[Promote the application of dual-energy CT in abdominal malignant tumors]

With the progress of medical imaging technology and the accumulation of experience, dual-energy CT has moved from simple scientific research to clinical application. In the imaging of abdominal tumors, dual-energy CT has obvious advantages over conventional CT in improving the diagnostic performance, reflecting the pathological characteristics of malignant tumors and evaluating the therapeutic effect. This paper briefly describes the classification of dual-energy CT, the current research status of this technology in abdominal malignant tumors, and puts forward the challenges and application traps faced by dual-energy CT technology, in order to promote the clinical generalization and application of this technology.

ALPK1 Aggravates TMJOA Cartilage Degradation via NF-κB and ERK1/2 Signaling

Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative joint disease without effective intervention strategies. Previous research implied that alpha-kinase 1 (ALPK1) is involved in the inflammatory responses of gout, a chronic arthritis. Herein, we found the main distribution of ALPK1 in a proliferative layer of condylar cartilage and marrow cavity of subchondral bone, as well as a lining layer of synovial tissues in human temporomandibular joint. Moreover, the expression of ALPK1 was augmented in degraded condylar cartilage of monosodium iodoacetate (MIA)-induced TMJOA mice. After MIA induction, ALPK1 knockout mice exhibited attenuated damage of cartilage and subchondral bone, as well as synovitis, as compared with wide type mice. In contrast, intra-articular administration of recombinant human ALPK1 aggravated the pathology of MIA-induced TMJOA. Furthermore, ex vivo study demonstrated that ALPK1 exacerbated chondrocyte catabolism by upregulating matrix metalloproteinase 13 and cyclooxygenase 2 by activating NF-κB (nuclear factor-kappaB) signaling and suppressed anabolism by downregulating aggrecan by inhibiting ERK1/2 (extracellular signal-regulated kinase 1/2) in articular chondrocytes. Taken together, ALPK1 exacerbates the degradation of condylar cartilage during TMJOA through the NF-κB and ERK1/2 signaling pathway. This study provides a new insight regarding the role of ALPK1 during TMJOA pathology.

Optimization of environmental factors in a dual in vitro biofilm model of Candida albicans-Streptococcus mutans

The biofilm formation of Streptococcus mutans-Candida albicans is an important virulence factor for dental caries. The purpose of this study was to determine the effect of some environmental conditions on the biofilm formation like inoculation concentration, temperature, sugar, amino acid, metal ions and saliva, and then establish a persistent in vitro biofilm model for further research. Based on the single factor experiment, the factors participating in the biofilm formation including sugar, inoculation concentration, and saliva increased the biofilm mass, while amino acid, metal ions, temperatures reduced biofilm mass. Optimal conditions for biofilm formation were the inoculation dosage of S. mutans and C. albicans of 10⁸ and 10⁷ , respectively, the addition of 0·3 g l^-1 sucrose and sterile saliva. These results contribute to a deep understanding of the factors involved in oral biofilm formation of the important cariogenic pathogen S. mutans and the opportunistic pathogen C. albicans to study better for biofilm and promote the design of new therapeutic approaches. The present research also provides a model for evaluating the therapeutic potential for drugs in the future.

[Characteristics and changes of sensitization patterns of major allergens in children from 2010 to 2020 in a hospital of pediatric in Beijing]

Objective: To analyze the sensitization characteristics and change of major allergens in children from 2010 to 2020 in Beijing, so as to provide basis for diagnosis, treatment and prevention of allergic diseases in children. Methods: A retrospective study was conducted to analyze the children who were suspected of allergic diseases and tested for serum immunoglobulin E (total IgE and specific IgE) in the children's Hospital Affiliated to the Capital Institute of Pediatrics from January 2010 to December 2020. A total of 45 746 children aged 0-17 years in Beijing were enrolled with a median (interquartile range) of 3.8 (2.5, 5.3) years. There were 28 918 boys (63.2%) and 16 828 girls (36.8%) and 14 984 cases (32.8%) in the infant group (<3 years old), 22 049 cases (48.2%) in the preschool group (3-6 years old), and 8 713 cases (19.0%) in the school-age group (6 years old and above). Immunocap allergen detection system (fluorescence enzyme-linked immunosorbent assay) was used to detect and the characteristics and change trend of allergens during 11 years were statistically analyzed by Chi square test. Results: The top three positive rates of single food allergens sIgE were egg white 42.6% (2 788/6 577 tests), milk 38.4% (2 606/6 782 tests) and wheat 31.8% (1 417/4 449 tests), and the sequence of single inhaled allergens were Ragweed 42.6% (440/1 034 tests), Artemisia 38.4% (1 045/3 191 tests) and Alternaria alternata 31.3% (3 358/10 725 tests). The positive detection rates of egg white 47.0%(1 904/4 048 tests), milk 41.9%(1 769/4 226 tests) and wheat 33.9%(973/2 870 tests) in the infant group were the highest, and there have statistically significant(χ²=91.495, 73.907, 16.966, P<0.05). The positive rates of fx1 (22.5%, 121/537 tests), peanut (24.9%, 111/446 tests), soybean (20.0%, 74/370 tests) and shrimp (7.48%, 44/588 tests) were the highest in the school-age group(χ²=14.436, 10.751, 11.569, 13.703, P<0.05). The most common inhaled allergens were Alternaria alternata (14.8%, 422/2 859 tests) in the infant group, Ambrosia (34.5%, 143/415 tests) and Alternaria alternata (33.5%, 1 762/5 254 tests) in the preschool group, while in the school-age group were Ambrosia (56.4%, 282/500 tests) and Artemisia (48.2%, 573/1 189 tests). The positive rates of egg white, milk, wheat, sesame seed and peanut varied from 2010 to 2020, showing a trend of falling first and then rising(χ²=10.293,χ²=12.066,χ²=7.402,χ²=32.458,χ²=31.747,P<0.05).The positive detection rates of soybean showed a significant downward trend (21.4%, 173/809 tests in 2010, 15.4%, 70/455 tests in 2020, χ²=6.751,P=0.009), while that of shrimp and crab were at a stable low level(χ²=0.263, 1.346;P>0.05). From 2010 to 2020, mold (26.7%, 1 066/3 998 tests in 2010, 40.2% 1 705/4 243 tests in 2020), grass pollen (19.8%, 259/1 308 tests in 2010, 39.3%, 1 472/3 746 tests in 2020), tree pollen(17%, 180/1 058 tests in 2010, 29.8%, 916/3 075 tests in 2020) and animal dander (18.5%, 111/601 tests in 2010, 26.6%, 672/2 522 tests in 2020) were all showed significant upward trend (χ²=168.600, 163.601, 65.931 and 17.271 respectively, P<0.001) but dust mites (30.7%, 1 270/4 132 tests in 2010, 26.7%, 1 126/4 221 tests in 2020) showed a significant downward trend(χ²=16.822,P<0.001).In 2010, the most common inhaled allergen was dust mite 30.7% (1 270/4 132 tests), followed by mold 26.7% (1 066/3 998 tests), while they were mold 40.2% (1 705/1 243 tests), and grass pollen 39.3% (1 472/3 746 texts) respectively in 2020. Conclusion: In the past 11 years, the main food allergens in children were still egg white and milk, wheat, but the mold and pollen gradually replaced dust mite as the most common inhaled allergen.

AB1442 A PREDICTIVE MODEL OF CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME: A RETROSPECTIVE COHORT STUDY

Background

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening form of antiphospholipid syndrome (APS), with rarely occurrence but high mortality. Current classification diagnosis criteria require more than 3 organs involvement in 1-week time and pathological evidence in patient with persistent positive antiphospholipid antibodies (aPL), which could result the delaying diagnosis and treatment. A predictive model could help identify CAPS patients earlier and initiate early intervention.

Objectives

To develop a predictive model of CAPS in APS patients in a single-center prospective APS cohort.

Methods

Data of consecutive APS patients referred into Peking Union Medical College Hospital from May 2013 to October 2021 was collected. A binary logistic regression method was used to identify predictors of CAPS, coefficient B was assigned with score value in the development of prediction model, and risk-stratification was based on the calculated score using the predictive model. The performance of the model was assessed by Nagelkerke’s R2, Hosmer-Lemeshow test, Omnibus test, and area under the receiver operating characteristic curve (AUC).

Results

A total of 27 CAPS (11.9%) occurred in 226 APS patients. CAPS were more likely to occur in male secondary APS patients with history of arterial thrombosis. Precipitating factors (OR 108.961, 95% CI 23.299 to 509.572), thrombocytopenia (OR 14.765, 95% CI 3.088 to 70.612) and elevated serum creatine (OR 5.339, 95% CI 1.301 to 21.907) were selected by the binary logistic regression. The scores of precipitating factors, thrombocytopenia and elevated serum creatine were 5, 3 and 2. The risk scores were divided into high-risk (7-10) and low-risk (0-6), the risk for CAPS were 73.3% and 2.6%, with sensitivity of 81.5% and specificity of 96%. The Nagelkerke’s R2 (0.696), the Hosmer-Lemeshow test (χ2 =2.192, df=4, p=0.701) and the Omnibus test (χ2 =101.307, df=3, p=0.000) indicated the logistic regression model has a good fit. The AUC was 0.969 (95% CI 0.947 to 0.991, SE=0.011, p=0.000) indicated the model has good discrimination.

