[The analysis of related factors on the unilateral aldosterone secretion in the functional diagnosis of primary aldosteronism and establishment of a predictive model]

Objective: To explore related factors associated with unilateral aldosterone secretion of patients with primary aldosteronism (PA) and construct a predictive model. Methods: The clinical data of patients who were diagnosed as PA in West China Hospital from April 2016 to September 2020 was analyzed retrospectively. According to the results of the adrenal enhancement CT, patients were divided into 3 groups, namely non-nodular group with no bilateral adrenal glands lesions, only with unilateral adrenal hyperplasia or bilateral adrenal hyperplasia, unilateral nodule group with unilateral adrenal nodules and the contralateral adrenal glands with hyperplasia or not, and bilateral nodules group with nodules in both adrenal glands. Regarding the related factors of dominant side of aldosterone secretion, univariate analysis and binary logistic regression were used. Receiver operating characteristic curve and nomogram were used to evaluate the diagnostic performance of regression models. Results: A total of 237 patients with PA were included, of which, 118 males and 119 females, the median age was 39 years, and the body mass index (BMI) was (25.2±3.5) kg/m². There were 157 (66.2%) of 237 patients with typical imaging findings. There were 32 cases in no-nodular group, 183 cases in unilateral nodule group, and 22 cases in bilateral nodules group. Multivariate analysis showed that age (OR=0.876, P<0.001), blood potassium concentration (OR=0.430, P=0.004), and typical imaging findings (OR=2.202, P=0.035) were associated with unilateral aldosterone secretion. As for unilateral nodule group, multivariate analysis showed that age (OR=0.900, P<0.001), plasma aldosteronism concentration (PAC) (OR=1.050, P=0.018), and typical imaging findings (OR=2.637, P=0.025) were associated with unilateral aldosterone secretion. The agreement rate between the dominant side of the adrenal CT and AVS was only 50.2%. Multivariate analysis showed that age (OR=0.954, P=0.001), BMI (OR=0.893, P=0.024) and PAC (OR=1.043, P=0.011) were independently associated with concordance between AVS and CT. The cut-off value of the ROC curve was 0.43; the model sensitivity was 56.3%; the specificity was 86.7% and the area under the ROC curve was 0.742. Conclusions: Age is an important predictor in the diagnosis of PA subtypes. It is recommended to refer to subgroup based on imaging results for clinical decision. For patients with no obvious lesions or bilateral lesions on CT, AVS should be performed as far as possible to confirm the subtypes in diagnosis of PA.

[Expression characteristics and functional analysis of ELK3 in gastric cancer]

OBJECTIVE

To explore the expression characteristics of ELK3 and its role in the occurrence, progression and prognosis of gastric cancer.

METHODS

We analyzed the expression characteristics of ELK3 in gastric cancer based on E-MTAB-6693 dataset and explored the prognostic value of ELK3 using Kaplan-Meier survival analysis and univariate and multivariate Cox regression analysis. Chip-Atlas, ChipBase, Genes Transcription Regulation Database, and hTFtarget were used for predicting the target genes of ELK3 and constructing the transcription regulation network. Functional enrichment analysis of the target genes was performed using R software. The proportions of infiltrating immune cells in gastric cancer were analyzed using Cibersort tool, and the Pearson coefficients between ELK3 and these cells were calculated. The expression profile of ELK3 was verified based on Gene Expression Profiling Interactive Analysis and Human Protein Atlas databases. We also collected 5 pairs of gastric cancer and adjacent tissue samples and detected the expression of ELK3 at both the mRNA and protein levels using RT-PCR and Western blotting.

RESULTS

In public datasets and clinical samples, ELK3 was highly expressed in gastric cancer (P < 0.05), and its expression increased with the progression of M stage, AJCC stage, and perineural invasion (P < 0.05). ELK3 expression was correlated with N stage, AJCC stage, Lauren classification, differentiation, pathological classification, and microsatellite status of gastric cancer (P < 0.05). A high expression of ELK3 was associated with significantly reduced overall survival and disease-free survival of the patients, and served as an independent prognostic factor of gastric cancer (P < 0.05). Comprehensive analysis identified 176 potential target genes of ELK3, and enrichment analysis showed that ELK3 may regulate Rap1, AMPK, chemokines, VEGF, TNF, and tumor PD-L1/PD-1 signaling (PP < 0.05). The expression of ELK3 was negatively correlated with regulatory T cells, follicular helper T cells, and CD8+T cells in gastric cancer (P < 0.05).

CONCLUSION

ELK3 acts as an oncogene in gastric cancer, and its high expression may promote the occurrence, progression and immune escape of gastric cancer.

[Procyanidin B2 protects neurons from cypermethrin-induced oxidative stress through the P13K/Akt/Nrf2 signaling pathway]

OBJECTIVE

To explore whether procyanidin B2 (PCB2) regulates the P13K/Akt/Nrf2 signaling pathway to protect neurons from oxidative stress induced by cypermethrin (CYP).

