[Immunization effect and persistence of hepatitis B vaccine in HIV-infected patients with different CD4+T cell levels]

Objective: To explore the immunogenicity and persistence of hepatitis B vaccine in HIV-infected patients with different CD4⁺T cell (CD4) levels, and analyze the influence effect of CD4 levels on immunization response. Methods: A total of 182 HIV-infected patients who participated in a randomized controlled trial of 20 µg and 60 µg hepatitis B vaccination at month 0, 1, and 6 in 2014 by Guangxi Zhuang Atonomous Region CDC and Ningming county CDC were surveyed. Six months later after the first dose and 1 month, 6 months, 1 year, and 3 years later after the full course of the vaccination, 5 ml of the venous blood of the patients was collected, and the anti-HBs was detected by Chemiluminescent Microparticle Immunoassay (CMIA). On the basis of previous studies, this study focused on analyzing the immunogenicity and persistence of hepatitis B vaccine under different CD4 levels. Results: One month later after the whole course of hepatitis B vaccination, the anti-HBs geometric mean concentration (GMC), anti-HBs positive rate (≥10 mIU/ml) and strong positive rate (≥100 mIU/ml) in HIV patients with CD4 <350 cells/µl were 442.50 mIU/ml, 71.05% (27/38) and 44.74% (17/38), respectively, which were significantly lower than those HIV-infected patients with CD4 ≥350 cells/µl [583.90 mIU/ml, 92.13% (117/127) and 77.95% (99/127)] (P<0.05). After controlling the confounding factors, the probability of being anti-HBs positive induced by hepatitis B vaccine in patients with CD4 <350 cells/µl was 0.14 times higher than in those with CD4≥350 cells/µl (95%CI: 0.03-0.62), and patients with CD4 <350 cells/µl had higher risk of no response. From 6 months to 3 years after the whole course of the vaccination, the anti-HBs GMC (195.00-27.55 mIU/ml vs. 300.10-45.81 mIU/ml), the positive rate (56.67%-36.67% vs. 78.57%- 51.58%) and the strong positive rate (33.33%-6.67% vs.44.64%-15.79%) in patients with CD4 <350 cells/µl gradually declined, lower than the levels in those with CD4 ≥350 cells/µl. Conclusions: HIV-infected patients with CD4 <350 cells/µl have high risk of no response to hepatitis B vaccination and poor immune persistence. It is necessary to strengthen the anti-HBs monitoring in HIV-infected patients, with special attention to those with CD4 <350 cells/µl. When anti-HBs is negative, hepatitis B vaccine should be injected as early as possible.

[Immunity persistence of 60 μg high dose hepatitis B vaccine and influencing factors in maintained hemodialysis patients]

Objective: To compare the anti-HBs level in maintained hemodialysis patients one year after receiving 20 μg and 60 μg hepatitis B vaccination at 0, 1 and 6 months, and explore the influence factors for the immunity persistence and their interactions. Methods: Based on a randomized controlled trial of 20 μg and 60 μg hepatitis B vaccine immunization in maintained hemodialysis patients at 0, 1, and 6 months, follow up was conducted for the patients for one year after the completion of the vaccination for the quantitative detection of anti-HBs, and χ² test, t test, unconditional logistic regression and interaction analyses were used for statistical analysis. Results: One year after the vaccination, 125 and 124 patients in the 20 μg and 60 μg groups were tested for anti-HBs, respectively. The positive rate of anti-HBs in the 60 μg group (77.42%, 96/124) was significantly higher than that in the 20 μg group (65.60%, 82/125) (P<0.05). After adjusting for the confounding factors, the positive probability of anti-HBs in the 60 μg group was 1.925 times higher than that in the 20 μg group (95%CI: 1.068-3.468). Patients with hemodialysis duration ≥5 years (OR=0.523, 95%CI: 0.293-0.935) and diabetes mellitus (OR=0.376, 95%CI: 0.173-0.818) had lower positive probability of anti-HBs. Moreover, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus. Conclusions: The immunity persistence after one year in 60 μg hepatitis B vaccination group was longer than that in 20 μg hepatitis B vaccination group in maintained hemodialysis patients, vaccine dose, hemodialysis duration and diabetes mellitus were the influencing factors for the immunity persistence, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus.