Conclusion

A predictive model of CAPS was developed with precipitating factors, thrombocytopenia, and elevated serum creatine. This model helps physicians identify CAPS in high-risk patients, could achieve early intervention and improve prognosis.

Table 1.

Characteristics and predicting factors of CAPS in PUMCH-APS cohort

CAPS（N=27）Non-CAPS（N=199）pOdds ratiopCoefficient ΒScoreGender（M）14(51.9)64(32.2)0.043Age (y)36.3±15.236.2±12.50.975Disease duration (m)49.7±77.753.9±72.30.777Secondary APS14(51.9)52(26.1)0.006APS diagnosisVenous thrombosis17(63.0)106(53.3)0.342Arterial thrombosis22(81.5)79(39.7)0.000Pregnancy morbidity5(18.5)68(34.2)0.103LA22(81.5)155(77.9)0.671aCL21(77.8)123(61.8)0.105a-β2GP123(85.2)155(77.9)0.384Precipitating factors24(88.9)19(9.5)0.000108.961(23.299-509.572)0.0004.6915WBC(×109/L)9.0±6.36.6±2.90.067HGB(g/L)82.7±20.4130±23.80.000Hemolytic anemia15(55.6)20(10.1)0.000PLT(×109/L)61.1±67.1132±84.00.000Thrombocytopenia24(88.9)80(40.2)0.00014.765(3.088-70.612)0.0012.6923Cr(μmol/L)224.5±225.874.4±28.40.002Elevated Cr15(55.6)34(17.1)0.0005.339(1.301-21.07)0.0201.6752LDH(U/L)476.4±227.0226.9±92.30.000 Elevated LDH25(92.6)54(27.1)0.000Proteinuria18(66.7)28(14.1)0.000Hematuria15(55.6)20(10.1)0.000Figure 1.

(A). Receiver Operating Characteristic (ROC) curve of the predictive model. Area under the receiver operating characteristic curve (AUC) was 0.969, the cut-off value of 7 were with sensitivity of 81.5% and specificity of 96%. (B). Calibration curve in internal validation.

Disclosure of Interests

None declared

POS0551 CLINICAL SIGNIFICANCE OF SERUM MPO-DNA COMPLEX IN RHEUMATOID ARTHRITIS

Background

Tumor necrosis factor inhibitors (TNFi) have been widely used in the treatment of RA. Few researches offered solid solution to predict the response of TNFi treatment. NETs formation (NETosis) is a key process participant in RA. NETs and their components also work as a source of auto-antigens for RA.

Objectives

To explore the relationship between serum MPO-DNA complex, which is one of the components of NETosis, and disease activity of RA, and to explore the possibility for serum MPO-DNA complex to predict the therapy response of anti-TNF therapy in RA patients.

Methods

RA patients were enrolled from a randomized controlled clinical trial (EScoRT study, ClinicalTrials.gov identifier: NCT02320630) conducted from Oct. 2014 to Oct. 2018. The clinical and demographic data and blood samples were collected at baseline and every 4 weeks. Serum levels of MPO-DNA complex were detected by a modified enzyme-linked immunosorbent assay (ELISA) kit. The Association between MPO-DNA complex level and disease activity was analyzed. The predictive value of baseline MPO-DNA complex for treatment response of RA patients was analyzed.

Results

86 RA patients were enrolled. The level of serum MPO-DNA was higher in patients with high disease activity (HDA) than that in patients with medium disease activity (MDA) (1.10±0.32 vs. 0.86±0.29, p=0.001). After 4 weeks of treatments, the level of seurm MPO-DNA complex decreased significantly (1.0±0.3vs. 0.6±0.2, p<0.001). Changes of MPO-DNA complex at week 4 (ΔMPO-DNA) was postively and linearly correlated with changes of TJC, SJC, PGA, EGA, ESR, CRP, DAS28ESR, DAS28CRP, SDAI and CDAI(r 0.270-0.495, all p-value<0.05). Receiver operating characteristic (ROC) analysis revealed that baseline MPO-DNA complex (95% CIs 0.57-0.79 for ACR50 and 0.66-0.85 for ACR70, all p-value<0.05) and ΔMPO-DNA complex at week 4 against baseline (95% CIs 0.63-0.83 for ACR 50 and 0.74-0.97 for ACR70) could predict the achievement of ACR50 and ACR70 within 12 weeks. ΔMPO-DNA complex at week 4 against baseline could predict the achievement of low disease activity (LDA) (95%CIs 0.57-0.79, p=0.03) and remission (95%CIs 0.54-0.8, p=0.024) within 12 weeks.

Conclusion

Serum MPO-DNA is associated with disease activity and can predict treatment response of RA.Serum MPO-DNA could serve as a powerful tool for clinicians to forecast the effectiveness of anti-TNF treatment in RA patients.

Table 1.

Predictive ability of MPO-DNA for treatment response at week 12

MeasuresAUCs for ACR50 at week 12AUCs for ACR70 at week 12AUC(95%CIs)PAUC differencepAUC(95%CIs)PAUC differencepb-MPO-DNA0.68(0.57-0.79)0.003Reference-0.77(0.66-0.85)<0.001Reference-b-ESR0.48(0.36-0.61)0.8480.200.0850.57(0.40-0.75)0.3320.200.036b-CRP0.55(0.43-0.68)0.0620.130.0720.65(0.52-0.79)0.0440.120.135ΔMPO-DNA0.73(0.63-0.83)<0.001reference-0.86(0.74-0.97)<0.001reference-ΔESR0.56(0.48-0.68)0.330.170.0170.64(0.48-0.80)0.0720.220.007ΔCRP0.59(0.47-0.71)0.140.140.0560.68(0.53-0.83)0.0190.180.068AUCs for DAS28ESR LDA at week 12AUCs for DAS28ESR remission at week 12MeasuresAUC(95%CIs)PAUC differencepAUC(95%CIs)PAUC differencepΔMPO-DNA0.68(0.57-0.79)0.03Reference-0.67(0.54-0.8)0.024Reference-ΔESR0.59(0.47-0.71)0.140.090.2260.54(0.41-0.68)0.5320.130.131ΔCRP0.60(0.47-0.72)0.110.080.2710.58(0.44-0.72)0.2740.080.258

Values are presented as areas under curve (95%CIs). Abbreviations: b-MPO-DNA/ESR/CRP, Serum MPO-DNA complex/ESR/CRP at baseline; ΔMPO-DNA/ESR/CRP, change of serum MPO-DNA/ESR/CRP at week 4 against baseline; ΔMPO-DNA/ESR/CRP%, reduction rate of serum MPO-DNA/ESR/CRP at week 4 against baseline.

Disclosure of Interests

None declared.

AB0171 TOWARDS A BETTER IMPLEMENTATION OF TREAT-TO-TARGET STRATEGY IN RHEUMATOID ARTHRITIS: A COMPARISON OF TWO REAL-WORLD COHORTS

Background

Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, however implemented distinctly varied in real practices.

Objectives

We tried to investigate the differences in disease activity and target achievement of two cohorts with different T2T implementations.

Methods

We used data of the CENTRA (Collaboratively intENsive Treat-to-target in RA) and TARRA (Treat-to-TARget in RA) cohorts. The CENTRA is a RA cohort prospectively follow-up by a fixed team with tight control, while the TARRA is a longitudinal observational cohort follow-up by a rheumatologist with casual control. Patients from two cohorts were matched 1:3 by propensity score matching (PSM). The primary outcome was simplified disease activity index (SDAI) at 1-year follow-up.

Results

102 patients from the CENTRA cohort and 271 patients from the TARRA cohort were included. Both groups were comparable in terms of age, gender, disease course, and seropositivity. At the end of 1 year follow-up, the SDAI of patients in the CENTRA cohort was significantly lower than that of patients in the TARRA cohort (2.1 vs 3.4, p＜0.001). The follow-up interval of patients in the CENTRA cohort was significantly shorter than that in the TARRA cohort when patients have not achieved remission (3.1 vs. 3.3 months, p=0.019).

Conclusion

RA patients may benefit more from a tight control T2T strategy with closer follow-up and appropriate education compared with a casual T2T strategy.

Disclosure of Interests

None declared

POS1158 CHARACTERIZATION OF GOUT IN US PATIENTS UNDERGOING HEMODIALYSIS (HD) AND PERITONEAL DIALYSIS (PD)

Background

Gout is the most common inflammatory arthritis and occurs frequently in patients with renal disease often leading to a significant burden on quality of life and functional status.1,2 Despite the established connection of renal disease with gout, little has been reported on the prevalence, patient characteristics, and associations of gout with other outcomes in the US hemodialysis (HD) and peritoneal dialysis (PD) population.

Objectives

This project used a large end-stage renal disease (ESRD) focused-database, Dialysis Outcomes and Practice Patterns Study (DOPPS), to examine gout in dialysis-dependent patients.