METHODS

Primary cultures of cerebral cortex neurons from C57BL/6 mice were randomly divided into 5 groups: normal control group (cultured in serum-free neurobasal-B27 medium), PCB2 treatment group(treated with 5 μg/mL PCB2 for 24 h), CYP exposure group(treated with 50 μmol/L CYP for 24 h), PCB2 pretreatment group(pretreated with 5 μg/mL PCB2 for 30 min followed by exposure to 50 μmol/L CYP for 24 h), and LY294002 treatment group (pretreated with 20 μmol/L LY294002 for 30 min before treatment with PCB2 for 30 min and then CYP for 24 h).CCK-8 assay was used to analyze the neuronal viability after the treatments.Reactive oxygen species (ROS) production in the cells was detected using the fluorescent probe DCFH-DA and flow cytometry.The changes in nuclear morphology and mitochondrial membrane potential of the cells were examined with Hoechst 33342 and JC-1 staining, respectively.Western blotting was performed to detect the protein expressions of Nrf2, HO-1, p-Akt and Akt in the cells.

RESULTS

In CYP exposure group, the cells showed significantly decreased viability and mitochondrial membrane potential with obvious apoptotic morphological changes and abnormal ROS production.By comparison, the cells in PCB2 preconditioning group showed improved cell survival rate, reduced abnormalities in nuclear morphology, increased mitochondrial membrane potential, and lowered intracellular ROS production.CYP exposure caused Nrf2 nuclear translocation and up-regulated Nrf2, HO-1, p-Akt protein expressions in the cells, which were inhibited by PCB2 pretreatment.Inhibition of the P13K/Akt signaling pathway obviously neutralized the protective effect of PCB2 against CYP-induced neuronal injury.

CONCLUSIONS

PCB2 regulates the Nrf2/ARE signaling pathway by activating the P13K/Akt signaling pathway to protect mouse cerebral cortical neurons against oxidative injury induced by cypermethrin.

A genome-wide association study reveals additive and dominance effects on growth and fatness traits in large white pigs

The dominance effect is a kind of non-additive effect due to the interaction between alleles at the same locus. Quantitative traits such as growth traits in farm animals have been found to be influenced by dominance effects. However, dominance effects are usually ignored in the genome-wide association study (GWAS) of complex traits for farm animals. In this study, we performed GWAS and genetic parameters estimation for the two traits age at 100 kg (AGE) and backfat thickness at 100 kg (BF) of 3572 Large White pigs. The pigs were from three breeding farms of China and were genotyped by an in-house designed 50k SNP chip. Our results showed significant non-zero variance for the dominance effect of AGE, while the dominance effect of BF was not significant. Using a GWAS model accounting for both additive and dominance effects, we identified three additive and two dominance significant SNPs for the trait AGE. For the trait BF, three genome-wide significant additive SNPs were detected, but no significant SNP was found for the dominance effect. In total, six important functional genes (NPAS3, USP16, PARN, ARL15, GPC3, ABHD4) near significant SNPs were identified as candidate genes associated with AGE or BF. Notably, ARL15 and PARN were associated with AGE near the dominance association signals. Overall, the newly detected SNPs and newly identified candidate genes in our study added new information about the genetic architectures of growth and fatness traits in pigs, and have the potential to be applied to the pig breeding program in the future.

Comparison of Clinical Outcomes Following Anterior Cervical Discectomy and Fusion with Zero-Profile Anchored Spacer-ROI-C-Fixation and Combined Intervertebral Cage and Anterior Cervical Discectomy and Fusion: A Retrospective Study from a Single Center

Background

The aim of this study was to compare the outcomes following anterior cervical discectomy and fusion with zero-profile anchored spacer-ROI-C-fixation (ROI-C) vs combined intervertebral cage and anterior cervical discectomy and fusion (ACDF).

Material/Methods

We retrospectively analyzed 87 patients who underwent operations between January 2015 and January 2019, including 42 patients that underwent ROI-C treatment (group A) and 45 that were treated by the ACDF approach (group B). Operative duration, blood loss, dysphagia, Neck Disability Index scores (NDI), Japanese Orthopaedic Association scores (JOA), and other complications were compared between these groups. In addition, implant settlement, fusion, and cervical Cobb angle were assessed via imaging analyses.

Results

Patients in group A and group B were followed for 22.6±3.3 months and 27.1±3.5 months, respectively (range: 13–30 months). Relative to preoperative values, JOA scores were increased and NDI scores were reduced in both groups following treatment (P<0.05), with comparable outcomes between groups (P>0.05). However, operative duration, intraoperative blood loss, and postoperative complications did differ significantly between these groups (P<0.05). Specifically, rates of short-term dysphagia were lower and recovery time was faster in group A relative to group B (P<0.05).

Conclusions

The findings from this study showed that ROI-C fixation achieved satisfactory outcomes, improved cervical curvature, restored intervertebral height, and was associated with shorter operative duration, reduced blood loss, and less dysphagia.

