012;15(1):110-21.

3.Zhou R, Pantel AR, Li S, et al. Cancer Res 2017;77(6):1476-84.

Citation Format: Cao J, Choi H, Pantel A, Kranseler D, Lee H, Mankoff D, Zhou R. [18F]Fluciclovine PET tracks cellular glutamine pool size in breast cancer and changes in response to metabolic inhibition [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD4-11.

Constraining the p-Mode-g-Mode Tidal Instability with GW170817

We analyze the impact of a proposed tidal instability coupling p modes and g modes within neutron stars on GW170817. This nonresonant instability transfers energy from the orbit of the binary to internal modes of the stars, accelerating the gravitational-wave driven inspiral. We model the impact of this instability on the phasing of the gravitational wave signal using three parameters per star: an overall amplitude, a saturation frequency, and a spectral index. Incorporating these additional parameters, we compute the Bayes factor (lnB_{!pg}^{pg}) comparing our p-g model to a standard one. We find that the observed signal is consistent with waveform models that neglect p-g effects, with lnB_{!pg}^{pg}=0.03_{-0.58}^{+0.70} (maximum a posteriori and 90% credible region). By injecting simulated signals that do not include p-g effects and recovering them with the p-g model, we show that there is a ≃50% probability of obtaining similar lnB_{!pg}^{pg} even when p-g effects are absent. We find that the p-g amplitude for 1.4  M_{⊙} neutron stars is constrained to less than a few tenths of the theoretical maximum, with maxima a posteriori near one-tenth this maximum and p-g saturation frequency ∼70  Hz. This suggests that there are less than a few hundred excited modes, assuming they all saturate by wave breaking. For comparison, theoretical upper bounds suggest ≲10^{3} modes saturate by wave breaking. Thus, the measured constraints only rule out extreme values of the p-g parameters. They also imply that the instability dissipates ≲10^{51}  erg over the entire inspiral, i.e., less than a few percent of the energy radiated as gravitational waves.

[Fluorescence in situ hybridization combined with cytomorphology for the detection of lung cancer in bronchial brushing specimens]

Objective: To evaluate the diagnostic value of fluorescence in situ hybridization (FISH) combined with bronchial brushing cytology for detecting lung cancer. Methods: Centromeric enumeration probes (CEPs) for chromosomes 7, 8 and 17 were used in FISH assay. The combination of FISH and cytology was analyzed in 69 bronchial brushing specimens. Results: The positive rates of CEP7, CEP8 and CEP17 in malignant cases diagnosed by cytology were 50.0%, 80.8% and 65.4%, respectively. CEP8 probe showed significantly higher positive rate than CEP7 (P=0.015). In the samples of suspicious of malignancy, the positive rates of CEP7, CEP8 and CEP17 were 46.6%, 66.7% and 58.8%, respectively. While in atypical cases, the positive rates of these three probes were 20.0%, 33.3% and 25.0%, respectively. There was no statistical difference between suspicious of malignancy and atypical cases (P>0.05) as well as between malignant and suspicious of malignancy (P>0.05). No chromosome aberrations were found in normal cases diagnosed by cytology. The positive rates of these three probes in adenocarcinoma (ADC) were slightly higher than those in squamous cell carcinoma and small cell lung cancer. However, only CEP8 probe showed statistically difference between ADC and small cell lung cancer (P=0.044). The combination of cytology and FISH using any one of the three-probe set (CEP7, CEP8 and CEP17) showed the sensitivity and specificity of 80.3% and 100.0%, while those of cytology were 54.1% and 100.0%, respectively. Conclusions: FISH combined with cytomorphology assisted the cytology diagnosis of suspicious of malignancy and atypical cases. Therefore, it significantly improved the diagnostic sensitivity for lung cancer without sacrificing specificity.

Enzyme-triggered deshielding of nanoparticles and positive-charge mediated lysosomal escape for chemo/photo-combination therapy

Smart nanoparticles with active-targeting, enzyme-triggered deshielding and positive-charge characteristics were fabricated for efficient chemo/photo-combination therapy.

Robot-Assisted Radical Prostatectomy in a Post-Kidney Transplant Patient: An Initial Case Report in China

OBJECTIVE

Our aim was to evaluate the general applicability, feasibility, and safety of robot-assisted radical prostatectomy (RARP) in Chinese renal allograft patients for prostate cancer removal.

PATIENTS AND METHODS

A 62-year-old patient diagnosed as having biopsy-proven localized prostate cancer in March 2016 who had undergone renal transplant 12 years ago was studied. The preoperative prostate-specific antigen value was determined to be 11.82 ng/mL and the Gleason score was determined to be 3 + 3. The RARP was carried out using a transperitoneal and posterior approach with 5 ports in May 2016. The most important technique was ensuring that the transplanted kidney and ureter remained untouched during the surgery. Only the right obturator lymph nodes were dissected because the renal allograft was overlying the iliac vessels.

RESULTS

The RARP was successfully concluded following 230 minutes with an estimated blood loss of 200 mL. There were no postoperative complications. Final pathology was T2cN0M0, Gleason 3 + 3. Following catheter removal, the patient was completely continent and was discharged with no change in serum creatinine or glomerular filtration rate levels. During a 21-month follow-up, unobstructed urination, no incontinence, no biochemical recurrence, and normal kidney function were observed.

CONCLUSION

RARP in Chinese renal allograft patients is a feasible method that can be accomplished with no injuries to the transplanted kidney or ureter and is achieved with favorable oncological and functional outcomes. In addition, post-kidney transplant male patients are recommended to have routine prostate-specific antigen screening for the early detection of prostate cancer.