Methods

Gout patients were identified by active prescription (Rx) of (1) colchicine, (2) febuxostat, or (3) allopurinol; or by (4) prior diagnosis of gout from US cohorts of 70,297 HD (DOPPS, 2012-2020) patients and 5117 PD (Peritoneal DOPPS, 2014-2020) patients. Outcomes of HD and PD patients with and without a history of gout were compared with propensity score matching. Outcomes included erythropoietin resistance index (ERI = ESA dose/(hemoglobin*weight), cardiovascular death, all-cause mortality/hospitalization, and baseline patient-reported outcomes (PROs).

Results

Gout prevalence was 13% in HD and 21% in PD and was highest among incident dialysis patients. Of the gout patients identified, the most-commonly used gout-related medications were allopurinol (9-12%), followed by colchicine (2-3%), and then febuxostat (1%, Figure 1). Both HD and PD patients with gout (vs. no gout) were older and more likely male. Gout HD and PD patients had higher BMI and higher prevalence of cardiovascular comorbidities than HD and PD patients without gout. After propensity score matching, mean ERI was 4% higher for gout vs. non-gout patients, while there was minimal evidence of association with clinical outcomes (mortality and hospitalization) or PROs.

Figure 1.

Gout prevalence by dialysis duration in patients undergoing HD and PD. Criteria for gout included gout diagnosis and use of a urate-lowering therapy.

HD, hemodialysis; PD, peritoneal dialysis; mo, months; Rx, prescription; yrs, years. Some patients were included in multiple gout categories.

Conclusion

Gout was common in US HD and PD patients, with a large proportion of these patients treated with drugs indicated for hyperuricemia (allopurinol and febuxostat) and gout flares (colchicine). The true prevalence of gout was likely higher than observed when considering potential under-ascertainment of gout diagnosis history in nephrology/dialysis-focused clinical settings.3 This report provides a snapshot of gout in the US dialysis population and offers opportunities to expand on research to improve awareness and care for patients with gout and ESRD.

References

[1]Singh JA, Strand V. Ann Rheum Dis. 2008;67:1310–6.

[2]Singh JA, Cleveland JD. BMC Neph 2019;20:93.

[3]Roughley M, et al. Arthritis Res Ther. 2018;20(1):243.

Disclosure of Interests

Angelo Karaboyas Grant/research support from: Horizon Therapeutics, Junhui Zhao Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brad Marder Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Barry Gorlitsky Consultant of: AstraZenica, Davita, Horizon Therapeutics, Jensen Pharmaceuticals, KidneyAide LLC, vinicius domingues Consultant of: Abbvie, Aurinia Pharma, Exagen, Eli Lilly, Roberto Pecoits-Filho Grant/research support from: Horizon Therapeutics, Bruce Robinson Grant/research support from: Horizon Therapeutics

POS0724 RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER, RETROSPECTIVE, COHORT STUDY

Background

Coronary artery disease (CAD) not only has an increased prevalence but also is a major cause of premature mortality in systemic lupus erythematosus (SLE) [1, 2]. However, information is limited regarding the risk factors for CAD in Chinese patients with SLE.

Objectives

To assess the risk factors for CAD in Chinese patients with SLE.

Methods

This multi-center, retrospective, cohort study included 3778 consecutive SLE patients, with CAD (CAD group) or without a medical history of CAD (control group). CAD was defined as a coronary stenosis ≥50% in any major epicardial coronary vessel detected by coronary angiography or a history of myocardial infarction confirmed by medical records. General parameters, clinical features, laboratory tests and medical therapies were compared between groups, and the risk factors for CAD in SLE were analyzed by logistic regression analysis.

Results

The age at baseline was older, male ratio was higher and body mass index was greater in CAD group (all P<0.001). Traditional CAD risk factors including diabetes mellitus, hypertension, dyslipidemia, family history of CAD and smoking were more common in CAD group (all P<0.001) (Figure 1). SLE Disease Activity Index 2000 was greater (P=0.012), hyperuricemia and elevated C-reactive protein (CRP) were more prevalent (both P<0.001), and an increased corticosteroids’ usage (P=0.018) was detected in CAD group (Table 1). Binary logistic regression analysis showed hyperuricemia (odds ratio: 3.082, 95% confidence interval: 1.283-7.403; P=0.012) and CRP (odds ratio: 7.248, 95% confidence interval: 2.931-17.925; P<0.001) were independent risk factors for CAD in SLE patients.

Table 1.

Comparison of clinical features in SLE patients between CAD group and control group.

ParametersControl group (n=3732)CAD group (n=46)PAge at baseline [years, median (P25, P75)]35.00 (29.00, 45.00)59.50 (50.25, 67.75)<0.001Male, n (%)296 (7.94)11 (23.91)<0.001Disease duration [years, median (P25, P75)]8.00 (4.00, 12.00)10.00 (4.00, 19.00)0.173Body mass index [kg/m2, median (P25, P75)]21.77 (19.63, 24.16)23.50 (22.09, 25.36)<0.001Renal disorder, n (%)1737 (46.57)9 (19.57)<0.001Neurologic disorder, n (%)595 (15.95)3 (6.52)0.082Thrombocytopenia, n (%)859 (23.03)8 (17.39)0.366SLEDAI-2K [median (P25, P75)]3.00 (0.00, 8.00)5.50 (1.50, 14.00)0.012Elevated creatinine, n (%)295 (7.91)10 (21.74)0.002Hyperuricemia, n (%)209 (5.60)16 (34.78)<0.001Elevated ESR, n (%)951 (25.5)22 (47.83)0.001Elevated CRP, n (%)210 (5.63)15 (32.61)<0.001Positive aPL, n (%)734 (19.68)11 (23.91)0.474Corticosteroids, n (%)2752 (73.78)41 (89.13)0.018Immunosuppressants, n (%)2950(79.09)37 (80.43)0.823

Abbreviations: aPL, antiphospholipid antibody; CAD, coronary artery disease; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; SLE, systemic lupus erythematosus; SLEDAI-2K, SLE Disease Activity Index 2000. P <0.05 are shown as italics and bold.

Figure 1.

Comparison of traditional risk factors in SLE patients between CAD group and control group. Abbreviations: CAD, coronary artery disease; SLE, systemic lupus erythematosus. All P<0.001.

Conclusion

Hyperuricemia and CRP are independent risk factors for CAD in SLE patients. This study highlights the association between hyperuricemia, CRP and CAD burden in SLE, and might provide a modifiable perspective on improving SLE outcomes.

References

[1]Gonzalez LA, Alarcon GS. The evolving concept of SLE comorbidities [J]. Expert Rev Clin Immunol, 2017, 13(8): 753-768.

[2]Kostopoulou M, Nikolopoulos D, Parodis I, et al. Cardiovascular Disease in Systemic Lupus Erythematosus: Recent Data on Epidemiology, Risk Factors and Prevention [J]. Curr Vasc Pharmacol, 2020, 18(6): 549-565.

Disclosure of Interests

None declared

LB0005 ORELABRUTINIB, AN IRREVERSIBLE INHIBITOR OF BRUTON’S TYROSINE KINASE (BTK), FOR THE TREATMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): RESULTS OF A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE IB/IIA DOSE-FINDING STUDY

Background

Orelabrutinib is an oral, highly-selective, irreversible inhibitor of Bruton’s tyrosine kinase (BTK). Orelabrutinib has been approved for the treatment of B cell malignancies in China. Two distinct lupus animal models showed significant efficacy of orelabrutinib in reducing disease activity, which supported the clinical development of orelabrutinib in Systemic Lupus Erythematosus (SLE).

Objectives

This phase Ib/IIa, randomized, double-blind, placebo-controlled, dose-finding study aimed to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), preliminary efficacy and biomarkers of orelabrutinib in patients with mild to moderate SLE who received standard of care (SoC) therapy.

Methods

Patients diagnosed with SLE by the ACR classification criteria for ≥ 6 months, who had a SLEDAI-2K score ≥5 at screening, and were autoantibody-positive, were randomized 1:1:1:1 to receive oral orelabrutinib at 50mg, 80mg, 100mg or placebo once daily for 12 weeks, respectively.

Results

This study randomized 60 patients with 55 patients who completed 12-week treatment. Age at baseline was 33.7±9.8 years and 96.7% were female. Baseline disease characteristics were generally balanced across treatment groups. Adverse events (AEs) were reported in 80%, 93.3% and 100% of orelabrutinib treated patients at doses of 50mg, 80mg and 100mg QD respectively versus 85.5% in placebo group. AEs were mostly mild or moderate. Treatment-related SAEs were reported in 3 patients treated with orelabrutinib, only 1 of which was grade 3. No deaths were reported. The plasma exposure of orelabrutinib (AUC and Cmax) was proportionally increased with doses. Nearly complete BTK occupancy was achieved at all dose levels, and the occupancy lasted for 24 hours without any decrease compared to that at 4 hour post-dosing. In all evaluable patients, the SLE Response Index (SRI)-4 response rates at week 12 were 50.0%, 61.5% and 64.3% in patients treated with orelabrutinib at 50mg (n=14), 80mg (n=13) and 100mg (n=14) respectively, compared with 35.7% in patients treated with placebo (n=14), which indicated the trend of dose-dependent improvement. Among the subgroup of patients with SLEDAI-2K≥8 at screening, SRI-4 response occurred in 70%, 70% and 66.7% of patients treated with orelabrutinib at 50mg (n=10), 80mg (n=10) and 100mg (n=9), respectively, compared with 30% who received placebo (n=10). Trends of reduced proteinuria, anti-dsDNA and IgG, total B cells and increased complements C4 were also observed following orelabrutinib treatment.