P–757 The risk of aspirin and prednisone using in women with antithyroid antibodies undergoing assisted reproductive technology

Study question

Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology?

Summary answer

Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate.

What is known already

Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood.

Study design, size, duration

A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer.

Participants/materials, setting, methods

Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables.

Main results and the role of chance

A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P &lt; 0.001) and implantation rate (F = 4.388, P = 0.036). The fertilization rate (P = 0.407), high-quality embryo rate (P = 0.208) and blastulation rate (P = 0.157) were not influenced by the use of medication. In this study, likelihood of clinical pregnancy (P = 0.066) did not change significantly after therapy, and miscarriage rate (P = 0.042) increased after medical treatment.

Limitations, reasons for caution

Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed.

Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious.

Trial registration number

n/a

The relationship between depressive symptoms and activity of daily living disability among the elderly: results from the China Health and Retirement Longitudinal Study (CHARLS)

OBJECTIVE

The acceleration of population aging has brought an unprecedented impact on China's health system. This study is designed to examine the association between depressive symptoms and activity of daily living disability among the elderly in China.

STUDY DESIGN

This is a cross-sectional study.

METHODS

Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies-Depression (CES-D) scale was used to access depressive symptoms, and physical function was assessed by the Activity of Daily Living (ADL) scale. Multivariate logistic regression was used to assess the association between depressive symptoms and ADL among the elderly.

RESULTS

Based on a sample of 5863 elderly people over 60 years old, our results showed that 1999 elderly people are with depressive symptoms, accounting for 34.1%. The mean score of ADL among the elderly with depressive symptoms (20.65 ± 7.14) was much higher than that in those without depressive symptoms (17.40 ± 4.87). After controlling potential confounders, multivariate logistic regression showed that ADL and its specific domains including personal care, transfer, medical care, household, and managing money were associated with depressive symptoms.

CONCLUSION

This cross-sectional study provides evidence of the association between depressive symptoms and ADL disability among the Chinese elderly. As a result, prevention or reduction of ADL disability may have a positive effect on the medical care of the elderly with depressive symptoms.

[Molecular epidemiology of norovirus associated with pediatric acute gastroenteritis in Beijing in 2020]

Objective: To investigate the molecular epidemiology of norovirus associated with pediatric acute gastroenteritis in Beijing under the Working Mechanism for Joint Prevention and Control of the Epidemic in 2020. Methods: This was a retrospective, repeated cross-sectional study. Fecal or vomit samples (1 213 cases) were collected from children visited the Capital Institute of Pediatrics Affiliated Children's Hospital for acute gastroenteritis from January 1 to December 31, 2020. First, real-time reverse PCR (RT-PCR) was used to screen the samples for norovirus, and then RdRp gene and capsid gene VP1 of norovirus-positive samples were amplified by conventional RT-PCR for genotyping based on the nucleotide sequence. The χ² test was used to compare the positive rates and genotypes of norovirus among different specimen types, genders of children, and different age groups. Results: Among the 1 213 samples were collected, 215 samples were positive for norovirus, with a positivity rate of 17.7% for the whole year. The peak of norovirus infection observed mainly in the cold seasons, as the positive rates were 28.6% (18/63), 26.2% (16/61), 22.8% (77/338) and 17.1% (89/520) in January, October, November and December, respectively. The positive rate of norovirus in fecal sample was significantly higher than that in vomit sample (χ² = 9.692, P<0.01). There was no significant difference between genders (χ²=0.041, P>0.05), but significant difference was found between age groups with the highest rate in the 6-48 months group (χ²=103.112, P<0.01). Three genogroups (GⅠ, GⅡ and GⅨ) of the circulating virus were detected by G-gene typing, and GⅡgenogroup was predominant, accounting for 98.5% (196/199). Among the GⅡ positive samples, genotype GⅡ.4 Sydney (55.1%, 108/196) was the most common, followed by GⅡ.2 (29.6%, 58/196), while the GⅡ.3 norovirus (10.2%, 20/196) which was common in previous years was not as much as before. Based on the P-type, GⅡ.P16 was predominant (61.5%, 96/156), followed by GII.P31 (19.9%, 31/156). The dual genotyping revealed that GⅡ.4 Sydney [P16] (36.4%, 56/154) and GⅡ.2 [P16] (24.7%, 38/154) were predominant. Conclusion: The prevalence of norovirus in children in 2020 in Beijing is not much different from those of the previous years, but the genotypes composition has changed significantly, and there are multiple genotypes circulating simultaneously.

Two atypical gram-negative bacteria-binding proteins are involved in the antibacterial response in the pea aphid (Acyrthosiphon pisum)

The activation of immune pathways is triggered by the recognition of pathogens by pattern recognition receptors (PRRs). Gram-negative bacteria-binding proteins (GNBPs)/β-1,3-glucan recognition proteins (βGRPs) are a conserved family of PRRs in insects. Two GNBPs are predicted in the genome database of pea aphids; however, little is known about their functions in the aphid immune system. Here, we show that pea aphid GNBPs possess domain architectures and sequence features distinct from those of typical GNBPs/βGRPs and that their expression is induced by bacterial infection. Knockdown of their expression by dsRNA resulted in lower phenoloxidase activity, higher bacterial loads and higher mortality in aphids after infection. Our data suggest that these two atypical GNBPs are involved in the antibacterial response in the pea aphid, likely acting as PRRs in the prophenoloxidase pathway.