Three Novel Structural Variations at MHC and IL12B Predisposing to Psoriasis

BACKGROUND

Structural variations (SVs, defined as DNA variants ≥50 bp) have been associated with various complex human diseases. However, research to screen the whole genome for SVs predisposing to psoriasis is still lacking.

OBJECTIVES

This study aimed to investigate the association of SVs and psoriasis.

METHODS

We performed a genome-wide screen on SVs using an imputation method on 5 independent cohorts with 45,386 subjects from the Chinese Han population. Fine mapping analysis, genetic interaction analysis and RNA expression analysis were conducted to explore the mechanism of SVs.

RESULTS

We obtained 4,535 SVs in total and identified 2 novel deletions (esv3608550, OR=2.73, P<2.00×10^-308 ; esv3608542, OR=0.47, P=7.40×10^-28 ) at 6q21.33 (MHC), 1 novel Alu element insertion (esv3607339, OR=1.22, P=1.18×10^-35 ) at 5q33.3 (IL12B), and confirmed 1 previously reported deletion (esv3587563, OR=1.30, P=9.52×10^-60 ) at 1q21.2 (LCE) for psoriasis. Fine mapping analysis including SNPs and small Insertions/Deletions (InDels) revealed that esv3608550 and esv3608542 were independently associated with psoriasis, and a novel independent SNP (rs9378188, OR=1.65, P=3.46×10^-38 ) was identified at 6q21.33. By genetic interaction analysis and RNA expression analysis, we speculate that the association of 2 deletions at 6q21.33 with psoriasis might relate to their influence on the expression of HLA-C.

CONCLUSIONS

Our study constructed the most comprehensive SV map for psoriasis thus far and enriched the genetic architecture and pathogenesis of psoriasis as well as highlighted the nonnegligible impact of SVs on complex diseases.

Bevacizumab biosimilar LY01008 compared with bevacizumab (Avastin) as first-line treatment for Chinese patients with unresectable, metastatic, or recurrent non-squamous non-small-cell lung cancer: A multicenter, randomized, double-blinded, phase III trial

BACKGROUND

Previous studies have demonstrated the preclinical pharmacological and toxicological consistency, and clinical pharmacokinetic equivalence of bevacizumab biosimilar LY01008 with reference bevacizumab (Avastin). This randomized controlled trial aimed to compare the efficacy and safety of LY01008 with Avastin in first-line treatment of Chinese patients with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC).

METHODS

Stage IIIB-IV NSCLC patients with evaluable lesions, good physical status, and adequate organ functions from 67 centers across China were randomized in a ratio of 1:1 to receive LY01008 or Avastin 15 mg/kg intravenously in combination with paclitaxel/carboplatin (combined treatment) for 4-6 cycles, followed by maintenance monotherapy with LY01008 until disease progression, intolerable toxicity, or death. The primary endpoint was objective response rate (ORR) in accordance with Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 confirmed by independent radiological review committees (IRRC). Secondary endpoints included disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety. This study was registered in ClinicalTrials.gov (NCT03533127).

RESULTS

Between December 15th , 2017, and May 15th , 2019, a total of 649 patients were randomized to the LY01008 (n = 324) or Avastin (n = 325) group. As of September 25th , 2019 for primary endpoint analysis, 589 patients received ORR evaluation, with a median number of combined treatment cycles of 5 (range 1-6) and median duration of treatment of 3.0 (range 0.0-5.1) months. ORR of response-evaluable patients in the LY01008 and Avastin groups were 48.5% and 53.0%, respectively. The stratified ORR ratio was 0.91 (90% CI 0.80-1.04, within the prespecified equivalence margin of 0.75-1.33). Up to May 15th , 2020, with a median follow-up of 13.6 (range 0.8-28.4) months, no notable differences in DCR, median DoR, median PFS, median OS, and 1-year OS rate were observed between the LY01008 and Avastin groups. There were no clinically meaningful differences in safety and immunogenicity across treatment groups.

CONCLUSIONS

LY01008 demonstrated similarity to Avastin in terms of efficacy and safety in Chinese patients with advanced or recurrent non-squamous NSCLC. LY01008 combined with paclitaxel/carboplatin is expected to become a new treatment option for unresectable, metastatic, or recurrent non-squamous NSCLC patients in the first-line setting.

P–774 Clinical effectiveness of elective single versus double blastocyst transfer in women aged 36 years or older

Study question

If the elective single-blastocyst transfer (eSBT) strategy can be applied to women aged 36 or older.