Conclusion

Orelabrutinib was generally safe and well tolerated in patients with SLE. Preliminary results also suggested encouraging efficacy which supports further development of orelabrutinib in larger and longer trials for SLE.

Table 1.

Efficacy results at week 12.

All Evaluable PatientsPlaceboOrelabrutinibOrelabrutinibOrelabrutinib50 mg80 mg100 mgN=5514141314SRI-4 response, n (%)5 (35.7%)7 (50.0%)8 (61.5%)9 (64.3%)Treatment difference vs. PBO (%)14.3%25.8%28.6%SLEDAI-2K≥8, N=391010109SRI-4 response, n (%)3 (30.0%)7 (70.0%)7 (70.0%)6 (66.7%)Treatment difference vs. PBO (%)40.0%40.0%36.7%

Note: All evaluable patients at week 12 efficacy data were included in the efficacy analysis.

Figure 1.

SRI-4 response rates at week 12.

Disclosure of Interests

Ru Li: None declared, Xiaoxia Zhu: None declared, Shengyun Liu: None declared, Xiao Zhang: None declared, Changhao Xie: None declared, Zili Fu: None declared, Anbin Huang: None declared, Lingyun Sun: None declared, Dongzhou Liu: None declared, Jinxia Zhao: None declared, Lin Wu: None declared, Zhoushuai Qin Employee of: InnoCare Pharma Limited., Sichen Li Employee of: InnoCare pharma Limited., Yaorong Liu Employee of: InnoCare pharma Limited., Zhanguo Li: None declared

POS0749 ANTI-Β2GPI-DOMAIN 1 ANTIBODIES STRATIFY HIGH RISK OF EXTRA-CRITERIA MANIFESTATIONS IN A LARGE PROSPECTIVE CHINESE COHORT OF ANTIPHOSPHOLIPID SYNDROME

Background

Anti-β2GPI-Domain 1 (β2GPI-D1) antibodies are potentially pathogenic in patients with antiphospholipid syndrome (APS), but their clinical associations and diagnostic value were unclear.

Objectives

To evaluate the clinical characteristics of APS patients with anti-β2GPI-D1 positivity, and its utility in diagnosing APS among SLE patients.

Methods

A total of 338 patients were included, of which 169 patients diagnosed with primary APS (PAPS group), 50 with APS secondary to SLE (SAPS group), 209 with SLE (SLE group). Serum anti-β2GPI-D1 IgG was measured using chemiluminescent immunoassay (Inova Company). Extra-criteria manifestations were analyzed, including thrombocytopenia, autoimmune hemolytic anemia, valvular lesions, APS nephropathy, and non-vascular neurological manifestations.

Results

Similar presence of anti-β2GPI-D1 IgG was seen among PAPS (32.80%) and SAPS (32.0%) patients, and 96.4% of those with positive anti-β2GPI-D1 IgG showed triple aPLs positivity. Anti-β2GPI-D1 IgG was significantly associated with recurrent thrombosis before APS diagnosis, microscopic thrombosis (p<0.05), but not with adverse pregnancy events (Figure 1). Notably, patients with extra-criteria manifestations, especially thrombocytopenia and APS nephropathy, showed significantly higher titers in anti-β2GPI-D1 IgG (p<0.05). After a median follow-up of twenty-five months, patients with anti-β2GPI-D1 IgG also showed a tendency of more extra-criteria events (3/55 vs 1/114, p=0.095), but not thrombotic events or adverse pregnancy events. Anti-β2GPI-D1 was positive among 8.13% of the SLE controls, and showed higher specificity (91.9%) in diagnosing SAPS among SLE patients as compared to classic aPLs.

Figure 1.

Conclusion

Anti-β2GPI-D1 IgG had a stronger association with extra-criteria manifestations in APS patients compared to three classic APLs, which properly indicated its pathogenic role of microangiopathy.

Disclosure of Interests

None declared

Probing CP symmetry and weak phases with entangled double-strange baryons

Though immensely successful, the standard model of particle physics does not offer any explanation as to why our Universe contains so much more matter than antimatter. A key to a dynamically generated matter-antimatter asymmetry is the existence of processes that violate the combined charge conjugation and parity (CP) symmetry1. As such, precision tests of CP symmetry may be used to search for physics beyond the standard model. However, hadrons decay through an interplay of strong and weak processes, quantified in terms of relative phases between the amplitudes. Although previous experiments constructed CP observables that depend on both strong and weak phases, we present an approach where sequential two-body decays of entangled multi-strange baryon-antibaryon pairs provide a separation between these phases. Our method, exploiting spin entanglement between the double-strange Ξ- baryon and its antiparticle2 [Formula: see text], has enabled a direct determination of the weak-phase difference, (ξP - ξS) = (1.2 ± 3.4 ± 0.8) × 10-2 rad. Furthermore, three independent CP observables can be constructed from our measured parameters. The precision in the estimated parameters for a given data sample size is several orders of magnitude greater than achieved with previous methods3. Finally, we provide an independent measurement of the recently debated Λ decay parameter αΛ (refs. 4,5). The [Formula: see text] asymmetry is in agreement with and compatible in precision to the most precise previous measurement4.

AB0542 ANTIPHOSPHOLIPID ANTIBODY CARRIERS WITH THROMBOCYTOPENIA COULD BE AN INDEPENDENT PHENOTYPE OF PRIMARY ANTIPHOSPHOLIPID SYNDROME

Background

Among patients with immune thrombocytopenic (ITP), 10-20% of them were found with positive antiphospholipid antibodies (aPLs) but without typical clinical manifestations of antiphospholipid syndrome (APS), especially thrombotic events1.

Objectives

To compare the clinical characteristics and prognosis between aPLs carriers and patients with APS.

Methods

This is a single center prospective cohort study consecutively enrolling thrombocytopenic patients with continuous positive aPLs. Patients developing thrombotic events are classified as the APS group. The exclusion criteria are other underlying connective tissue diseases such as lupus and other causes that might manifest as thrombocytopenia, such as virus infection, hypersplenism, etc.

Results

This cohort included 47 thrombocytopenic patients with continuous positive aPLs and 55 with diagnosed primary APS. The proportion of thrombotic high risk demographic characteristics including smoking, hypertension, and higher level of homocysteine are higher in the APS group (p = 0.03, 0.04, 0.03, respectively). The prevalence of nephropathy was significantly higher in patients with diagnosed APS [0 vs 7 (12.7%), p =0.01]. Laboratory results and antibody profiles are presented in Table 1. The platelet count of aPLs carriers at admission was lower than APS patients [26×109/L (9×109/L, 46×109/L) vs 64×109/L (24×109/L, 89×109/L), p = 0.0002]. The proportion of positive anti-β2-glycoprotein I, anticardiolipin and lupus anticoagulant separately was similar, but triple aPLs positivity is more common in primary APS patients with thrombocytopenia [24 (51.1%) vs 40 (72.7%), p = 0.04]. There is no significant differences over the complement levels between the two groups [p = 0.2 for low complement 3 (C3), p = 0.8 for low C4]. Regarding the treatment response, the complete response (CR) rate is similar between aPLs carriers and primary APS patients with thrombocytopenia (p = 0.2). Nonetheless, the proportion of response, no response and relapse differed significantly between the two groups [13 (27.7%) vs 4 (7.3%), p < 0.0001; 5 (10.6%) vs 8 (14.5%), p < 0.0001; 5 (10.6%) vs 8 (14.5%), p < 0.0001, respectively]. In Kaplan-Meier analysis (Figure 1), primary APS patients had significantly more thrombotic events than aPLs carriers (p = 0.0006). aPLs carriers with thrombocytopenia share similar clinical manifestations with primary APS patients but hardly develop thrombotic events.

Figure 1.

Kaplan-Meier analysis of thrombotic events.

aPLs: antiphospholipid antibodies; PAPS: primary antiphospholipid syndrome.

Table 1.

Baseline characteristics of laboratory results and antibody profiles.