Autophagy induction regulates aquaporin 3-mediated skin fibroblasts aging

BACKGROUND

Long- and short-term ultraviolet (UV) exposure have distinct biological effects on human fibroblasts.

OBJECTIVES

This study aimed to elucidate the underlying mechanisms of the biological effects of UV exposure on human skin fibroblasts.

METHOD

We subjected human skin fibroblast cells with or without AQP3, DEDD, or Beclin1 manipulation to UVA treatment and evaluated autophagy and senescence/aging in them.

RESULTS

Short-term UVA irradiation induced autophagy and upregulated AQP3 but not senescence, whereas long-term UVA irradiation inhibited autophagy, AQP3, and senescence/aging in vitro and in vivo. Silencing AQP3 abolished short-term UVA irradiation-induced autophagy and led to cellular senescence, whereas AQP3 overexpression partially rescued the senescence and autophagy inhibition induced by long-term UVA exposure in vitro. Mechanistically, the transcription factor JUN was found to bind to the AQP3 promoter to activate its transcription following short-term UVA exposure. Subsequently, AQP3 interacted with DEDD to induce its ubiquitination-mediated degradation and promote autophagy, and bound to Beclin1 to directly activate autophagy. Finally, autophagy induced by AQP3 overexpression robustly prevented UVA-induced senescence/aging in vitro and in vivo.

CONCLUSIONS

Thus, our study indicates that AQP3 controls skin fibroblasts photoaging by regulating autophagy and represents a potential target for future interventions against skin aging.

Population-based evaluation of the risk factors and prognosis among renal cell carcinoma patients with initially diagnosed lung metastases

OBJECTIVES

To evaluate risk factors and prognosis of lung metastases in patients with renal cell carcinoma (RCC) based on the Surveillance, Epidemiology, and End Results (SEER) database.

METHODS

56,617 patients with RCC were selected from the SEER database. Based on univariate and multivariate logistic regression, the risk factors for developing lung metastases were derived. 2906 patients were initially diagnosed with lung metastases, and then were used to research the prognostic factors. Multivariable Cox regression analyses were performed for the prediction of cancer-specific mortality.

RESULTS

In total, 2906 RCC patients were initially diagnosed with lung metastases. The prevalence of lung metastases in RCC was approximately 5% with poor survival. Aging, male, other race (American Indian/AK native, Asian Pacific islander) uninsured status, bilateral tumor, collecting duct, higher T stage, local lymph node metastases, higher tumor grade, and evidence of other distant metastases were significantly associated with developing lung metastases at diagnosis. Age >70 years-old, black, female, bilateral tumor, T4 stage, higher tumor grade, local lymph node metastases, collecting duct, and evidence of bone, liver, or brain metastases were related to higher risk of mortality. Blacks and female have lower odds of developing lung metastases at the time of diagnosis both in crude and adjusted logistic regression. Meanwhile, blacks and female showed higher risk of mortality compared with whites and male in Cox regression analyses.

CONCLUSION

Several factors related to the development and prognosis of lung metastases were revealed, especially black people and female gender have lower risk of developing lung metastatic RCC at initial diagnosis but have higher risk of mortality. These may provide preventive guidelines for the screening and treatment of lung metastases in patients with renal cell carcinoma.

[TRIM59 regulates invasion and migration of nasopharyngeal carcinoma cells by targeted modulation of PPM1B]

OBJECTIVE

To investigate whether TRIM59 regulates invasion and metastasis of nasopharyngeal carcinoma cells by targeting PPM1B.

METHOD

We analyzed the expression of TRIM59 in nasopharyngeal carcinoma tissues based on data from TCGA database and detected the expressions of TRIM59 and PPM1B in nasopharyngeal carcinoma and adjacent tissues using Western blotting. We also detected the expressions of TRIM59 and PPM1B at both the mRNA and protein levels in nasopharyngeal carcinoma cell lines using RT-PCR and Western blotting. Stable cell lines with TRIM59 overexpression or knockdown were established in HNE1 cells, in which the targeting relationship between TRIM59 and PPM1B was analyzed using Western blotting and a luciferase reporter gene assay. Transwell chamber assay was used to assess changes in the invasion and migration abilities of HNE1 cells with TRIM59 overexpression or knockdown.