Summary answer

In women ≥36 years old with at least two blastocysts, eSBT increased cumulative livebirth rate (LBR) while minimizing twins compared with double blastocyst transfer (DBT). What is known already: In young women with a good prognosis, eSBT policy is an accepted strategy to maintain LBR while decreasing multiple gestation. However, in many areas of the world DBT is still applied in older women.

Study design, size, duration

We performed a retrospective cohort study of 429 women aged ≥36 years or older who received IVF ovarian stimulation cycles between Jan 2015 and Oct 2018 and who had at least two blastocysts. Women were followed up until Oct 2020 for their fertility outcomes including cumulative live birth and multiple pregnancies. The study was performed at the Northwest Women and Children’s Hospital, Xi’an, China.

Participants/materials, setting, methods

Out of 429 women, 240 underwent a fresh cycle of eSBT and 189 DBT. The subsequent frozen-thawed embryo transfer cycles were a combination of single- and double- blastocyst transfers, more commonly the latter. Analysis was stratified for patients in age groups 36–37, 38–39 and ≥40 and quality of the blastocyst transferred, as graded by morphological examination. Outcomes were the LBR in the fresh cycle, cumulative LBR and multiple rate after fresh and frozen embryo transfers.

Main results and the role of chance

The cumulative LBR was 74.2% (178/240) for eSBT versus 63.0% (119/189) for DBT (OR = 1.69, 95%CI 1.12–2.56), irrespective of female age. The multiple rate was 9% (16/178) after eSBT versus 29.4% (35/119) after DBT (P- value &lt; .001). The total number of children born was 194 after eSBT versus 154 after DBT. Stratified by female age, the cumulative LBRs in women aged 36–37 (78.9 vs 70.5%), 38–39 (68.9 and 61.1%) and ≥ 40 years (59.3 and 47.5%), were higher after eSBT compared with DBT, however, the differences did not reach statistical significance in each subgroups. LBRs in the fresh cycles were comparable for patients with eSBT compared with DBT (52.1% vs. 52.4%, OR = 0.99, 95%CI 0.68–1.45). In women &lt; 40 years, DBT resulted in a small non-significant increase in LBR in the fresh transfer (63.2% vs. 61.2%, 95%CI=0.64–1.85, 36–37 years; 48.1% vs. 41.0%, 95%CI=0.64–2.80, 38–39 years) at the expense of a marked increase in twinning rate (0–5.4% vs. 31.7–34.6%). For women ≥40 years, no significant differences were observed in the LBR (37.0% vs 45%, 95%CI 0.47–4.07) or twinning rate (0 vs 7.7%) between eSBT and DBT group. The findings persisted with and without accounting for quality of the blastocyst transferred.

Limitations, reasons for caution

This study is limited by its observational character.

Wider implications of the findings: In women ≥36 years with two blastocysts, eSBT should be the preferred treatment which maximizes the cumulative LBR for a decrease in the rate of multiple pregnancies.

Trial registration number

Not applicable

[Preoperative video distraction alleviates separation anxiety and improves induction compliance of preschool children: a randomized controlled clinical trial]

Objective: To explore the effect of video distraction on preoperative separation anxiety and induction compliance of preschool children receiving strabismus surgery under general anesthesia. Methods: In this prospective trial, 80 children aged 3 to 6 years scheduled for strabismus surgery under inhalation anesthesia were randomly allocated to one of two groups, a control group and a video distraction group, with 40 cases in each group. Children in the video distraction group continuously watched videos from waiting in the holding area, separating with parents, entering the operating room and induction of anesthesia, while children in the control group didn't watch videos during the same process. The modified Yale Preoperative Anxiety Scale (mYPAS) of children were recorded upon arriving at the holding area(T₁)and separating with parents(T₂). Induction Compliance Checklist (ICC) score was recorded when the anesthesia induction was performed. The emergence time, the occurrence rate of adverse events in post-anesthesia care unit (PACU) including nausea and vomiting, laryngospasm, severe cough, hypoxemia and sinus bradycardia, incidence of postoperative adverse reactions such as pain, dizziness, nausea and vomiting and lethargy, the parents' satisfaction of anesthesia were also assessed. Results: There were no significant difference in mYPAS score and the proportion of mYPAS score>30 between 2 groups at T₁ (all P>0.05). At T₂, the mYPAS score and the proportion of mYPAS score>30 in video distraction group were (34.41±13.23) and 52.50%, which were lower than those in control group (50.64±20.96, 87.50%) with statistically significant difference (all P<0.05). The ICC score of video distraction group was lower than that of the control group, which was (1.83±2.26) vs (4.03±2.99), and the difference was statistically significant (P<0.05). The proportion of children with ICC score=0 in video distraction group was 37.50%, which was higher than that in the control group (12.50%), while the proportion of children with ICC score=4-10 was lower than that of the control group, which was 17.50% vs 45.00%, and the difference was statistically significant (P<0.05). No significant intergroup differences were observed in emergence time, incidence of adverse events in PACU, and incidence of postoperative adverse reactions (P>0.05). The parents' satisfaction of anesthesia in the video distraction group was (9.23±0.89), which was higher than that in the control group (8.63±1.23), with statistically significant (P<0.05). Conclusion: Preoperative video distraction alleviates separation anxiety, improves induction compliance of preschool children receiving strabismus surgery under general anesthesia, and increases the parents' satisfaction of anesthesia.