Measurement of the Electron Antineutrino Oscillation with 1958 Days of Operation at Daya Bay

We report a measurement of electron antineutrino oscillation from the Daya Bay Reactor Neutrino Experiment with nearly 4 million reactor ν[over ¯]_{e} inverse β decay candidates observed over 1958 days of data collection. The installation of a flash analog-to-digital converter readout system and a special calibration campaign using different source enclosures reduce uncertainties in the absolute energy calibration to less than 0.5% for visible energies larger than 2 MeV. The uncertainty in the cosmogenic ^{9}Li and ^{8}He background is reduced from 45% to 30% in the near detectors. A detailed investigation of the spent nuclear fuel history improves its uncertainty from 100% to 30%. Analysis of the relative ν[over ¯]_{e} rates and energy spectra among detectors yields sin^{2}2θ_{13}=0.0856±0.0029 and Δm_{32}^{2}=(2.471_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the normal hierarchy, and Δm_{32}^{2}=-(2.575_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the inverted hierarchy.

Search for Subsolar-Mass Ultracompact Binaries in Advanced LIGO's First Observing Run

We present the first Advanced LIGO and Advanced Virgo search for ultracompact binary systems with component masses between 0.2  M_{⊙}-1.0  M_{⊙} using data taken between September 12, 2015 and January 19, 2016. We find no viable gravitational wave candidates. Our null result constrains the coalescence rate of monochromatic (delta function) distributions of nonspinning (0.2  M_{⊙}, 0.2  M_{⊙}) ultracompact binaries to be less than 1.0×10^{6}  Gpc^{-3}  yr^{-1} and the coalescence rate of a similar distribution of (1.0  M_{⊙}, 1.0  M_{⊙}) ultracompact binaries to be less than 1.9×10^{4}  Gpc^{-3}  yr^{-1} (at 90% confidence). Neither black holes nor neutron stars are expected to form below ∼1  M_{⊙} through conventional stellar evolution, though it has been proposed that similarly low mass black holes could be formed primordially through density fluctuations in the early Universe and contribute to the dark matter density. The interpretation of our constraints in the primordial black hole dark matter paradigm is highly model dependent; however, under a particular primordial black hole binary formation scenario we constrain monochromatic primordial black hole populations of 0.2  M_{⊙} to be less than 33% of the total dark matter density and monochromatic populations of 1.0  M_{⊙} to be less than 5% of the dark matter density. The latter strengthens the presently placed bounds from microlensing surveys of massive compact halo objects (MACHOs) provided by the MACHO and EROS Collaborations.

[Exploration of thrombus histological composition and clinical effect in mechanical thrombectomy of acute ischemic stroke]

Objective: To explore histological composition of thrombus and clinical effect in mechanical thrombectomy of acute ischemic stroke. Methods: From March 2017 to August 2017 at the Institutes of Biology and Medical Sciences of Soochow University, hematoxylin and eosin (HE) staining was used to quantitatively analyze the composition of thrombus in 58 cases with acute ischemic stroke. The differences in components of thrombus with different TOAST classifications were compared, meanwhile, clinical data such as surgical process and prognosis were also analyzed. Results: (1) Baseline data: the age of arteriosclerosis was significantly lower than that of cardiogenic (P<0.05). There was statistically significant differences in onset to admission between the two types of stroke of other undetermined etiology (SUE) and Cardioembolism (CE) (P<0.05). (2) Histological composition of thrombus: there were no significant differences in fibrin and red blood cells (RBC) between the two types of SUE and CE thrombus (P>0.05). There were more RBC in LAA thrombus and more fibrin in CE thrombus (P<0.05). (3) Intraoperative data: the time of admission to recanalization of type LAA was longer than that of type CE (P<0.05). (4) Prognosis: there was no significant difference in the good prognosis between the two types of SUE and CE (P>0.05). It is the same between the types of LAA and CE (P>0.05). Conclusions: LAA thrombus contains more RBC, and cardiogenic thrombus contains more fibrin. Cryptogenic thrombus has the same composition with cardioembolism. The results may help to choose appropriate recanalization technique in different TOAST stroke and have guiding significance for the secondary prevention of SUE stroke.

GW170817: Measurements of Neutron Star Radii and Equation of State

On 17 August 2017, the LIGO and Virgo observatories made the first direct detection of gravitational waves from the coalescence of a neutron star binary system. The detection of this gravitational-wave signal, GW170817, offers a novel opportunity to directly probe the properties of matter at the extreme conditions found in the interior of these stars. The initial, minimal-assumption analysis of the LIGO and Virgo data placed constraints on the tidal effects of the coalescing bodies, which were then translated to constraints on neutron star radii. Here, we expand upon previous analyses by working under the hypothesis that both bodies were neutron stars that are described by the same equation of state and have spins within the range observed in Galactic binary neutron stars. Our analysis employs two methods: the use of equation-of-state-insensitive relations between various macroscopic properties of the neutron stars and the use of an efficient parametrization of the defining function p(ρ) of the equation of state itself. From the LIGO and Virgo data alone and the first method, we measure the two neutron star radii as R_{1}=10.8_{-1.7}^{+2.0}  km for the heavier star and R_{2}=10.7_{-1.5}^{+2.1}  km for the lighter star at the 90% credible level. If we additionally require that the equation of state supports neutron stars with masses larger than 1.97  M_{⊙} as required from electromagnetic observations and employ the equation-of-state parametrization, we further constrain R_{1}=11.9_{-1.4}^{+1.4}  km and R_{2}=11.9_{-1.4}^{+1.4}  km at the 90% credible level. Finally, we obtain constraints on p(ρ) at supranuclear densities, with pressure at twice nuclear saturation density measured at 3.5_{-1.7}^{+2.7}×10^{34}  dyn cm^{-2} at the 90% level.

Effect of Different Proteases on the Degree of Hydrolysis and Angiotensin I-Converting Enzyme-Inhibitory Activity in Goat and Cow Milk

Angiotensin I-converting enzyme (ACE) peptides are bioactive peptides that have important value in terms of research and application in the prevention and treatment of hypertension. While widespread literature is concentrated on casein or whey protein for production of ACE-inhibitory peptides, relatively little information is available on selecting the proper proteases to hydrolyze the protein. In this study, skimmed cow and goat milk were hydrolyzed by four commercial proteases, including alkaline protease, trypsin, bromelain, and papain. Angiotensin I-converting enzyme-inhibitory peptides and degree of hydrolysis (DH) of hydrolysates were measured. Moreover, we compared the difference in ACE-inhibitory activity between cow and goat milk. The results indicated that the DH increased with the increase in hydrolysis time. The alkaline protease-treated hydrolysates exhibited the highest DH value and ACE-inhibitory activity. Additionally, the ACE-inhibitory activity of hydrolysates from goat milk was higher than that of cow milk-derived hydrolysates. Therefore, goat milk is a good source to obtain bioactive peptides with ACE-inhibitory activity, as compared with cow milk. A proper enzyme to produce ACE-inhibitory peptides is important for the development of functional milk products and will provide the theoretical basis for industrial production.