RESULTS

Analysis based on TCGA database showed that TRIM59 expression was significantly higher in nasopharyngeal carcinoma tissues than in adjacent tissues (P=0.006); the expression of TRIM59 increased (P=0.01) and PPM1B expression decreased significantly (P=0.03) in nasopharyngeal carcinoma tissues. Compared with HNEpC cells, HNE1 cells expressed a significantly higher level of TRIM59 (P=0.04) but a lower level of PPM1B (P=0.01). Luciferase reporter gene assay indicated that PPM1B was a downstream target gene of TRIM59 and its expression was negatively correlated with TRIM59 expression (P=0.01). In HNE1 cells, TRIM59 overexpression significantly promoted cell invasion (P=0.01) and migration (P=0.02) while TRIM59 knockdown obviously suppressed cell invasion (P=0.01) and migration (P=0.01). TRIM59 knockdown with simultaneous PPM1B overexpression more strongly inhibited invasion (P=0.02) and migration (P=0.01) of HNE1 cells as compared with TRIM59 knockdown alone.

CONCLUSION

TRIM59 regulates invasion and migration of nasopharyngeal carcinoma cells through targeted modulation of PPM1B.

Telomerase enhances osteogenic ifferentiation of sheep bone marrow mesenchymal stem cells (BMSCs) by up-regulating PI3K/Akt pathway in vitro

Telomerase reverse transcriptase (TERT) vectors were transfected into bone marrow mesen- chymal stem cells (BMSCs) which were then cultured and selected to establish TERT-BMSC cell lines whilst sequencing BMSCs and TERT-BMSCs via transcriptome in this study to explore their regulatory mechanism and effect on osteogenic differentiation after TERT ectopic expres- sion in sheep BMSCs. After sequencing and analysing differential genes, PI3K/Akt signalling pathway related to osteogenic differentiation was investigated. Western blot was used before and after applying the PI3K/Akt signalling pathway inhibitor LY294002 to detect protein expression levels of AKT and p-AKT. On the twenty-first day of osteogenic differentiation, RT-qPCR and Western blot were used to detect mRNA and protein expression levels of RUNX2 and OPN and alizarin red staining was utilised to analyse calcium salt deposition. Results showed that pro- tein expression levels of AKT and p-AKT were significantly up-regulated, mRNA and protein expression levels of RUNX2 and OPN increased and calcium salt deposition increased after ectopic expression of TERT. After applying LY294002, the protein expression of AKT and p-AKT was down-regulated, mRNA and protein expression levels of RUNX2 and OPN were reduced and calcium salt deposition was reduced. These results confirmed the stable integration and expression of the exogenous TERT gene in BMSCs to promote the differentiation of BMSC osteoblasts, which may be mediated by the PI3K/Akt signalling pathway.

[Treatment status of tyrosine kinase inhibitors in Chinese patients with chronic myeloid leukemia in 2020]

Objective: To investigate the current status of treatment choice and responses in patients with chronic myeloid leukemia (CML) in China. Methods: From the end of April to mid-May in 2020, a cross-sectional survey, by filling out a survey questionnaire, was conducted to explore the first-line choice of tyrosine kinase inhibitors (TKI) , current medications, drug switch and major molecular responses (MMR) as well as the variables associated with them in patients in China. Results: Data of 2933 respondents with CML from 31 provinces, municipalities, and autonomous regions across the country were included in this study. 1683 respondents (57.4%) were males. Median age was 38 (16-87) years old. 2481 respondents (84.6%) received imatinib as first-line TKI; 1803 (61.5%) , the original new drug (branded drug) . When completing the questionnaire, 1765 respondents (60.2%) were receiving imatinib; 1791 (61.1%) , branded drug. 1185 respondents (40.4%) had experienced TKI switch. With a median follow-up of 45 (3-227) months, 1417 of 1944 (72.9%) respondents with newly diagnosed CML in the chronic phase achieved MMR. Multivariate analysis showed that the respondents with urban household registration (OR=0.6, 95%CI 0.5-0.8, P<0.001) , ≥ bachelor degree (OR=0.5, 95%CI 0.4-0.7, P<0.001) , and in the advanced phase at diagnosis (OR=0.5, 95%CI 0.3-0.8, P=0.001) less preferred Chinese generic TKI, while the respondents from the central region in China more preferred Chinese generic TKI more than those from the eastern region (OR=1.7, 95%CI 1.4-2.0, P<0.001) . Moreover, the respondents in the advanced phase at diagnosis more preferred second-generation TKI (OR=5.4, 95%CI 3.6-8.2, P<0.001) ; those ≥60 years old, less preferred second-generation TKI (OR=0.4, 95%CI 0.2-0.7, P=0.002) . Being in the advanced phase at diagnosis (OR=2.2, 95%CI 1.6-3.2, P<0.001) , first-line choice of imatinib (OR=2.0, 95%CI 1.6-2.6, P<0.001) or Chinese generic drugs (OR=1.3, 95%CI 1.1-1.6, P=0.002) , longer interval from diagnose of CML to starting TKI treatment (OR=1.2, 95%CI 1.1-1.2, P<0.001) and longer duration of TKI therapy (OR=1.1, 95%CI 1.0-1.1, P<0.001) were significantly associated with TKI switch; urban household registration (OR=0.7, 95%CI 0.6-0.8, P<0.001) , ≥MMR (OR=0.6, 95%CI 0.5-0.8, P<0.001) and unknown response (OR=0.7, 95%CI 0.6-0.9, P=0.003) , no TKI switch. Female sex (OR=1.4, 95%CI 1.1-1.7, P=0.003) , urban household registration (OR=1.6, 95%CI 1.3-2.0, P<0.001) , front-line imatinib therapy (OR=1.4, 95%CI 1.1-1.9, P=0.016) and longer duration of TKI treatment (OR=1.2, 95%CI 1.2-1.3, P<0.001) were significantly associated with achieving a MMR or better response; age ≥ 60 years old (OR=0.7, 95%CI 0.4-1.0, P=0.047) and TKI switch (OR=0.6, 95%CI 0.5-0.7, P<0.001) , achieving no MMR. Conclusions: By 2020, the majority of Chinese CML patients received imatinib as the fist-line TKI therapy and continue to take it. More than half of TKIs were branded drugs. Socio-demographic characteristics and clinical variables affect their TKI choice, drug switch, and treatment response.