CharacteristicsaPLs carriers (n=47)Primary APS with thrombocytopenia (n=55)p-valueLaboratory results, median (Q1, Q3)Platelet count (×109/L)26 (9,46)64 (24, 89)0.0002*hsCRP (mg/L)1.39 (0.475, 2.845)1.08(0.41, 2.565)0.8ESR (mm/h)5.5 (2.75, 10.75)7.5 (5, 14.25)0.06LDH (U/L)221 (176, 252)228 (184.8, 282)0.3Low C3, n (%)3 (6.4)9 (16.4)0.2Low C4, n (%)5 (10.6)8 (14.5)0.8Antibody profiles, n (%)Positive aCL45 (95.7)33 (69.1)0.3Positive Anti-β2GP I38 (80.9)48 (87.3)0.5Positive LA35 (74.5)50 (90.9)0.05Triple positivity24 (51.1)40 (72.7)0.04*Positive Coombs,6 (12.8)10 (18.2)0.4

*p < 0.05, statistically significant. aPLs: antiphospholipid antibodies; APS: antisphopholipid syndrome; Q1/3: quantile 1/3; hsCRP: hypersensitive C-reactive protein; ESR: erythrocyte sedimentation rate; LDH: lactate dehydrogenase; C3/4: complement 3/4; aCL: anticardiolipin; GP: glycoprotein; LA: lupus anticoagulant.

Conclusion

In the absence of other high risk factor for thrombosis, Thrombocytopenia could be an independent and long-lasting clinical phenotype for aPLs carriers.

References

[1]Bidot CJ, Jy W, Horstman LL, Ahn ER, Yaniz M, Ahn YS. Antiphospholipid antibodies (APLA) in immune thrombocytopenic purpura (ITP) and antiphospholipid syndrome (APS). Am J Hematol. Jun 2006;81(6):391-6.

Disclosure of Interests

None declared

AB0182 THE PROFILE OF POOR PROGNOSTIC FACTORS BASED ON EULAR RECOMMENDATIONS IN CHINESE RA PATIENTS: A SINGLE-CENTER OBSERVATIONAL STUDY

Background

Despite the constant updating of rheumatoid arthritis (RA) treatment strategies, whether poor prognostic factors (PPFs) can guide RA treatment is still controversial. There are limited data about the presence of PPFs in Chinese RA patients.

Objectives

To describe the profile of PPFs based on European League Against Rheumatism (EULAR) recommendations in Chinese RA patients, and explore the significance of these factors in adjusting treatment therapy.

Methods

In this real-world study, RA patients were enrolled from 2012 to 2020. The baseline characteristics and prognostic factors based on EULAR recommendations include acute-phase reactant levels, rheumatoid factor (RF), anti-cyclic citrullinate peptide (anti-CCP antibody), swollen joint counts (SJC), early bone erosions, and responses to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) at month 3 or month 6 were collected. Disease activity was assessed by disease activity score of 28 joints-erythrocyte sedimentation rate (DAS28-ESR), DAS28-C-reactive protein (DAS28-CRP), simple disease activity index (SDAI), and clinical disease activity index (CDAI). The association of different factors was represented by a Venn diagram. The number of patients presenting with different combinations of prognostic factors was graphically displayed by UpSetR. Correlation between binary variables was analyzed by the Chi-square test.

Results

1252 registered RA patients were enrolled. 901/1252 (72.0%) patients had elevated ESR or CRP and 1027/1164 (88.2%) patients had positive RF or anti-CCP antibody. 397/1252 (31.7%) patients had ors was graphicas. 166/444 (37.0%) patients had early bone erosions, which usually coexisted with other PPFs. 394 (34.4%) of the 1105 patients who received csDMARD therapy as prescribed had persistent moderate or high disease activity (MDA/HDA). Failure of two or more csDMARDs was found in 245 (22.2%) patients. 99% of RA patients had at least one PPF. Patients with MDA/HDA usually coexisted with other PPF. MDA/HDA was significantly correlated with elevated ESR/CRP or high SJC and is not correlated with positive RF/anti-CCP antibody or early bone erosion.

Conclusion

PPFs are prevalent in RA patients in real-world data. It is inappropriate to guide treatment strategies just based on the presence or absence of PPFs. The categories of PPFs should be simplified and the role of different combinations of PPFs in guiding treatment therapies remains to be explored.

References

[1]Hu, H., et al., Burden of rheumatoid arthritis from a societal perspective: A prevalence-based study on the cost of this illness for patients in China. International journal of rheumatic diseases, 2018. 21(8): p. 1572-1580.

[2]Muñoz-Fernández, S., et al., Use of prognostic factors of rheumatoid arthritis in clinical practice and perception of their predictive capacity before and after exposure to evidence. Rheumatology international, 2018. 38(12): p. 2289-2296.

[3]Koga, T., et al., Prognostic Factors Toward Clinically Relevant Radiographic Progression in Patients With Rheumatoid Arthritis in Clinical Practice: A Japanese Multicenter, Prospective Longitudinal Cohort Study for Achieving a Treat-to-Target Strategy. Medicine, 2016. 95(17): p. e3476.

[4]Smolen, J.S., et al., EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the rheumatic diseases, 2020. 79(6): p. 685-699.

[5]Fraenkel, L., et al., 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis care & research, 2021. 73(7): p. 924-939.

Figure 1.

Coexistence of 6 PPFs including positive RF/anti-CCP antibody, elevated ESR/CRP, high SJC, persistent MDA/HDA, failure of two or more csDMARDs, and early bone erosion.

Acknowledgements

This study was based on the contributions of all colleagues in our department during the outpatient visits over the past decade.

Disclosure of Interests

None declared

Observation of B 0 → ψ (2S)K S 0 π + π - and B s 0 → ψ (2S)K S 0 decays

Using a data sample of s = 13 TeV proton-proton collisions collected by the CMS experiment at the LHC in 2017 and 2018 with an integrated luminosity of 103 fb - 1 , the B s 0 → ψ ( 2S ) K S 0 and B 0 → ψ ( 2S ) K S 0 π + π - decays are observed with significances exceeding 5 standard deviations. The resulting branching fraction ratios, measured for the first time, correspond to B ( B s 0 → ψ ( 2S ) K S 0 ) / B ( B 0 → ψ ( 2S ) K S 0 ) = ( 3.33 ± 0.69 ( stat ) ± 0.11 ( syst ) ± 0.34 ( f s / f d ) ) × 10 - 2 and B ( B 0 → ψ ( 2S ) K S 0 π + π - ) / B ( B 0 → ψ ( 2S ) K S 0 ) = 0.480 ± 0.013 ( stat ) ± 0.032 ( syst ) , where the last uncertainty in the first ratio is related to the uncertainty in the ratio of production cross sections of B s 0 and B 0 mesons, f s / f d .

OP0145 VALIDATION OF 3 PREDICTION MODELS FOR THROMBOSIS IN ANTIPHOSPHOLIPID SYNDROME PATIENTS BASED ON A PROSPECTIVE COHORT

Background

Antiphospholipid syndrome (APS) is a rare and complicated acquired autoimmune thrombophilia characterized by arterial/venous thrombosis and/or recurrent pregnancy loss. Thrombosis is the first cause of death of APS patients. However, there has been no generally acknowledged model to predict thrombosis. Only adjusted global APS score (aGAPSS) was developed for prediction but based on a cross-sectional study1. Additionally, the predictive ability of Padua score and Caprini score has not been validated in APS patients.

Objectives

Aim to validate the ability of aGAPSS, Padua score and Caprini score to predict thrombosis in APS patients basing on a prospective cohort.

Methods

Consecutive APS patients who fulfilled the 2006 Sydney Revised Classification Criteria for APS, referred to Peking Union Medical College Hospital were included. Clinical data, aGAPSS, Padua score, and Caprini score at the time of diagnosis were collected. Patients with less than 1-year follow-up were excluded. Harrell c-index and calibration curve were used to validate the prediction models.

Results

A total of 302 patients were enrolled in this study. The mean age was 32±12 years old, and 202 (66.9%) were female (Table 1). Patients were followed up for a median of 36 months. During the follow-up period, there were 62 thrombotic events, with 40 (13.25%) venous and 22 (7.28%) arterial thrombosis. The 1-, 3-, and 5-year thrombosis risks were 8.9%, 16.9%, and 21.3% respectively (Figure 1A). The Harrell c-indexes for predicting thrombosis of aGAPSS, Padua score, and Caprini score were 0.56 (95% confidence interval [CI], 0.52-0.60), 0.58 (95% CI, 0.54-0.62), and 0.61 (95%CI, 0.57-0.65) respectively. The model predicting venous thrombosis with the best discrimination was Padua score whose Harrell c-index was 0.64 (95% CI, 0.60-0.68), and the model predicting arterial thrombosis with the best discrimination was Caprini score whose Harrell c-index was 0.62 (95%CI, 0.56-0.68). The calibration curves illustrated that the calibration for predicting thrombosis within 3 years after diagnosis of all the 3 models was poor (Figure 1B-D).

Table 1.