A NO/ROS/RNS cascaded-releasing nano-platform for gas/PDT/PTT/immunotherapy of tumors

Nitric oxide (NO) gas treatment offers a promising strategy for tumor therapy; however, its practical application is still limited due to its poor efficacy and biotoxicity which were caused by gas leakage during blood delivery. Herein, a nano-platform (CMH-OBN) composed of chlorin e6-melanin-hyaluronic acid nanoparticles (Ce6-MNP-HA, CMH) and oxidized bletilla striata polysaccharide microcapsules (Oxi-BSP) carrying NO donors was prepared for responsive and cascaded release of NO, reactive oxygen species (ROS) and its secondary metabolite reactive nitrogen species (RNS) in tumor sites. Melanin not only endowed CMH with good photothermal properties, but also helped Ce6 to produce a large number of ROS under near-infrared (NIR) irradiation. OBN microcapsules, which were sensitive to ROS, can release NO donors under the stimulation of ROS released by CMH nanoparticles under NIR irradiation and can further release NO in the tumor microenvironment (TME) with high expression of glutathione (GSH). NO could further up-regulate soluble guanylate cyclase-cyclic guanosine monophosphate (sGC-cGMP) signal pathways to relieve hypoxia, thus further enhancing the photodynamic therapy (PDT). Moreover, the cascaded release of ROS and NO could produce RNS with higher lethality, which could sequentially initiate the cellular apoptotic procedure and promote immunotherapy by activating T cells at the tumor sites. More interestingly, the CMH-OBN nano-platform could supply magnetic resonance imaging (MRI) and infrared photothermal imaging guidance for tumor therapy. In conclusion, the development of a CMH-OBN nano-platform provides a satisfactory demonstration by combining NO therapy with photothermal therapy (PTT), PDT and immunotherapy for the treatment of cancer.

POS0754 DEVELOPMENT OF A RISK PREDICTION MODEL FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE SLE-VTE SCORE

Background:

Patients with systemic lupus erythematosus (SLE) have a substantially increased risk of venous thromboembolism (VTE). An individual VTE risk assessment is important to ensure that all patients are assessed and given adequate thromboprophylaxis.

Objectives:

We conducted this study to develop a risk score for VTE in patients with SLE.

Methods:

Patients with SLE who participated in the Chinese SLE Treatment and Research group were enrolled in this study. Patient baseline information and clinical laboratory indicators were obtained, and VTE events were recorded every 3-6 months during follow-up visits. The risk prediction model was created and internally validated using the bootstrap methods, and a scoring system was established (Figure 1).

Figure 1.

Flow chart of study design.

Results:

Out of 4,502 patients included in this study, 135 had a VTE event. After univariate analysis and Lasso regression, the following 11 variables were identified and included in the risk prediction model: male sex, age, BMI ≥25 kg/m2, hyperlipidemia, hypoalbuminemia, hsCRP>3 mg/L, renal involvement, nervous system involvement, anti-β2-glycoprotein I antibody positivity, lupus anticoagulant positivity, and no use of hydroxychloroquine. The AUC for the SLE-VTE score (Table 1) was 0.947 (95% CI, 0.9249-0.9694). The SLE-VTE score’s sensitivity and specificity with the optimal cutoff value of 13 were 0.919 and 0.881, respectively. The SLE-VTE score was superior to the GAPSS system in predicting the risk of VTE in patients with SLE (AUC= 0.947 vs. 0.680, P< 0.001; integrated discrimination improvement (IDI)= 0.6652, P< 0.001; net reclassification improvement (NRI)= 0.6652, P< 0.001).