Application of remote online learning in oral histopathology teaching in China

Background

The aim of this study was to investigate the application of remote learning and virtual microscopy in oral histopathology teaching, a unique experience in China. The oral histopathology teaching in Nanjing Medical University has been extraordinary.

Material and Methods

98 third-year dental students of Grade 2016 took oral histopathology theoretical course face-to-face in 2019 (Traditional group). The 94 participants of Grade 2017 took online oral histopathology course using digital methods(E-Learning platform and Virtual Simulation Experiment Teaching Center for Dentistry) in 2020. During the practical laboratory sessions, the students in both Traditional group and Online group observed the same glass slides for morphological learning. A questionnaire survey explored students' attitudes towards the remote online learning. Results: The mean Theory test scores of the Online group (80.93±12.15) were significantly higher than those of the Traditional group (73.65±8.46) (P < 0.01). The mean total scores of the Online group (82.94±10.76) were significantly higher than those of the Traditional group (77.25±7.55) (P < 0.01). The percentage of high total test score (test score > 85) of the Online group (54%) was also significantly higher than that of the Traditional group (15%) (P< 0.01). Furthermore, both remote learning and virtual microscopy courses were well accepted by students according to the questionnaire.

Conclusions

This study found that remote learning and virtual technology have a positive impact on oral histopathology. The findings reveal that the application of remote online learning has enhanced oral histopathology teaching in China.

Key words:Oral histopathology, dental undergraduate students, virtual microscopy, remote online learning, questionnaire.

Screening and bioinformatics analysis of cellular proteins interacting with chicken bromodomain-containing protein 2 in DF-1 cells

1. Bromodomain-containing protein 2 (BRD2) is an important member of the BET protein family, which can specifically bind histone acetylated lysine to participate in gene transcriptional regulation, chromatin remodelling, cell proliferation and apoptosis. The following investigation of cellular proteins interacting with chBRD2 will be helpful in understanding the new functions of chBRD2 and the mechanism of NDV replication.2. The recombinant eukaryotic expression vector pEGFP-chBRD2 and empty vector pEGFP-C1 were transfected into DF-1 cells to overexpress GFP-chBRD2 and GFP, respectively. GO annotation, KEGG pathway, and protein-protein interaction network were used to analyse the cellular proteins interacting with chBRD2. In addition, one targeted protein was selected to verify its interaction with chBRD2 using fluorescent co-localisation and Co-IP.3. A total of 225 cellular proteins were identified that potentially interact with chBRD2. GO analysis showed that these play key roles in gene transcriptional regulation, cell cycle and development, immunity and viral infection. Further KEGG pathway analysis showed that these proteins were mainly involved in genetic information processing, immune system, cellular processes and translation. In addition, one targeted cellular protein chicken matrin 3 (chMATR3) was also identified as chBRD2 complex using both fluorescence co-localisation and Co-IP analysis.4. This study presents the interactome data of chBRD2 protein in DF-1 cells, which provides new information to understand the functions of chBRD2 and new targets for further investigating the replication and pathogenesis of NDV.

LINC00641 regulates prostate cancer cell growth and apoptosis via the miR-365a-3p/VGLL4 axis

OBJECTIVE

Long non-coding RNA (lncRNA) was frequently abnormally expressed in cancers. LINC00641 was reported to play crucial roles in regulating tumor progression. However, its role in prostate cancer (PCa) has not been fully explored.

PATIENTS AND METHODS

In this work, proliferation, invasion and apoptosis assays were performed to detect the biological roles of LINC00641 in PCa. Bioinformatic analyses, Luciferase activity reporter assay, and rescue experiments were performed to investigate the potential mechanisms of LINC00641 in PCa. Expression levels of LINC00641, microRNA-365a-3p (miR-365a-3p), and vestigial like family member 4 (VGLL4) in PCa tissues and normal tissues were analyzed at ENCORI.