[Analyses of pathogenic factors and clinicopathological characteristics of vocal leukoplakia]

Objective: To investigate the pathogenic factors of vocal leukoplakia and its clinical and pathological features. Methods: Eighty-one patients with vocal cord leukoplakia who underwent surgery between February 2010 and December 2016 and 160 volunteers without pharyngeal symptoms designed as controls were included in this case control study. The clinicopathological characteristics of 81 patients were summarized and analyzed synthetically. Results: There was statistical significance in reflux symptom index(RSI), reflux finding score(RFS), smoking index, and drinking index between case group and control group(Z=-5.35, -4.82, -4.76, -2.44, P<0.05). The voice-using duration per day in case group was significantly longer than that of control group.There was no statistical significance in hospital anxiety and depression scale for anxiety(HADA) scores、hospital anxiety and depression scale for depression(HADD) scores between case group and control group(P>0.05). In 42 patients who received 24-hour dual probe pH monitoring the prevalence of pathologic LPR was 42.8%. In 81 patients, 39(48%)patients were pathologically diagnosed as squamous cell hyperplasia, 18(22%)patients as mild dysplasia, 12(15%)sides as moderate dysplasia , 10(12%)patients as severe dysplasia and 2(2%)patients as carcinoma in-situ. The average age of high-risk pathological vocal leukoplakia was significantly higher than that of low-risk leukoplakia(t=-2.73, P<0.01). The propotion of speckled leukoplakia in high-risk leukoplakia was significantly higher than that of low-risk leukoplakia(χ(2)=23.81, P<0.01). There was no statistical significance between high-risk leukoplakia and low-risk leukoplakia in the prevalence of pathologic LPR(P>0.05). The bilateral lesions, speckled leukoplakia were more likely to relapse(χ(2)=4.27, 12.17, P<0.05). The more serious the pathology, the more likely it was to relapse (Z=-2.168, P=0.03). There was no statistical significance between recurrence group and non-recurrence group in the prevalence of pathologic LPR(P>0.05). Conclusions: LPR, smoke constitute the risk factors of vocal cord leukoplakia. Drinking, voice abuse are related to vocal cord leukoplakia. Senile, speckled leukoplakia are more likely to be malignancy. A speckled leukoplakia, bilateral leukoplakia, severe pathological degree are important factors to predict recurrence.

Determination of Endosulfan Concentrations in Biological Samples by GC-MS/MS

OBJECTIVES

To establish an analytical method of the endosulfan concentrations （α-endosulfan and β-endosulfan） in biological samples by GC-MS/MS. To observe the distribution of endosulfan in aquatic animals and provide experimental evidence for forensic identification of relevant cases.

METHODS

Acetonitrile was added to the blood and muscle samples for precipitating the protein. The endosulfan concentrations were determined by GC-MS/MS in multiple reaction monitoring mode. Qualitative analysis was performed according to the retention time and ion rate, and quantitative analysis was performed by external standard working curve method.

RESULTS

In blood samples, the calibration curves of α-endosulfan and β-endosulfan ranging from 0.062 5 to 10 μg/mL had good linear relationship, the correlation coefficients （r） of which were >0.99. The limits of detection （LOD） were 1 ng/mL and 2 ng/mL and the limits of quantification （LOQ） were 4 ng/mL and 8 ng/mL, respectively. In muscle samples, the calibration curves of α-endosulfan and β-endosulfan ranging from 0.062 5 to 10 μg/g, the r of which were >0.98. The LOD were 1 ng/g and 4 ng/g and the LOQ were 4 ng/g and 16 ng/g, respectively. The accuracy of α-endosulfan and β-endosulfan was 90.76%-108.91% both in blood and muscle samples, the interday and intraday precision were 2.35%-8.71% and 5.44%-10.29%, respectively. In poisoning cases, endosulfan were detected in all parts of fish and crab and the content difference was statistically significant.

CONCLUSIONS

The endosulfan detection method based on GC-MS/MS established in the present study is rapid, sensitive and accurate, which can be applied to the endosulfan detection in traces biological samples. The distribution of endosulfan in fish and crab was different, which can provide evidence to the sample collection and analysis for toxicological analysis in relevant forensic identification.

[Study on Urinary Metabolic Profile in Rats with Deep Venous Thrombosis Based on Pattern Recognition]

OBJECTIVES

To study the urinary metabolic profile in rats with deep venous thrombosis （DVT） based on metabolomics and to screen out small molecular biomarkers for the diagnosis and forensic identification of DVT.

METHODS

Inferior vena cava of rats was ligated to construct DVT models. The rats were randomly divided into three groups： DVT, sham, and control groups, 10 in each group. The urine of DVT and sham rats was collected during 24 hours in the metabolic cage at 48 hours after operating, meanwhile, 24 hours urine was collected in control group. The metabolic profile was analyzed by nuclear magnetic resonance. SIMCA-P 14.1 software was used for pattern recognition. The variable importance in projection （VIP） value from orthogonal PLS-DA （OPLS-DA） model combined with Mann-Whitney U test were used to search the different metabolites in the urine.

RESULTS

The metabolic profiles of urine from DVT, sham, and control groups had significant differences. The DVT, sham, and control groups could be distinguished by the partial least squares method-discriminant analysis （PLS-DA） model. Compared with the urine of the rats in control groups, the levels of leucine, glutamine, creatine, creatinine and sucrose in the urine of DVT rats were up-regulated, and the levels of 3-hydroxybutyrate, lactate, acetone, α-oxoglutarate, citrate and hippurate were down-regulated.