Table 1.

Final multivariable analysis for venous thromboembolism risk in patients with SLE

β coefficientsOdds ratio* (95% CI)P-valuePoints in scoring systemMale0.6211.86(0.953-3.503)0.0612Age at study entry(≥50)0.8372.308(1.339-3.915)0.0023BMI02(kg/m20.7922.209(1.333-3.627)0.0023Hyperlipemia0.8382.313(1.246-4.166)0.0063Hypoalbuminemia2.1638.697(5.185-14.794)< 0.0017hsCRP>3 mg/L1.4524.272(2.618-6.968)< 0.0015Anti β2GPI1.0132.754(1.543-4.853)0.0013LA1.5594.752(2.799-8.072)< 0.0015Nervous system2.38210.832(6.163-18.998)< 0.0018Lupus nephritis0.8352.305(1.414-3.756)0.0013No use of hydroxychloroquine1.7715.876(3.722-9.401)< 0.0016

BMI: body mass index; hsCRP: Hypersensitive c-reactive protein; ACL: anticardiolipin, antiβ2GPI: anti-β2-glycoprotein I, LA: lupus anticoagulantm;

Values in bold are statistically significant at p <0.05.

Conclusion:

Various factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify SLE patients with a high risk of VTE who may benefit from thromboprophylaxis.

References:

[1]Ramirez GA, Efthymiou M, Isenberg DA, Cohen H. Under crossfire: thromboembolic risk in systemic lupus erythematosus. Rheumatology. 2018;58:940-952.

[2]Chung WS, Lin CL, Chang SN, Lu CC, Kao CH. Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study. J Thromb Haemost. 2014;12:452-458.

[3]Liew NC, Alemany GV, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol. 2017;36:1.

[4]Savino S, Giovanni S, Veronica M, Dario R, Khamashta MA, Laura BM. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013:8.

[5]Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603.

[6]Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Nguyen NT, Stamos MJ. A Nationwide Analysis of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Colon and Rectal Surgery. J Gastrointest Surg. 2014;18:2169-2177.

Disclosure of Interests:

None declared

Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis

In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM.

INTRODUCTION

Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports.

METHODS

In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I² method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies.

RESULTS

Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, - 0.47, 95% CI, - 0.92 to - 0.02, I² = 80.2%) and lumbar spine (pooled WMD, - 0.41, 95% CI, - 0.69 to - 0.12, I² = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias.

CONCLUSION

This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.

POS0736 IDENTIFICATION OF MOLECULAR PHENOTYPES AND IMMUNE CELL INFILTRATION IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS ACCORDING TO LONGITUDINAL GENE EXPRESSION

Background:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with highly heterogeneous clinical presentation characterized by disease unpredictable flares and multi-systemic involvement1 2. This clinical heterogeneity calls for design a molecular stratification to improve clinical trial design and formulate personalization treatment therapies.

Objectives:

This research was conducted to develop a reliable method to stratify SLE patients combined gene expression information and disease status.

Methods:

The mRNA expression profile of GSE138458 (contained 307 patients and 23 controls) and GSE49454 (contained 111 patients and 16 controls) were downloaded from the publicly GEO databases. After background adjustment, batch correction, and other pre-procession, obtaining a big gene matrix to identify the differentially expressed genes (DEGs) in SLE compared with healthy controls, which were screened by P value < 0.01. SLE subtypes were identified by non-negative matrix factorization (NMF) based on DEGs. Acquired signature genes in different SLE subtypes were conducted to process pathway enrichment analysis in Metascape. SLEDAI score and immune cell infiltration was also performed between subtypes by software package R (version 4.0.3).