Demographic characteristics and clinical manifestations at baseline

N=302N=302Age, mean±SD32±12Clinical manifestationsFemale, n (%)202 (66.9)Venous thrombosis, n (%)156 (51.7)Disease duration (months), median (Q1, Q3)11.50 (3.00, 44.00)Deep venous thrombosis, n (%)112 (37.1)Secondary to SLE, n (%)73 (24.2)Pulmonary embolism, n (%)70 (23.2)Smoking history, n (%)63 (20.9)Visceral venous thrombosis, n (%)12 (4.0)Hypertension, n (%)59 (19.5)Cranial venous sinus thrombosis, n (%)13 (4.3)Hyperlipidemia, n (%)151 (50.0)Arterial thrombosis, n (%)113 (37.4)BMI, mean±SD23.96±3.89Stroke/TIA, n (%)62 (20.5)LA positive, n (%)241 (79.8)Myocardial infarction, n (%)14 (4.6)aCL positive, n (%)208 (68.9)Arterial thrombosis of lower extremities, n (%)22 (7.3)aβ2GPI positive, n (%)242 (80.1)Visceral arterial thrombosis, n (%)18 (6.0)Triple aPL positive, n (%)165 (54.6)Thrombocytopenia, n (%)118 (39.1)Obstetric manifestations, n (%)N=202Valvular lesions, n (%)24 (7.9)Pregnancy morbidity103 (51.0)Early miscarriages (<10 weeks)13 (6.4)Fetal death (>= 10 weeks)68 (33.7)Preeclampsia, eclampsia and placental dysfunction36 (17.8)Figure 1.

The Kaplan-Meier curve and the calibration curve of 3 prediction models within 3 years after diagnosis. A: The Kaplan-Meier curve of venous, arterial and both venous and arterial thrombosis. B: The calibration curves for venous thrombosis. C: The calibration curves for arterial thrombosis. D: The calibration curves for both venous and arterial thrombosis.

Conclusion

The ability of aGAPSS, Padua score and Caprini score to predict thrombosis in APS patients is relatively poor. Construction of a new prediction model specifically for APS patients is required to help with early prevention and treatment.

References

[1]Sciascia, S., et al., GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology (Oxford), 2013. 52(8): p. 1397-403.

Disclosure of Interests

None declared

Measurements of Proton High-Order Cumulants in sqrt[s_{NN}]=3 GeV Au+Au Collisions and Implications for the QCD Critical Point

We report cumulants of the proton multiplicity distribution from dedicated fixed-target Au+Au collisions at sqrt[s_{NN}]=3.0  GeV, measured by the STAR experiment in the kinematic acceptance of rapidity (y) and transverse momentum (p_{T}) within -0.5<y<0 and 0.4<p_{T}<2.0  GeV/c. In the most central 0%-5% collisions, a proton cumulant ratio is measured to be C_{4}/C_{2}=-0.85±0.09 (stat)±0.82 (syst), which is 2σ below the Poisson baseline with respect to both the statistical and systematic uncertainties. The hadronic transport UrQMD model reproduces our C_{4}/C_{2} in the measured acceptance. Compared to higher energy results and the transport model calculations, the suppression in C_{4}/C_{2} is consistent with fluctuations driven by baryon number conservation and indicates an energy regime dominated by hadronic interactions. These data imply that the QCD critical region, if created in heavy-ion collisions, could only exist at energies higher than 3 GeV.

Measurements of _{Λ}^{3}H and _{Λ}^{4}H Lifetimes and Yields in Au+Au Collisions in the High Baryon Density Region

We report precision measurements of hypernuclei _{Λ}^{3}H and _{Λ}^{4}H lifetimes obtained from Au+Au collisions at sqrt[s_{NN}]=3.0  GeV and 7.2 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider, and the first measurement of _{Λ}^{3}H and _{Λ}^{4}H midrapidity yields in Au+Au collisions at sqrt[s_{NN}]=3.0  GeV. _{Λ}^{3}H and _{Λ}^{4}H, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221±15(stat)±19(syst)  ps for _{Λ}^{3}H and 218±6(stat)±13(syst)  ps for _{Λ}^{4}H. The p_{T}-integrated yields of _{Λ}^{3}H and _{Λ}^{4}H are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of _{Λ}^{4}H is different for 0%-10% and 10%-50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the _{Λ}^{3}H yield well, while underestimating the _{Λ}^{4}H yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured _{Λ}^{3}H and _{Λ}^{4}H yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.

MiR-572 promotes the development of non-small cell lung cancer by targeting KLF2

OBJECTIVE

The aim of this study was to uncover the role of miR-572 in regulating proliferative and migratory abilities in non-small cell lung cancer (NSCLC) and the possible mechanism.

PATIENTS AND METHODS

Expression levels of miR-572 in 46 matched NSCLC and paracancerous samples were detected. The relationship between miR-572 level and clinical features of NSCLC was analyzed. Subsequently, the regulatory effects of miR-572 on proliferative and migratory abilities in lung cancer cells were assessed by functional experiments. Finally, the downstream genes of miR-572 were tested by luciferase assay, and their functions in the development of NSCLC were finally explored by rescue experiments.

RESULTS

It was found that miR-572 was upregulated in NSCLC samples. High level of miR-572 predicted high rates of lymphatic and distant metastases, as well as poor prognosis in NSCLC. Besides, the knockdown of miR-572 suppressed proliferative and migratory abilities in A549 and SPC-A1 cells. KLF2 was identified to be the downstream gene of miR-572, which was involved in the regulation of NSCLC phenotypes influenced by miR-572.

CONCLUSIONS

MiR-572 is closely linked to metastasis and prognosis in NSCLC patients, and it promotes the malignant development of NSCLC via targeting KLF2.

Dynamical Synthesis of ^{4}He in the Scission Phase of Nuclear Fission

In the exothermic process of fission decay, an atomic nucleus splits into two or more independent fragments. Several aspects of nuclear fission are not properly understood, in particular the formation of the neck between the nascent fragments, and the subsequent mechanism of scission into two or more independent fragments. Using an implementation of time-dependent density functional theory, based on a relativistic energy density functional and including pairing correlations, we analyze the final phase of the process of induced fission of ^{240}Pu, and show that the timescale of neck formation coincides with the assembly of two α-like clusters. Because of its much larger binding energy, the dynamical synthesis of ^{4}He in the neck predominates over other light clusters, e.g., ^{3}H and ^{6}He. At the instant of scission the neck ruptures exactly between the two α-like clusters, which separate because of the Coulomb repulsion and are eventually absorbed by the two emerging fragments. The mechanism of light charged clusters formation at scission could also be linked to ternary fission.

[Study of clinical characteristics in patients with gp210 antibody-positive primary biliary cholangitis]

Objective: To analyze the clinical characteristics and prognostic value of liver function in a large samples of patients with anti-glycoprotein 210 (gp210 antibody) positive primary biliary cholangitis (PBC). Methods: A retrospective study was performed on 931 PBC cases in Beijing You'an Hospital affiliated to Capital Medical University from 2010 to 2019. According to the detection of gp210 antibody, 318 cases were divided into gp210 antibody positive group (positive group) and 613 cases were divided into gp210 antibody negative group (negative group). The differences in demographic, medical history, clinical indicators, B-ultrasound and pathological indicators as well as the histopathological basis were compared between the two groups. SPSS 16.0 software was used for statistical analysis. Measurement data were analyzed by t-test or rank sum test, and enumeration data by χ² test. Multivariate analysis was used for logistic test, and and survival analysis was used for prognosis. Results: The positive and the negative groups were compared. The ratio of male to female was significantly higher in positive than negative group (1:5.35 vs. 1:9.73, P＜0.05), and the difference was statistically significant. The proportion of hormone use in history of past diagnosed and treated was higher in positive than negative group (12.9% vs. 3.47%, P＜0.05), and the difference was statistically significant. The detection of biochemical indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT) were higher in positive than the negative group (51.1 U/L vs. 41.1 U/L, 62.6 U/L vs. 49.6 U/L, 24.1 μmol/L vs. 17.9 μmol/L, 228.3 U/L vs. 169.6 U/L, 203.9 U/L vs. 147.6 U/L), (P＜0.05), and the differences were statistically significant. Antinuclear antibody (ANA)-positive rate, high titer ratio and immunoglobulin G (IgG) levels were higher in positive than negative group (95.2% vs. 81.6%, 69.7% vs. 48.8%, 17.2 g/L vs. 16.2 g/L), (P＜0.05), and the differences were statistically significant. The incidence of liver failure was higher in positive than negative group (P＜0.05). CK7 and inflammation score were higher in positive group than negative group in liver histopathological observations (0.83±0.53 vs. 0.28±0.47; 1.06±0.39 vs. 0.54±0.65), (P＜0.05), and the differences were statistically significant. Conclusion: The illness condition of patients with gp210 antibody positive PBC is more severe than patients with gp210 antibody negative PBC, and the incidence of liver failure is significantly increased. Cholangiocytes may be the histopathological basis of the clinical characteristics of gp210 antibody positive PBC patients.

[Prevalence and frequencies of human papilloma virus types in adenocarcinoma in situ of the uterine cervix]

Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group (P<0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.