CONCLUSIONS

The different metabolites in the urine of DVT rats are expected to become its candidate biomarkers. The results can provide a research basis for the diagnosis, treatment and forensic identification of DVT.

[Study on the effects of total flavonoids from litchi nucleus on nuclear translocation of nuclear factor-kappa B and related protein expression in rat hepatic stellate cell]

Objective: The effect of total flavonoids of litchi (TFL) on nuclear translocation of nuclear factor-kappa B (NF- kappa B) in rat hepatic stellate cell line (HSC-T6) induced by transforming growth factor - beta 1 (TGF- beta 1) in vitro was studied to explore the mechanism of action of anti-hepatic fibrosis drugs. Methods: HSC-T6 was cultured in vitro, induced by TGFβ1 for 24 h, and then treated with TFL at 125, 250 and 500 μg/ml for 48 h. The effect of TFL on NF-κB nuclear translocation in HSC-T6 was observed by confocal laser microscopy. The effects of TFL on the expression of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and Collagen I protein were detected by western blot. The expressions of TLR4 and p-NF-κB p65 were detected by immunofluorescence. Data were presented as mean±SEM. Homogeneity test of variance was performed and then followed by one-way analysis of variance (ANOVA). The multiple comparisons between groups were performed by LSD test. P < 0.05 was considered statistically significant. Results: Confocal laser scanning microscopy showed TFL inhibited the nuclear translocation of NF-κB in activated HSC-T6 in a concentration-dependent manner and TFL down regulated the protein expression levels of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and collagen I protein in HSC-T6 in a concentration-dependent manner. Conclusion: The mechanism of TFL against hepatic fibrosis may be related to the inhibition of nuclear translocation of NF-κb in the activated HSC-T6 and the expression of TLR4, P-iκbɑ, P-nf-κb p65, NF-κb and collagen I protein in HSC-T6.

[Current status of malaria rapid diagnostic testing strips application in primary-level healthcare providers in Jiangsu Province]

Objective: To investigate the current status of malaria rapid diagnostic test (RDT) strips application and malaria laboratory technicians' evaluation about them at primary healthcare provider level in Jiangsu Province. Methods: From November to December 2016, 878 medical institutions and 118 CDCs of city, county and township/community level in Jiangsu Province were selected as study samples using stratified random sampling method. Self-designed questionnaire was distributed to investigate the institution's malaria work task, RDT strips application and evaluation status in 2015. We also investigated the socio-demographic information and collected the RDT strips evaluation score from the malaria laboratory technicians selected from the institutions investigated (one technician from each institution). Rank sum test was performed to compare the RDT strips evaluation scores between medical institutions and CDCs, and among different medical institutions and CDCs. Results: In 2015, 405 cases of malaria were reported, 362 200 person-time of malaria blood testing task was conducted, and 100 000 RDT strips were procured and provided for healthcare providers in Jiangsu province for free. Of the 996 healthcare institutions investigated, 628 used RDT strips in the year 2015 and the median (P(25), P(75)) of RDT strips volume used in these institutions was 10 (2, 25). The volume of RDT strips used in CDCs (15 (5, 52)) was significantly higher than that in medical institutions (10 (2, 25), (Z=3.42, P=0.001)). The investigated CDCs gave higher score on RDT strips' testing time per operation (10 (8.5, 10)) than medical institutions (9(8, 10), (Z=-2.20, P=0.028)). The employers of 614 investigated malaria laboratory technicians used RDT strips in 2015. The median of the scores given by CDC malaria laboratory technicians for RDT strips in terms of testing time per operation, testing operation and results judgement difficulties were 10 (9, 10), 10 (9, 10) and 10 (9, 10), respectively, which were significantly higher than those from technicians of medical institutions (9 (8, 10), 9 (8, 10), 9 (8, 10), (Z values were -2.55, -2.97 and -2.96, respectively; P values were all less than 0.05)). Conclusion: RDT strips had been widely performed in health institutions in Jiangsu Province. The amount of RDT strips used in CDCs was significantly higher than that in medical institutions. Primary-level institutions and malaria laboratory technicians generally recognized RDT strips' advantage for application in terms of testing time and operational procedure. CDCs and malaria laboratory technicians from them gave higher regards on RDT strips in terms of testing time per operation, testing operation and results judgement difficulties compared with that of medical institutions.

[Efficacy of extended-infusion of carbapenem plus sulbactam for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii]

Objective: To evaluate the efficacy of extended-infusion of carbapenem plus sulbactam for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii (XDRAB). Methods: Clinical data of patients with ventilator-associated pneumonia caused by XDRAB who were treated with extended-infusion carbapenem plus sulbactam or tigecycline-based therapy in Peking University First Hospital from January 2015 to December 2016 were collected and reviewed in this retrospective study. Twenty-one patients were treated with extended-infusion carbapenem plus sulbactam, and 20 other patients received tigecycline combined with other antibiotics. The general status of the patient, microbiological eradication rate, superinfection rate, new microorganism colonization rate, clinical resolution rate on the third day, clinical cure rate and mortality during treatment were compared between the two groups. Results: The two groups shared similar characteristics except that patients in the carbapenem group were younger. Microbiological eradication was not observed. Superinfections occurred in 1 patients (4.8%) in the carbapenem group and 0 patients in the tigecycline group (P=1.000), the occurrences of new microorganisms colonization were 14.3% and 25.0% respectively (P=0.638). Clinical cure were achieved in 57.1% of the patients in the carbapenem group and 50.0% of the patients in the tigecycline group (P=0.647), the clinical resolution rates on the third day were 52.4% and 45.0% respectively (P=0.636). The mortality during treatment was 9.5% in carbapenem group, and 20.0% in tigecycline group (P=0.612). No serious adverse drug reactions occurred. Conclusions: Ventilator-associated pneumonia caused by XDRAB treated with either extended-infusion carbapenem plus sulbactam or tigecycline-based therapy has a similar clinical outcome.