Results:

Total 1202 DEGs were imputed to NMF unsupervised machine learning method. Patients with SLE were stratified into two subsets based on 184 signature genes derived from obtained DEGs(Fig.1A, 1B). GO and KEGG enrichment analysis showed that signature genes were mainly involved in negative regulation of innate immune response, toll-like receptor signaling pathway, regulation of immune effector process and so on(Fig.1C). Patients in Sub1 group had severe disease activity measures compared with those in Sub2(Fig.1D). SLEDAI scores from GSE49454 dataset were also higher in Sub1 compare with Sub2(Fig.1E). Further, immune cell infiltration results revealed an insufficient of regulatory T cell, CD8 T cells and naive CD4 T cells in Sub1 and neutrophils cells in Sub2(P<0.05)(Fig.1F).

Conclusion:

Our findings indicate that patients with SLE could be stratified into 2 subtypes which had different lymphocyte status and closely related to disease activity. This phenotyping may help us understand the etiology of the disease, inform patient in the design of clinical trials and guide treatment decision.

References:

[1]Dorner T, Furie R. Novel paradigms in systemic lupus erythematosus. Lancet 2019;393(10188):2344-58. doi: 10.1016/S0140-6736(19)30546-X [published Online First: 2019/06/11].

[2]Fanouriakis A, Tziolos N, Bertsias G, et al. Update οn the diagnosis and management of systemic lupus erythematosus. Annals of the rheumatic diseases 2021;80(1):14-25. doi: 10.1136/annrheumdis-2020-218272 [published Online First: 2020/10/15].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

Electronegativity Assisted Synthesis of Magnetically Recyclable Ni/NiO/g-C3N4 for Significant Boosting H2 Evolution

A magnetically recyclable Ni/NiO/g-C₃N₄ photocatalyst with significantly enhanced H2 evolution efficiency was successfully synthesized by a simple ethanol-solvothermal treatment. The presence of electronegative g-C₃N₄ is found to be the key factor for Ni⁰ formation in ternary Ni/NiO/g-C₃N₄, which provides anchoring sites for Ni²⁺ absorption and assembling sites for Ni⁰ nanoparticle formation. The metallic Ni⁰, on one side, could act as an electron acceptor enhancing carrier separation and transfer efficiency, and on the other side, it could act as active sites for H₂ evolution. The NiO forms a p–n heterojunction with g-C₃N₄, which also promotes carrier separation and transfer efficiency. The strong magnetic property of Ni/NiO/g-C₃N₄ allows a good recyclability of catalyst from aqueous solution. The optimal Ni/NiO/g-C₃N₄ showed a full-spectrum efficiency of 2310 μmol·h⁻¹·g⁻¹ for hydrogen evolution, which is 210 times higher than that of pure g-C₃N₄. This ethanol solvothermal strategy provides a facile and low-cost synthesis of metal/metal oxide/g-C₃N₄ for large-scale application.

[The gender disparity and relevant factors of frailty in the elderly of communities in Beijing based on Fairlie decomposition analysis]

Objective: To analyze the gender disparity and relevant factors of frailty in the elderly of communities in Beijing. Methods: From November 2015 to January 2016, 1 557 participants aged 60 and older in four communities of Dongcheng district in Beijing were recruited by cluster sampling. The information of demographic characteristics, social support, economic status, health status, prevalence situation, cognitive function, emotion and comprehensive assessment of the elderly were collected by a self-made questionnaire. The frailty index (FI) model was used to evaluate the frailty of the elderly. Multivariate nonconditional logistic regression model and Fairlie decomposition method were applied to analyze the relevant factors and their contribution rate to the difference between males and females. Results: The age of subjects was (74.5±8.5) years old, ranging from 60-102 years old, among which 641 were males, accounting for 41.2%. The M (Q₁, Q₃) of FI was 0.09 (0.06, 0.14), among which the value in males was 0.08 (0.05, 0.13), lower than females [0.10 (0.06, 0.15)] (P<0.001).The frail proportion in female was 14.9% (137/916), higher than that of male [8.4% (54/641)] (P<0.001). Multivariate nonconditional logistic regression model analysis demonstrated that common relevant factors associated with frailty in older women and men include: age ≥80 years old, marital status as not married (unmarried, separated, divorced, or widowed), living alone increased the risk of frailty; participating in group activities ≥3 times/week and exercising regularly decreased the risk of frailty (all P<0.05). Fairlie decomposition method showed that the contribution rate of life style, family support, marital status and social support were 32.21%, 15.26%, 8.23% and 4.34%, respectively (all P<0.05). Conclusions: The frailty degree and frailty proportion of elderly women in communities in Beijing were higher than those of men of the same age. The frailty gender difference was related to lifestyle, family support, marital status and social support.