Observation of the Singly Cabibbo Suppressed Decay Λ_{c}^{+}→nπ^{+}

The singly Cabibbo-suppressed decay Λ_{c}^{+}→nπ^{+} is observed for the first time with a statistical significance of 7.3σ by using 3.9  fb^{-1} of e^{+}e^{-} collision data collected at center-of-mass energies between 4.612 and 4.699 GeV with the BESIII detector at BEPCII. The branching fraction of Λ_{c}^{+}→nπ^{+} is measured to be (6.6±1.2_{stat}±0.4_{syst})×10^{-4}. By taking the upper limit of branching fractions of Λ_{c}^{+}→pπ^{0} from the Belle experiment, the ratio of branching fractions between Λ_{c}^{+}→nπ^{+} and Λ_{c}^{+}→pπ^{0} is calculated to be larger than 7.2 at the 90% confidence level, which disagrees with most predictions of the available phenomenological models. In addition, the branching fractions of the Cabibbo-favored decays Λ_{c}^{+}→Λπ^{+} and Λ_{c}^{+}→Σ^{0}π^{+} are measured to be (1.31±0.08_{stat}±0.05_{syst})×10^{-2} and (1.22±0.08_{stat}±0.07_{syst})×10^{-2}, respectively, which are consistent with previous results.

Search for low-mass dilepton resonances in Higgs boson decays to four-lepton final states in proton-proton collisions at s = 13 TeV

A search for low-mass dilepton resonances in Higgs boson decays is conducted in the four-lepton final state. The decay is assumed to proceed via a pair of beyond the standard model particles, or one such particle and a Z boson. The search uses proton-proton collision data collected with the CMS detector at the CERN LHC, corresponding to an integrated luminosity of 137 fb - 1 , at a center-of-mass energy s = 13 TeV . No significant deviation from the standard model expectation is observed. Upper limits at 95% confidence level are set on model-independent Higgs boson decay branching fractions. Additionally, limits on dark photon and axion-like particle production, based on two specific models, are reported.

Quasi-isentropic compression of LiH above 400 GPa using magnetocumulative generator

The knowledge of high-pressure behavior of LiH is significant for the validation of fundamental theoretical models and applications in thermonuclear materials and potential energy supplies. The compressibility of ⁷LiH under isentropic compression at high pressure was investigated experimentally and theoretically. The experimental technique for quasi-isentropic compression with low-density materials was developed using the magnetocumulative generator CJ-100 and x-ray flash radiography. The x-ray images and extracted interface of the sample target in dynamic flash radiography experiments were obtained. According to each interface size of the target both before and after compression, the compression ratio of ⁷LiH and reference material aluminum was obtained. The density of the reference and using its known isentropic curve provide the pressure in the reference. The pressure in ⁷LiH was deduced from the pressure in the reference and using the calculated gradient correction factor. The quasi-isentropic data point at 438 GPa was obtained experimentally. A semiempirical three-term complete equation of state was constructed and validated for ⁷LiH using the theory of Mie-Grüneisen-Debye with experimental data from the literature. The quasi-isentrope data point is reasonably consistent with the theoretical results. The quasi-isentropic experimental techniques and results broaden the existing research scope and are practical and helpful to further validate theoretical models in the future.

Probing the Gluonic Structure of the Deuteron with J/ψ Photoproduction in d+Au Ultraperipheral Collisions

Understanding gluon density distributions and how they are modified in nuclei are among the most important goals in nuclear physics. In recent years, diffractive vector meson production measured in ultraperipheral collisions (UPCs) at heavy-ion colliders has provided a new tool for probing the gluon density. In this Letter, we report the first measurement of J/ψ photoproduction off the deuteron in UPCs at the center-of-mass energy sqrt[s_{NN}]=200  GeV in d+Au collisions. The differential cross section as a function of momentum transfer -t is measured. In addition, data with a neutron tagged in the deuteron-going zero-degree calorimeter is investigated for the first time, which is found to be consistent with the expectation of incoherent diffractive scattering at low momentum transfer. Theoretical predictions based on the color glass condensate saturation model and the leading twist approximation nuclear shadowing model are compared with the data quantitatively. A better agreement with the saturation model has been observed. With the current measurement, the results are found to be directly sensitive to the gluon density distribution of the deuteron and the deuteron breakup process, which provides insights into the nuclear gluonic structure.

Teacher-to-parent communication and vision care-seeking behaviour among primary school students

INTRODUCTION

To determine the associations between teacher-to-parent communication and vision care-seeking behaviour among students.

METHODS

This cross-sectional study included 19 934 students from 252 primary schools in two prefectures in western China. Information regarding the sampled students was collected through questionnaires and vision examinations. Eligible students with uncorrected refractive error were allocated to four groups according to whether and how parents were informed about vision problems in their children: uninformed, informed by only teachers or only students, or informed by both. The relationship between teacher-to-parent communication and vision care-seeking behaviour was analysed by multiple logistic regression.

RESULTS

Among valid responses (n=2922) analysed, 42.3% (n=1235) of parents were not informed about vision problems in their children. Teacher-to-parent communication enabled 35.9% (n=1050) of parents to learn about vision problems in their children. When only teachers informed parents, the odds of students having refraction examinations (odds ratio [OR]=1.499; P=0.002) and spectacles ownership (OR=1.755; P=0.002) were significantly higher than for students in the uninformed group. When both students and teachers informed parents, the odds of students having refraction examinations (OR=5.565; P<0.001) and spectacles ownership (OR=7.935; P<0.001) were highest.

CONCLUSIONS

Knowledge of vision problems is an essential step in vision care for students. Teacherto- parent communication concerning vision problems is positively associated with the rate of vision care-seeking behaviour. Teacher-to-parent communication provides an important route for parents to learn about vision problems in their children.

Using Z Boson Events to Study Parton-Medium Interactions in Pb-Pb Collisions

The spectra measurements of charged hadrons produced in the shower of a parton originating in the same hard scattering with a leptonically decaying Z boson are reported in lead-lead nuclei (Pb-Pb) and proton-proton (pp) collisions at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Both Pb-Pb and pp data sets are recorded by the CMS experiment at the LHC and correspond to an integrated luminosity of 1.7  nb^{-1} and 320  pb^{-1}, respectively. Hadronic collision data with one reconstructed Z boson candidate with the transverse momentum p_{T}>30  GeV/c are analyzed. The Z boson constrains the initial energy and direction of the associated parton. In heavy ion events, azimuthal angular distributions of charged hadrons with respect to the direction of a Z boson are sensitive to modifications of the in-medium parton shower and medium response. compared to reference data from pp interactions, the results for central Pb-Pb collisions indicate a modification of the angular correlations. The measurements of the fragmentation functions and p_{T} spectra of charged particles in Z boson events, which are sensitive to medium modifications of the parton shower longitudinal structure, are also reported. Significant modifications in central Pb-Pb events compared to the pp reference data are also found for these observables.

[Research advances on the application of stem cells in sweat gland regeneration]

Sweat gland is one of the important appendage organs of the skin, which plays an important role in thermoregulation and homeostasis maintenance. Sweat glands are damaged and unable to self-repair after burns, resulting in perspiration disorders eventually. However, current clinical strategies cannot restore the function of the damaged sweat glands effectively. Therefore, it is urgent to seek treatments that can promote the regeneration of sweat glands and restore their normal functions. Stem cells have extensive sources, low immunogenicity, high proliferation capacity, and multi-directional differentiation potential, which have become a focus in the field of regenerative medicine. In recent years, a variety of stem cells have been induced to differentiate into sweat gland-like tissue with certain secretory function, which provides treatment direction for sweat gland regeneration after burns in clinic. This article reviews the recent research advances on the application of stem cells in sweat gland regeneration from the perspectives of the manner by which stem cells transform into sweat gland cells in different environments and their influencing factors.

Cohesive properties of PbBi/Fe3O4 and PbBi/(Fe,Cr)3O4 interfaces

First principles calculations reveal that the effects of PbBi on the cohesive properties of Fe₃O₄ and (Fe,Cr)₃O₄: PbBi can reduce the cohesive strength of the oxides, and the contents of O and Cr on the O-terminated oxide side play a significant role in the cohesive properties of the PbBi/Fe₃O₄ and PbBi/(Fe,Cr)₃O₄ interfaces. Specifically, the performance of oxidation decreases more significantly under the conditions of insufficient oxygen, and a high ratio of Cr of the subsurface of oxides can lead to the reduction of the cohesive properties of O-terminated interfaces. Calculations also show that the Pb-O-terminated interfaces are energetically favorable and are more stable than the Bi-O-terminated surfaces due to the strong bond of Pb-O, while the Bi-Cr and Bi-Fe interfaces are more stable than the Pb-Cr and Pb-Fe interfaces. Moreover, it is found that the stability and cohesion of the PbBi/Fe₃O₄ and PbBi/(Fe,Cr)₃O₄ interfaces will decrease when the oxygen concentration is insufficient or the degree of wetting of PbBi of oxides is low, and the PbBi/Fe₃O₄ interface is more sensitive to these conditions. The bond-dissociation energies and electronic structures provide a deep understanding of various interface properties, and the obtained results are in good agreement with experimental measurements in the literature.