Néel Spin-Orbit Torque Driven Antiferromagnetic Resonance in Mn_{2}Au Probed by Time-Domain THz Spectroscopy

We observe the excitation of collective modes in the terahertz (THz) range driven by the recently discovered Néel spin-orbit torques (NSOTs) in the metallic antiferromagnet Mn_{2}Au. Temperature-dependent THz spectroscopy reveals a strong absorption mode centered near 1 THz, which upon heating from 4 to 450 K softens and loses intensity. A comparison with the estimated eigenmode frequencies implies that the observed mode is an in-plane antiferromagnetic resonance (AFMR). The AFMR absorption strength exceeds those found in antiferromagnetic insulators, driven by the magnetic field of the THz radiation, by 3 orders of magnitude. Based on this and the agreement with our theory modeling, we infer that the driving mechanism for the observed mode is the current-induced NSOT. Here the electric field component of the THz pulse drives an ac current in the metal, which subsequently drives the AFMR. This electric manipulation of the Néel order parameter at high frequencies makes Mn_{2}Au a prime candidate for antiferromagnetic ultrafast memory applications.

Effect of Xanthan⁻Chitosan Microencapsulation on the Survival of Lactobacillus acidophilus in Simulated Gastrointestinal Fluid and Dairy Beverage

Lactobacillus acidophilus was encapsulated in xanthan⁻chitosan (XC) and xanthan⁻chitosan⁻xanthan (XCX) polyelectrolyte complex (PEC) gels by extrusion method. The obtained capsules were characterized by X-ray diffraction and FTIR spectroscopy. The effects of microencapsulation on the changes in survival and release behavior of the Lactobacillus acidophilus during exposure to simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) were studied. Encapsulated Lactobacillus acidophilus exhibited a significantly higher resistance to SGF and SIF than non-encapsulated samples. In addition, the viability of free and immobilized cells of Lactobacillus acidophilus incorporated into dairy beverages was assessed for 21 days both at room temperature and in refrigerated storage. The results indicated that xanthan⁻chitosan⁻xanthan (XCX) and xanthan⁻chitosan (XC) significantly (p < 0.05) improved the cell survival of Lactobacillus acidophilus in yogurt during 21 days of storage at 4 and 25 °C, when compared to free cells.

Search for Tensor, Vector, and Scalar Polarizations in the Stochastic Gravitational-Wave Background

The detection of gravitational waves with Advanced LIGO and Advanced Virgo has enabled novel tests of general relativity, including direct study of the polarization of gravitational waves. While general relativity allows for only two tensor gravitational-wave polarizations, general metric theories can additionally predict two vector and two scalar polarizations. The polarization of gravitational waves is encoded in the spectral shape of the stochastic gravitational-wave background, formed by the superposition of cosmological and individually unresolved astrophysical sources. Using data recorded by Advanced LIGO during its first observing run, we search for a stochastic background of generically polarized gravitational waves. We find no evidence for a background of any polarization, and place the first direct bounds on the contributions of vector and scalar polarizations to the stochastic background. Under log-uniform priors for the energy in each polarization, we limit the energy densities of tensor, vector, and scalar modes at 95% credibility to Ω_{0}^{T}<5.58×10^{-8}, Ω_{0}^{V}<6.35×10^{-8}, and Ω_{0}^{S}<1.08×10^{-7} at a reference frequency f_{0}=25  Hz.

[Cases diagnosis of imported malaria in Jiangsu province, 2014-2016]

Objective: To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province. Methods: Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016. Relevant information on health seeking behavior, diagnosis and treatment of the disease was gathered. Results: A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016. Except for one malaria case that was caused by blood transfusion, the rest patients were all recognized as 'imported'. Majority of the cases were migrant laborers working in African countries. The accurate rates on the diagnosis of ovale, vivax and quartan malaria and mixed infection were relatively low, as 79.3% (107/135), 29.5% (18/61), 52.9% (18/34) and 0.0% (0/2) at the primary health care settings, respectively. Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (χ(2)=18.6, P=0.001). While only 65.4% (699/1 068) of the patients were diagnosed correctly at the primary health care settings. There appeared no statistical difference in the 3-year-study period (χ(2)=5.4, P=0.246). Capacity on 'correct diagnosis' seemed stronger at the CDC than at the hospital levels (χ(2)=13.2, P=0.000; χ(2)=5.4, P=0.020). Totally, 72.7% (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started. Conclusions: Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services. Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.

Systematic review and meta-analysis of the genetic association between protamine polymorphism and male infertility

While several previous studies have proposed an association between male infertility and protamine polymorphism, the reported findings have shown some inconsistency. To evaluate the potential association between the two most common single nucleotide polymorphisms (rs2301365 and rs1646022) in protamine and male infertility, we performed a meta-analysis involving 2713 cases and 2086 controls from 15 published case-controlled studies. Overall, our analysis showed significant associations between the specific protamine single-nucleotide polymorphism (rs2301365) and male infertility, and this association was indicated by all of the models we tested. Subgroup analysis revealed significant associations with a Caucasian background, PCR sequence, population-based, case size of > 150 and case size of < 150 subgroups. Similarly, significant associations were found between rs1646022 and male infertility in the hospital population and case size of < 200 subgroups. However, trial sequential analysis showed that the number of patients in the study did not reach optimal information size. Further studies with larger sample sizes are now warranted to clarify the potential roles of the two protamine polymorphisms in the pathogenesis of male infertility. This may help us to understand the precise molecular mechanisms underlying the effect of protamines upon male infertility.

GW170817: Implications for the Stochastic Gravitational-Wave Background from Compact Binary Coalescences

The LIGO Scientific and Virgo Collaborations have announced the event GW170817, the first detection of gravitational waves from the coalescence of two neutron stars. The merger rate of binary neutron stars estimated from this event suggests that distant, unresolvable binary neutron stars create a significant astrophysical stochastic gravitational-wave background. The binary neutron star component will add to the contribution from binary black holes, increasing the amplitude of the total astrophysical background relative to previous expectations. In the Advanced LIGO-Virgo frequency band most sensitive to stochastic backgrounds (near 25 Hz), we predict a total astrophysical background with amplitude Ω_{GW}(f=25  Hz)=1.8_{-1.3}^{+2.7}×10^{-9} with 90% confidence, compared with Ω_{GW}(f=25  Hz)=1.1_{-0.7}^{+1.2}×10^{-9} from binary black holes alone. Assuming the most probable rate for compact binary mergers, we find that the total background may be detectable with a signal-to-noise-ratio of 3 after 40 months of total observation time, based on the expected timeline for Advanced LIGO and Virgo to reach their design sensitivity.