LncRNA LINC00467 contributes to osteosarcoma growth and metastasis through regulating HMGA1 by directly targeting miR-217

OBJECTIVE

Osteosarcoma (OS) is a common primary bone tumor. Despite multiple treatment strategies have made great progress, the overall clinical outcome of OS patients is frustrating. Long non-coding RNA (lncRNA) LINC00467 has been reported in several cancers, while the research of the role of LINC00467 in OS is limited. The aim of this study was to figure out the potential mechanism of LINC00467 in OS.

PATIENTS AND METHODS

The expression levels of LINC00467, microRNA-217 (miR-217) and high mobility group A1 (HMGA1) were quantified by reverse transcription quantitative polymerase chain reaction (qRT-PCR). Cell counting kit-8 (CCK-8), flow cytometry and transwell assay were performed to detect cell proliferation, apoptosis, migration and invasion, respectively. The protein levels of HMGA1, B-cell lymphoma-2 (Bcl-2), Bax, Cleaved Caspase-3 (C-Caspase 3), E-cadherin, N-cadherin and vimentin were measured by Western blot assay. Online software starbase was used to predict the binding sites of miR-217. Luciferase report assay and RNA Binding Protein Immunoprecipitation (RIP) assay were carried out for detecting the interaction between miR-217 and LINC00467 or HMGA1.

RESULTS

The expression of LINC00467 and HMGA1 was increased in OS tissues and cells, while miR-217 expression was reduced. High expression of HMGA1 led to the poor overall survival. Down-regulation of LINC00467 or up-regulation of miR-217 could accelerate cell apoptosis, and slump cell proliferation, migration, invasion and EMT. However, miR-217 under-expression or HMGA1 over-expression could rescue these effects. Moreover, it was indicated that LINC00467 directly targeted miR-217 and HMGA1 was a target of miR-217.

CONCLUSIONS

LINC00467 promoted cell proliferation, migration, invasion and EMT, and suppressed cell apoptosis by up-regulating HMGA1 via targeting miR-217.

[Analysis for the breast cancer screening among urban population in Hebei province, 2018-2019]

From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ²=30.28,P<0.001) or mammography alone (3.06%) (χ²=14.56,P<0.001).

Retraction notice to "30MO ORIENT-3: A randomized, open-label, phase III study of sintilimab versus docetaxel in previously treated advanced/metastatic squamous non-small cell lung cancer (sqNSCLC)": [Annals of Oncology Volume 31, Supplement 7, December 2020, Page S1428]

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article was retracted at the request of the authors. The authors of this abstract have advised that full agreement between authors and sponsors on publication of the abstract has not been reached and they are therefore unable to publish this data at present.

A Three-in-one ZIFs-Derived CuCo(O)/GOx@PCNs Hybrid Cascade Nanozyme for Immunotherapy/Enhanced Starvation/Photothermal Therapy

Glucose oxidase (GOx) is regarded as an ideal endogenous natural enzyme for tumor starvation therapy and photothermal therapy (PTT) is a promising strategy for the ablation of primary tumor. In this work, Cu-doped cobalt oxide and porous carbon nanocomposites (CuCo(O)@PCNs) were synthesized from double-layered ZIF-8@ZIF-67 and GOx was loaded in the porous carbon to form a CuCo(O)/GOx@PCNs hybrid nanozyme. CuCo(O) was characterized as the Cu_0.3Co_2.7O₄ phase through X-ray diffraction analysis and it can react with H₂O₂ to generate O₂ and alleviate tumor hypoxia, resulting in the recovered enzymatic activity of GOx and the enhanced starvation therapy. The porous nanocarbon can ablate the primary tumor because of its high photothermal conversion efficiency of 40.04%. The three-in-one functions of oxygen supply, glucose consumption, and photothermal conversion were realized in the ZIFs-derived CuCo(O)/GOx@PCNs nanozyme and the starvation therapy effect was improved by PTT and oxygen supplement. Furthermore, the inhibition effect of CuCo(O)/GOx@PCNs on metastatic tumor is similar to combined therapy of the nanozyme and the immune checkpoint-blocking antibody, α-PD-1. The related antitumor immune mechanism was studied through the analysis of immune-related proinflammatory cytokines and the activated T cells. This work may provide new ideas for the development and application of the ZIFs-derived hybrid nanozyme in tumor therapy and the CuCo(O)/GOx@PCNs nanozyme may be a promising alternative to immune checkpoint inhibitors.