Search for strongly interacting massive particles generating trackless jets in proton-proton collisions at s = 13 TeV

A search for dark matter in the form of strongly interacting massive particles (SIMPs) using the CMS detector at the LHC is presented. The SIMPs would be produced in pairs that manifest themselves as pairs of jets without tracks. The energy fraction of jets carried by charged particles is used as a key discriminator to suppress efficiently the large multijet background, and the remaining background is estimated directly from data. The search is performed using proton-proton collision data corresponding to an integrated luminosity of 16.1 fb - 1 , collected with the CMS detector in 2016. No significant excess of events is observed above the expected background. For the simplified dark matter model under consideration, SIMPs with masses up to 100 GeV are excluded and further sensitivity is explored towards higher masses.

[Progress in research of safety, efficiency and vaccination status of influenza vaccine in populations at high risk]

This paper reviews the domestic and foreign studies published in 2020 on the application of influenza vaccine in populations at high risk. The importance of influenza vaccination in population at high risk has been proved by larger sample, multicentre, high-quality evidence-based studies. Influenza vaccination is the most cost-effective measure to prevent influenza. However, the coverage rate of influenza vaccine is very low in China, it is necessary to strengthen the health education to promote influenza vaccination in different populations. It is recommended to give influenza vaccination to the population in whom influenza vaccination has been proven safe and effective before influenza season. Research of the safety, efficiency and cost-effectiveness of influenza vaccine should be accelerated for the populations in whom such data are lacking or insufficient.

[Analysis of the characteristics of MRI T2 value changes of the muscles around the knee joint before and after the race in amateur marathon runners based on T2 mapping]

Objective: To evaluate the characteristics of MRI T₂ value changes of muscles around the knee joint in amateur marathon athletes based on T₂ mapping. Methods: A total of 12 amateur marathon runners (5 males and 7 females) were recruited as the marathon group, aged from 21 to 37(27.5±5.4) years. MRI examination of bilateral knee joint was performed one week before the race, within 12 hours after the race and two months after the race, respectively. Fifteen healthy volunteers (5 males and 10 females) were recruited as the control group, aged from 24 to 27(24.9±1.0) years, and underwent MRI examination of both knee joints. The T₂ mapping imaging sequence was used to measure the T₂ values of the sartorius, vastus medialis, biceps femoris, semimembranosus, medial head of gastrocnemius and lateral gastrocnemius head on the post-processing platform, and analyzed the marathon group before and after the race. The differences in the T₂ value of each muscle of the marathon group before and after the race within 12 hours, before and 2 months after the race, and between the control group and the marathon group before the marathon were analyzed. Results: All subjects had not knee joint pain during the examination. Routine MRI examination showed that there was no obvious abnormality in the shape and signal of the muscles around the knee joint. The T₂ value of the semimembranosus [(34.3±2.8) ms vs (35.5±2.5) ms, P=0.008], medial head of gastrocnemius [(34.1±3.4) ms vs (37.7±3.1) ms,P<0.001] and lateral head of gastrocnemius [(35.2±2.9) ms vs (37.2±3.9) ms,P=0.011] increased after the competition compared with that of pre-competition in the marathon group, while the T₂ value of the remaining muscles showed no significant difference compared with that of pre-competition(P>0.05). At the follow-up of 2 months, the T₂ value of semimembranosus remains higher than before the marathon [(34.3±2.8) ms vs (35.4±2.5) ms,P=0.043], and the T₂ value of the medial head of the gastrocnemius and lateral head of gastrocnemius showed no statistically difference compared with pre-competition (P>0.05). Compared with the control group, the T₂ value of the lateral head of the gastrocnemius in the marathon group was decreased [(35.3±3.0) ms vs (38.5±4.1) ms,P=0.007]. There was no significant difference in the T₂ value of the remaining muscles in the marathon group (P>0.05). Conclusions: After the marathon, the changes in the T₂ value of the muscles around the knee joint is reversible. T₂ mapping imaging sequence can indirectly reflect the changes of skeletal muscle microstructure to a certain extent.

Search for the Chiral Magnetic Effect via Charge-Dependent Azimuthal Correlations Relative to Spectator and Participant Planes in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

The chiral magnetic effect (CME) refers to charge separation along a strong magnetic field due to imbalanced chirality of quarks in local parity and charge-parity violating domains in quantum chromodynamics. The experimental measurement of the charge separation is made difficult by the presence of a major background from elliptic azimuthal anisotropy. This background and the CME signal have different sensitivities to the spectator and participant planes, and could thus be determined by measurements with respect to these planes. We report such measurements in Au+Au collisions at a nucleon-nucleon center-of-mass energy of 200 GeV at the Relativistic Heavy-Ion Collider. It is found that the charge separation, with the flow background removed, is consistent with zero in peripheral (large impact parameter) collisions. Some indication of finite CME signals is seen in midcentral (intermediate impact parameter) collisions. Significant residual background effects may, however, still be present.

Measurement of the Inclusive and Differential Higgs Boson Production Cross Sections in the Decay Mode to a Pair of τ Leptons in pp Collisions at sqrt[s]=13 TeV

Measurements of the inclusive and differential fiducial cross sections of the Higgs boson are presented, using the τ lepton decay channel. The differential cross sections are measured as functions of the Higgs boson transverse momentum, jet multiplicity, and transverse momentum of the leading jet in the event, if any. The analysis is performed using proton-proton collision data collected with the CMS detector at the LHC at a center-of-mass energy of 13  TeV and corresponding to an integrated luminosity of 138  fb^{-1}. These are the first differential measurements of the Higgs boson cross section in the final state of two τ leptons. In final states with a large jet multiplicity or with a Lorentz-boosted Higgs boson, these measurements constitute a significant improvement over measurements performed in other final states.

Joint Determination of Reactor Antineutrino Spectra from ^{235}U and ^{239}Pu Fission by Daya Bay and PROSPECT

A joint determination of the reactor antineutrino spectra resulting from the fission of ^{235}U and ^{239}Pu has been carried out by the Daya Bay and PROSPECT Collaborations. This Letter reports the level of consistency of ^{235}U spectrum measurements from the two experiments and presents new results from a joint analysis of both data sets. The measurements are found to be consistent. The combined analysis reduces the degeneracy between the dominant ^{235}U and ^{239}Pu isotopes and improves the uncertainty of the ^{235}U spectral shape to about 3%. The ^{235}U and ^{239}Pu antineutrino energy spectra are unfolded from the jointly deconvolved reactor spectra using the Wiener-SVD unfolding method, providing a data-based reference for other reactor antineutrino experiments and other applications. This is the first measurement of the ^{235}U and ^{239}Pu spectra based on the combination of experiments at low- and highly enriched uranium reactors.

[Initial clinical experience of left bundle branch pacing after transcatheter aortic valve implantation]

Objective: To investigate the efficacy and safety of left bundle branch pacing(LBBP) in patients after transcatheter aortic valve implantation (TAVI). Methods: This is a retrospective study. A total of 35 patients underwent TAVI and received pacemaker implantation from January 2018 to December 2020 in Beijing Fuwai Hospital were enrolled. Patients were divided into LBBP group (n=12) and right ventricular apex pacing (RVAP) group (n=23) according to the pacing position. The success rate of operation in LBBP group was calculated, and the occurrence of complications were observed, and the parameters of pacemaker were measured on the 3rd day and 1, 3 and 6 months after operation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and ECG indexes were compared between the two groups on the 3rd day and 1, 3, and 6 months after pacemaker implantation. Result: A total of 35 patients were included, The age was (76.4±7.7) years, including 19 males (54.3%). The procedure time ((86.58±17.10)min vs. (68.74±9.18)min, P<0.001) and fluoroscopy duration ((20.08±4.44)min vs. (17.00±2.26)min, P<0.001) were significantly longer in LBBP group compared with RVAP group. The operation success rate of LBBP group was 11/12. There was no serious operation related complications such as pneumothorax, hemothorax, electrode dislocation, infection, and lower limb bleeding. The patients were followed up for 7.43 (5.21, 9.84) months. The programmed parameters of pacemaker were in the ideal range and stable during follow-up. At 3 and 6 months after operation, the left ventricular ejection fraction in LBBP group was higher than that in RVAP Group (at 3 months: (60.75±2.89)% vs. (57.35±3.33)%, P=0.004; at 6 months: (63.17±3.33)% vs. (56.17±3.97)%, P<0.001), NT-proBNP values was lower in LBBP group than that in RVAP Group (at 3 months: 822 (607, 1 150)ng/L vs. 1 052 (902, 1 536)ng/L, P=0.006; at 6 months: 440 (330,679)ng/L vs. 783 (588, 1 023)ng/L, P=0.001). At 1, 3 and 6 months after operation, the QRS duration was shorter in LBBP group than that in RVAP group (1 month: 99 (97, 107)ms vs. 126(124, 130)ms, P<0.001; 3 months: 98(96, 105)ms vs. 129(128, 133)ms, P<0.001; 6 months: 96(94, 104)ms vs. 130(128, 132)ms, P<0.001). Conclusions: For patients with permanent pacemaker indications after TAVI, LBBP is feasible, safe and reliable. It could improve the cardiac function in the short term, the long-term effect of LBBP needs to be further observed.