[Effects of chronic intermittent hypoxia on hepatic function and protective mechanism of adiponectin in rats]

Objective: To explore the effect of chronic intermittent hypoxia (CIH) on rats hepatic function, and the protective mechanism of adiponectin (Ad). Methods: Sixty healthy male wistar rats were randomly divided into 4 groups: normal control (NC), NC+ Ad, CIH, and CIH+ Ad groups with 15 rats in each. The rats in CIH and CIH+ Ad groups were exposed to an intermittent hypoxic chamber 8 hours per day for 4 months. Meanwhile, the rats in both the NC and NC + Ad groups were housed with normal pressure air. The rats in the NC+ Ad and CIH+ Ad groups were additionally treated with an intravenous injection of Ad (10 μg), twice a week for 4 months. At the end of experiment, comparison among groups was made about plasma levels of aspartate amino transferase (AST), alanine amino transferase (ALT), degrees of endoplasmic reticulum stress (ERS) and mitochondrium associated cellular apoptosis. Results: No significant difference was detected in all items between NC and NC+ Ad groups (all P>0.05). Plasma hepatic enzyme levels of AST and ALT were significantly higher in CIH group [(319±21) and (113±9) U/L] than those in NC group [(178±19) and (51±9) U/L] and NC+ Ad group [(175±16) and (52±8) U/L] (all P<0.05). Compared NC with NC+ Ad group, there was more remarkable ERS and mitochondrial injury associated cellular apoptosis in hepatic tissues of CIH group. Such pathological changes were less obvious in CIH+ Ad group than in CIH group (all P<0.05). Conclusion: CIH can induce hepatic injury in rats, while Ad supplement may play a protective role possibly through inhibition of ERS and associated pathways of cellular apoptosis.

[Evaluation of using cone beam computed tomography as a regular test before and after periodontal regenerative surgery]

OBJECTIVE

To test the accuracy and credibility of cone-beam computed tomography (CBCT) on measuring the height and volume of alveolar bone defects before periodontal regeneration surgery. By comparing the bone density measured by CBCT before and after the operation, the time to evaluate the efficacy of the periodontal regenerative surgery would be determined.

METHODS

Periodontal regenerative surgeries were performed on three-wall bone defects of ten teeth in nine patients. The height of bone defects was measured using both periapical film of distant parallel technique and CBCT before periodontal regenerative surgery. Before the surgery, CBCT data were used to measure the volume of the bone defects and the bone density around the defective areas. The height of the bone defects was measured during periodontal regeneration surgery, and the volume of the defective areas was obtained with bone wax in operation. CBCT was taken 6, 12 and 24 weeks after surgery to measure the bone density in the regenerated region.

RESULTS

The Wilcoxon test showed that the height of the bone defects measured preoperatively using periapical film was (0.822±0.222) mm deeper than the intraoperative measurement results, and the difference was statistically significant (P<0.05). Whereas CBCT measurement results was (0.150±0.171) mm less than the intraoperative measurement results, without statistical significant (P>0.05). The regression analysis and the Bland-Altman method also showed that the results of CBCT measurement were more accurate. The Wilcoxon test showed that the bone defect volume measured by CBCT preoperatively was accurate, and the difference between the preoperative and the intraoperative measurements was not statistically significant, ranging from 0.38 to 2.83 mm3 (P>0.05). The bone density of the regenerated areas measured by CBCT was (0.49±0.03) times in the sixth week, (0.74±0.09) times in the twelfth week and (1.16±0.11) times in the twentieth week as that of the areas around the bone defects after the surgery.

CONCLUSION

The present data suggest that using CBCT before periodontal regenerative surgery could result in accurate measurement of height and volume of alveolar bone defects. For the purpose of evaluating the effectiveness of regenerative surgery, CBCT could be taken 24 weeks after surgery.

Abstract GS2-02: Direct regulation of estrogen receptor-α (ER) transcriptional activity by NF1

Inactivating germline mutations in the NF1 gene (encoding neurofibromin) cause neurofibromatosis type 1. In addition to peripheral nervous system tumors, NF1 patients are at higher risk for other cancers, including breast cancer. Tumor exome-sequencing studies demonstrate that approximately 20% of all human cancers have somatic NF1 mutations. NF1 has been best known for its ability to inactivate Ras as a GAP (GTPase Activating Protein). However, this function is served by a small GAP domain in a very large protein. Recurrent missense mutations inactivating the GAP activity are infrequent. In contrast, it is common to detect frameshift (FS) and nonsense (NS) NF1 mutations, which can create an NF1-null state deleting not only GAP, but also, potentially, undefined NF1 functions whose loss could also drive tumorigenesis.

As we reported at SABCS previously, in 600+ patients treated by tamoxifen adjuvant monotherapy, we found that FS/NS NF1 mutations independently correlate with relapse risk (HR=2.6, p=0.03). To explore this finding, we silenced NF1 in preclinical models of ER+ breast cancer, which markedly enhanced ER transcriptional activities, causing estradiol (E2) hypersensitivity and converted tamoxifen into an agonist (in vitro and in vivo). Most important, these activities depend on ER, but not on NF1's GAP activity. These findings readily explain the poor patient outcomes associated with NS/FS NF1 mutations, and reveal a previously unrecognized function for NF1 in ER regulation.