RESULTS

We found LINC00641 and VGLL4 was reduced, while miR-365a-3p was elevated expression in PCa tissues compared with normal tissues. LINC00641 overexpression inhibited growth and invasion abilities of PCa cells in vitro. Functional assays revealed that miR-365a-3p/VGLL4 pair was the downstream targets of LINC00641.

CONCLUSIONS

The findings of our work provided evidence that LINC00641 serves as a tumor suppressive lncRNA in PCa by regulating miR-365a-3p/VGLL4 axis.

Sex-specific associations of serum insulin-like growth factor-1 with bone density and risk of fractures in Chinese patients with type 2 diabetes

We evaluated the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D). We found positive associations between IGF-I and BMD and negative associations between IGF-I and all three modified 10-year probabilities of MOFs and HFs in men, but not in women.

INTRODUCTION

The objective was to investigate the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D) in each gender.

METHODS

This was a cross-sectional, retrospective study that included men over 50 years and postmenopausal women with T2D without medical conditions or medications known to significantly affect BMD or serum IGF-I levels. Data of IGF-1, bone metabolism markers, lumbar spine (LS), femoral neck (FN), and total hip (TH) BMD were obtained; 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was calculated and modified with rheumatoid arthritis, femoral neck T-score, and age. Correlations of IGF-1 levels with bone metabolism and risk of fractures were statistically analyzed in men and women, respectively.

RESULTS

A total of 391 patients, including 226 men and 165 women, were included. The age, serum fasting C-peptide, glycosylated hemoglobin (HbA1c), bone formation marker, and all three modified 10-year probabilities of MOFs and HFs were higher in women than those in men (all p < 0.05). The levels of 25 hydroxyvitamin D (25OHD), IGF-1, and BMD were lower in women than those in men (all p < 0.05). In men, IGF-1 was positively correlated with FN and TH BMD (FN BMD: r = 0.267, p < 0.001; TH BMD: r = 0.235, p < 0.001) and negatively correlated with all three modified 10-year probabilities of MOFs (RA-modified MOFs: r = - 0.289, p < 0.001; age-modified MOFs: r = - 0.237, p < 0.001; FN T-score-modified MOFs: r = - 0.280, p < 0.001) and HFs (RA-modified HFs: r = - 0.291, p < 0.001; age-modified HFs: r = - 0.271, p < 0.001; FN T-score-modified HFs: r = - 0.270, p < 0.001), while no significant correlations were found between serum IGF-I and BMD and three modified 10-year probability in women.

CONCLUSIONS

According to this study, we found sex differences in the associations of serum IGF-1 with BMD and risk of fractures in Chinese patients with T2D. These results suggested that increasing serum IGF-1 might be a clinical target for protecting fractures in T2D, especially in men.

POS0320 POOR PROGNOSIS PREDICTION IN ANTI-MDA5 POSITIVE DERMATOMYOSITIS ASSOCIATED WITH INTERSTITIAL LUNG DISEASE: THE CROSS-CAR DECISION TREE MODEL

Background:

The prognosis of anti-melanoma differentiation-associated gene 5 positive dermatomyositis (anti-MDA5+ DM) – associated interstitial lung disease (ILD) is poor and heterogeneity.

Objectives:

The aim of this study was to evaluate prognostic factors and to develop a simple and generally applicable bedside decision tree model for predicting outcomes in patients with anti-MDA5+ DM and to guide treatment.

Methods:

We analyzed data for 246 anti-MDA5+ DM patients from Myositis Study Group-Jiangsu, a multicenter cohort across eighteen tertiary hospitals in Jiangsu province, from March 2019 to October 2020. The primary end point was all-cause death, and the secondary end point was occurring of rapidly progressive-ILD (rp-ILD). We used a multivariable Cox proportional hazards model to identify the independent prognostic risk factors of death and rp-ILD respectively. A decision-tree prediction model was developed by using data from 10 hospital of southern region (n=163), with validation by using contemporaneous data from northern region (n=83).

Results:

To assess the risk of rp-ILD, we developed a combined risk score, the CROSS score, that included the following values and scores: C-reactive protein (≤8mg/L, 0; >8mg/L, 3), anti-Ro52 antibody (negative, 0; positive, 4), Sex (Female, 0; Male, 2) and Short course of disease (More than 3 months, 0; Less than 3 months, 2). The mortality risk was identified by the CAR score, including C-reactive protein (≤8mg/L, 0; >8mg/L, 1), Alanine Transaminase (≤50units/L, 0; >50units/L, 1) and rp-ILD (non-rpILD, 0; rp-ILD, 3). We divided patients into three risk groups according to the CROSS score: low, 0 to 3; medium, 4 to 7; and high 8-11. And then Use of a simple decision tree prediction model permitted stratification into three different outcome prediction groups. High-risk patients had significantly higher mortality rates than low- and medium-risk patients in both discovery and validation cohorts (p < 0.0001).