MicroRNA-29c-3p inhibits osteosarcoma cell proliferation through targeting PIK3R3

OBJECTIVE

MicroRNAs (miRNAs) are endogenous, non-coding small RNAs involving in pathological regulation. Previous studies have shown that microRNA-29c-3p is a tumor-suppressor gene. However, the role of microRNA-29c-3p in osteosarcoma (OS) has not been reported. This study aims to investigate the potential influence of microRNA-29c-3p on the progression of OS.

PATIENTS AND METHODS

Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was applied to examine microRNA-29c-3p levels in 40 matched pairs of OS tumor tissues and adjacent ones. The correlation between microRNA-29c-3p expression and clinical indicators in OS patient was analyzed. At the same time, qRT-PCR was used to detect microRNA-29c-3p level in OS cell lines. In addition, microRNA-29c-3p knockdown and the overexpression models were constructed in OS cell lines. The effects of microRNA-29c-3p on the biological functions of OS cells were analyzed via cell counting kit-8 (CCK-8) and transwell assays. Finally, the potential mechanism underlying microRNA-29c-3p in OS was explored by Western Blot and cell recovery experiment.

RESULTS

QRT-PCR results revealed that microRNA-29c-3p level in OS tumor tissues was conspicuously lower than that in adjacent tissues. Compared with OS patients with the high expression of microRNA-29c-3p, those with low expression of microRNA-29c-3p had a higher incidence of distant metastasis and worse overall survival. Cell proliferative capacity and invasiveness in OS were enhanced after knockdown of microRNA-29c-3p; while the opposite results were observed after the overexpression of microRNA-29c-3p. QRT-PCR results revealed that microRNA-29c-3p negatively regulated PIK3R3 expression in OS cells. Moreover, microRNA-29c-3p and PIK3R3 levels were confirmed to be negatively correlated in OS tissues. In addition, cell reverse experiment demonstrated that PIK3R3 was responsible for the malignant progression of OS regulated by microRNA-29c-3p.

CONCLUSIONS

MicroRNA-29c-3p expression was reduced in OS, and conspicuously associated with distant metastasis and poor prognosis. MicroRNA-29c-3p might inhibit the malignant progression of OS by modulating PIK3R3 expression.

[A real-world study of 176 cases with aplastic anemia treated in outpatient]

目的

探索真实世界门诊治疗再生障碍性贫血（AA）患者的诊断流程、治疗及疗效。

方法

评估2018年1月至2019年12月门诊治疗176例AA患者的诊断流程、治疗方案及疗效。

结果

患者出现症状至首次就诊中位时间7（5～120）个月，就诊原因包括出血（52.3%）、贫血（51.7%）、感染（6.8%）。诊断流程中168例（95.5%）患者完成髂骨骨髓穿刺（骨穿），仅22例（17.1%）完善了多部位骨穿（胸骨分类）；骨髓活检完成率85.1%（143/168）；只有59.5%（100/168）和58.9%（99/168）完成了骨髓流式免疫分型及染色体核型分析；86例（48.5%）完成阵发性睡眠性血红蛋白尿（PNH）克隆筛查；造血祖细胞培养检查完成率最低，仅45例（26.8%）。环孢素A（CsA）联合雄激素及左旋咪唑为最常见治疗方案，总计77例（43.8%），其次为CsA联合雄激素45例（25.6%），单用CsA者24例（13.6%），单用雄激素者16例（9.1%），14例（7.9%）患者确诊后选择中药或未治疗。根据门诊复诊频率将176例患者分为复诊规律组（每年≥4次）130例（73.9%）和复诊欠规律组（每年<4次）46例（26.1%）。复诊规律组6个月有效率较高（52.5%对28.0%，P＝0.005），12个月高质量缓解率更好（40.7%对16.7%，P＝0.027），24个月复发率更低（4.4%对36.4%，P＝0.001）。

结论

真实世界治疗的AA患者诊断流程需重视多部位骨穿检查并完成PNH克隆筛查、流式免疫分型、染色体核型分析及造血祖细胞培养检查；门诊规律复诊患者可获得高质量缓解，复发率低，推荐每年至少复诊4次。