In the presence of an agonist, liganded ER repels co-repressors and recruits co-activators, while the reverse is true with an antagonist such as tamoxifen. Many co-regulators contain leucine/isoleucine rich motifs, which bind directly to the ligand-binding domain (LBD) in ER. NF1 has several of these motifs that are much more highly conserved in species with a functional ER pathway, and some of these are mutated in cancers (e.g., in our patient cohort). Furthermore, we found that NF1 canbind directly to ER, and that this binding is mediated between the ER LBD and the NF1 leucine-rich regions. Like a classic co-repressor, wildtype NF1 (but not mutants lacking GAP activity or the Leu-rich motif) binds to ER, and is recruited by ER to the ERE in the presence of tamoxifen, but not E2.

Further preclinical treatment studies indicate that while NF1-deficient ER+ breast cancer should not be treated by tamoxifen or AIs, fulvestrant remains effective. Furthermore, when fulvestrant is combined with dabrafinib and trametinib to inhibit Ras effectors Raf and MEK, apoptosis is induced in vitro, and tumor regression is observed in vivo. In conclusion, we have demonstrated that NF1 is a dual negative regulator at the intersection of two potent oncogenic signaling pathways, Ras and ER, and that NF1-deficient ER+ breast cancer patients may be more effectively treated by co-targeting the Ras and ER signaling. These patients, up to 10% of those with advanced ER+ breast cancer, can be readily identified for treatment by ctDNA analysis. A clinical trial is under development.

Citation Format: Chang EC, Zheng Z, Philip L, Burcu C, Lei J, Singh P, Anurag M, Chan D, Li JD, Du XP, Shafaee MN, Banks K, Sacker S, Song W, Nguyen T, Cao J, Chen X, Haricharan S, Kavuri M, Kim B-J, Zhang B, Gutmann DH, Lanman RB, Foulds C, Ellis M. Direct regulation of estrogen receptor-α (ER) transcriptional activity by NF1 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr GS2-02.

Abstract OT2-05-01: A phase II randomized trial of gemcitabine plus cisplatin(GP) vs. gemcitabine plus carboplatin (GC) as the first-line treatment for patients with metastatic triple negative breast cancer

Background:

Triple-negative breast cancer (TNBC) is an aggressive disease with limited treatment options and poor prognosis. Gemcitabine plus carboplatin (GC) is one of the preferred chemotherapeutic regimens for patients with metastatic triple-negative breast cancer(mTNBC), with a median progression-free survival(PFS) of 4.6 months in the first-line patients (O'Shaughnessy J, et al. J Clin Oncol 2014). Gemcitabine plus cisplatin (GP) has also demonstrated promising efficacy and safety in the first-line phase III trial of mTNBC, with a median PFS of 7.7 months (Hu XC, Lancet Oncol 2015). A recent analysis, based on data derived from a cohort of 379 mTNBC patients, indicated that patients receiving cisplatin-based regimen as the first-line chemotherapy showed better PFS compared with other platinum agents (8.0 vs 4.3 months, P = 0.03) (Zhang J, et al. Oncotarget 2015). To further investigate the superiority between carboplatin and cisplatin when combined with gemcitabine, this phase II study was conducted to directly compare the efficacy and safety of GP with GC in the first-line treatment for patients with metastatic triple negative breast cancer.

Trial Design:

This prospective phase II, single center, open-label, randomized study has been designed to compare the efficacy and safety of GP with GC as the first-line treatment for mTNBC. Patients are randomized 1:1 to receive gemcitabine (1250 mg/m2, D1,8) plus cisplatin (75 mg/m2, D1) or gemcitabine (1000mg/m2, D1,8) plus carboplatin (area under the curve 2 mg × min/mL, D1,8) every 21 days until disease progression or intolerable toxicity.

Eligibility Criteria:

Patients with histologically confirmed triple negative metastatic breast cancer, with no prior chemotherapy in metastatic setting will be included in this trial. Eligible patients must be between 18 and 70 years of age with a performance status of 0–1, adequate organ function and at least one RECIST 1.1-measurable lesion.

Specific Aims:

The primary endpoint is PFS. Secondary endpoints include objective response rate, safety and overall survival.

Statistical Methods:

The sample size of the present study was determined based on the results of two phase III clinical trials: the median PFS for patients receiving GC and GP as the first-line treatment for mTNBC was 4.6 and 7.7 months, respectively. This design was hypothesized that GP would be superior to GC in terms of efficacy. Thus, in order to detect an improvement of median PFS from 4.6 months to 7.7 months, with 80% power and a 1-sided type I error of 0.05, 136 patients would be required. Considering a drop-out rate of 10%, a total of 150 patients planned to be enrolled.

Present Accrual and Target Accrual:

Target accrual: 150. Present accrual (2017/5/24): 83

Contact information: Contact: Xichun Hu, MD, PHD xchu2009@hotmail.com

Biyun Wang, MD pro_wangbiyun@163.com

ClinicalTrials.gov Identifier: NCT02341911.

Citation Format: Gong C, Cao E, Wang Z, Zhang J, Wang L, Cao J, Zhang S, Tao Z, Li T, Zhao Y, Li Y, Wang B, Hu X. A phase II randomized trial of gemcitabine plus cisplatin(GP) vs. gemcitabine plus carboplatin (GC) as the first-line treatment for patients with metastatic triple negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-05-01.

Abstract PD8-03: ESR1 gene fusions drive endocrine therapy resistance and metastasis in breast cancer

Background. Dysregulation of the estrogen receptor gene (ESR1) is an established mechanism of inducing endocrine therapy resistance. We previously discovered a chromosomal translocation event generating an estrogen receptor gene fused in-frame to C-terminal sequences of YAP1 (ESR1-YAP1) that contributed to endocrine therapy resistance in estrogen receptor positive (ER+) breast cancer models. This study compares functional, transcriptional, and pharmacological properties of additional ESR1 gene fusion events of both early stage (ESR1-NOP2) late stage (ESR1-YAP1 and ESR1-PCDH11x) breast cancers to gain a better understanding of therapeutic resistance and metastasis. Understanding the role of ESR1 fusions in inducing metastasis is critical, since the primary cause of death in breast cancer patients is through metastasis to distant sites.

Methods. RNA-seq screens identified ESR1 fusions from early and late stage, endocrine therapy resistant breast tumor samples. Functional experiments were conducted using ER+ breast cancer cell lines, xenograft, and PDX models to test the ability of ESR1 fusions to induce therapeutic resistance and metastasis. ChIP-seq and RNA-seq were performed to examine transcriptional properties and differential gene expression induced by the fusions which directed subsequent pharmacological experiments with a CDK4/6 inhibitor.

Results. ESR1-YAP1 and ESR1-PCDH11x promoted estrogen-independent and fulvestrant-resistant growth in vitro and induced greater tumor growth and increased metastatic capacity to the lungs of xenografted mice. In contrast, the ESR1-NOP2 fusion was sensitive to low estrogen conditions in vitro, and did not promote tumor growth. RNA-seq profiling revealed E2F targets pathway as the most highly enriched pathway induced by the ESR1 fusions. IHC revealed higher levels of pRb in ESR1-YAP1 and ESR1-PCDH11x xenograft tumors and subsequent CDK4/6 inhibition completely blocked tumor growth in an ESR1-YAP1 PDX model. Integrating RNA-seq with ChIP-seq data, we discovered a set of EMT and metastasis genes bound by all ESR1 fusions and WT-ER, but whose expression was strongly and uniquely up-regulated only by the ESR1-YAP1 and ESR1-PCDH11x fusions. These studies also revealed gained sites bound only by the ESR1-YAP1 and ESR1-PCDH11x fusions, not bound by WT-ER nor ESR1-NOP2. Genes mapping to these sites have a role in metastatic biology and were highly up-regulated by the YAP1 and PCDH11x fusions, potentially mediated by long range transcriptional activation.

Conclusion. ESR1-YAP1 and ESR1-PCDH11x are driver fusions that occur in drug-resistant, advanced stage breast cancer and are a new class of recurrent somatic mutation that can cause acquired endocrine therapy resistance, yet can be treated with CDK4/6 inhibition. These driver fusions also confer increased metastatic ability through their ability to drive expression of genes that contribute to EMT and metastasis. In contrast, ESR1-NOP2 did not produce functional protein and appears to be a passenger event. These studies may provide pre-clinical rationale for targeting ESR1 translocated breast tumors, since the presence of an ESR1 driver fusion places a patient in a therapeutic category where none of the currently available endocrine therapies are likely to be effective.

Citation Format: Lei JT, Shao J, Zhang J, Iglesia M, Chan DW, Cao J, Anurag M, Singh P, Haricharan S, Kavuri SM, Matsunuma R, Schmidt C, Kosaka Y, Crowder R, Hoog J, Phommaly C, Goncalves R, Ramalho S, Rodrigues-Peres RM, Lai W-C, Hampton O, Rogers A, Tobias E, Parikh P, Davies S, Ma C, Suman V, Hunt K, Watson M, Hoadley KA, Thompson A, Perou CM, Creighton CJ, Maher C, Ellis MJ. ESR1 gene fusions drive endocrine therapy resistance and metastasis in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD8-03.

CYP-450 Epoxygenase Derived Epoxyeicosatrienoic Acid Contribute To Reversal of Heart Failure in Obesity-Induced Diabetic Cardiomyopathy via PGC-1 α Activation

We have previously shown that an Epoxyeicosatrienoic Acid (EET) -agonist has pleiotropic effects and reverses cardiomyopathy by decreasing inflammatory molecules and increasing antioxidant signaling. We hypothesized that administration of an EET agonist would increase Peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α), which controls mitochondrial function and induction of HO-1 and negatively regulates the expression of the proinflammatory adipokines CCN3/NOV in cardiac and pericardial tissues. This pathway would be expected to further improve left ventricular (LV) systolic function as well as increase insulin receptor phosphorylation. Measurement of the effect of an EET agonist on oxygen consumption, fractional shortening, blood glucose levels, thermogenic and mitochondrial signaling proteins was performed. Control obese mice developed signs of metabolic syndrome including insulin resistance, hypertension, inflammation, LV dysfunction, and increased NOV expression in pericardial adipose tissue. EET agonist intervention decreased pericardial adipose tissue expression of NOV, while normalized FS, increased PGC-1α, HO-1 levels, insulin receptor phosphorylation and improved mitochondrial function, theses beneficial effect were reversed by deletion of PGC-1α. These studies demonstrate that an EET agonist increases insulin receptor phosphorylation, mitochondrial and thermogenic gene expression, decreased cardiac and pericardial tissue NOV levels, and ameliorates cardiomyopathy in an obese mouse model of the metabolic syndrome.

Beyond a phenomenological description of magnetostriction

Magnetostriction, the strain induced by a change in magnetization, is a universal effect in magnetic materials. Owing to the difficulty in unraveling its microscopic origin, it has been largely treated phenomenologically. Here, we show how the source of magnetostriction-the underlying magnetoelastic stress-can be separated in the time domain, opening the door for an atomistic understanding. X-ray and electron diffraction are used to separate the sub-picosecond spin and lattice responses of FePt nanoparticles. Following excitation with a 50-fs laser pulse, time-resolved X-ray diffraction demonstrates that magnetic order is lost within the nanoparticles with a time constant of 146 fs. Ultrafast electron diffraction reveals that this demagnetization is followed by an anisotropic, three-dimensional lattice motion. Analysis of the size, speed, and symmetry of the lattice motion, together with ab initio calculations accounting for the stresses due to electrons and phonons, allow us to reveal the magnetoelastic stress generated by demagnetization.

First Search for Nontensorial Gravitational Waves from Known Pulsars

We present results from the first directed search for nontensorial gravitational waves. While general relativity allows for tensorial (plus and cross) modes only, a generic metric theory may, in principle, predict waves with up to six different polarizations. This analysis is sensitive to continuous signals of scalar, vector, or tensor polarizations, and does not rely on any specific theory of gravity. After searching data from the first observation run of the advanced LIGO detectors for signals at twice the rotational frequency of 200 known pulsars, we find no evidence of gravitational waves of any polarization. We report the first upper limits for scalar and vector strains, finding values comparable in magnitude to previously published limits for tensor strain. Our results may be translated into constraints on specific alternative theories of gravity.