Conclusion:

The CROSS-CAR decision tree model is easy to evaluate the poor prognostic risk in MDA5+ DM patients during any follow-up period. Unnecessary lung examination, such as chest CT scan and arterial blood gas analysis was avoided in low- and medium- rpILD risk patients. The special ambulance, with red cross sign tagged on car in China, may help to screen the high risk patients and to guide further treatment.

Disclosure of Interests:

None declared

POS0943 GEOGRAPHIC VARIATION OF ANKYLOSING SPONDYLITIS (AS) DIAGNOSIS AND TREATMENT IN THE UNITED STATES: A REAL-WORLD EVIDENCE STUDY

Background:

AS is a chronic inflammatory immune-mediated disease primarily affecting the sacroiliac joints and spine, with a prevalence of 0.2%–0.5% in the United States.1 Because radiographic features of the disease can take years to develop, diagnosis may be delayed by up to 10 years2, which can negatively affect patients’ function, ability to work, and overall quality of life.

Objectives:

To describe geographic variations in AS diagnostic prevalence and treatment in the United States.

Methods:

This study utilized the IBM® MarketScan® Administrative Claims Database from 2014–2019. Patients (pts) ≥18 years of age with AS, continuous medical and pharmacy enrollment during the calendar year, and complete geographic information during the study period were included. Pts were identified by having ≥1 claim with ICD-9-CM or ICD-10-CM codes for AS (720.0 or M45.x, respectively). Two AS diagnosis definitions were used; Definition 1 (D1): Pts with ≥1 claim for an AS diagnosis in the year by any provider and Definition 2 (D2): Pts with ≥2 claims for an AS diagnosis within 18 months by rheumatologists. Annual AS diagnostic prevalence rates were calculated for both groups; treatment was evaluated among pts with D2. Diagnosis and treatment rates were assessed from 2014–2019 at the national and state levels and reported for states where >20 pts received an AS diagnosis (D1 or D2) or respective treatment (D2). The effect of age, sex, race (surrogate for HLA-B27), and rheumatologist per capita on geographic variation was assessed.

Results:

The number of pts included per year ranged between 10,811–13,077 (D1) and 3,775–4,901 (D2). AS diagnostic prevalence increased over time for both groups, with the annual prevalence rate per 10,000 persons for D2 pts increasing from 2.5 in 2014 to 3.5 in 2019 (Table 1). The AS diagnostic prevalence by D2 in 2019 was highest for Idaho (13) and Colorado (6), and lowest for Michigan (2). The state variations in prevalence did not appear to be explained by age, sex, racial distribution, or rheumatologists per capita. The percentage of D2 pts receiving advanced therapies (all FDA-approved indicated biologic disease-modifying antirheumatic drugs [bDMARDs] for AS) were >70% and increased each year, whereas the use of conventional synthetic DMARDs (csDMARDs) decreased (Figure 1. next page). While opioid use decreased, 37% of D2 pts were prescribed such treatment in 2019. Percentage of D2 pts receiving advanced therapy in 2019 was highest (91) in Minnesota and South Carolina and lowest in Idaho (69) and Indiana (70). In 2019, the percentage of D2 pts using csDMARDs in 2019 was highest in Oklahoma (33) and lowest (16) in North Carolina and New York, while for opioids it was highest in Idaho (69) and lowest in Wisconsin (28).

Conclusion:

The prevalence of AS is increasing each year nationally, with significant variability observed across states that is not explained by differences in age, sex, race, or rheumatologists per capita. Among pts with confirmed AS diagnosis (D2), national rates of csDMARDs and opioids are decreasing although opioid use is still high, and high treatment rates exist for advanced therapies. Rates of all treatments also vary substantially across states. Observed variations may indicate the opportunity for further education that can be targeted based on regional need to improve diagnosis and treatment.

References:

[1]Reveille JD. Am J Med Sci. 2011. 2. Deodhar A, et al. Arthritis Rheumatol. 2016.

Table 1.

AS diagnostic prevalence by calendar year, 2014–2019

Patients with ≥1 AS diagnosis (D1)Patients with ≥2 AS diagnoses by rheumatologists (D2)YearNumber of annual enrolleesNumber of patients with ASPrevalence rate/10,000Number of patients with ASPrevalence rate/10,000201419,470,78013,0776.74,9012.5201515,159,11811,8637.84,2782.8201614,836,59412,8018.64,4733.0201712,618,30110,8118.63,7753.0201813,460,22412,2599.14,3023.2201912,105,04911,6469.64,2943.5

Acknowledgements:

Medical writing services provided by Alan Saltzman of Fishawack Facilitate Ltd, part of Fishawack Health, and funded by AbbVie.

The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship.

Disclosure of Interests:

Atul Deodhar Speakers bureau: Novartis, Pfizer, Consultant of: Novartis, Pfizer, AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Galapagos, Janssen, Boehringer Ingelheim, Celgene, Amgen, Grant/research support from: Novartis, Pfizer, AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Denise Kruzikas Shareholder of: AbbVie, Employee of: AbbVie, Lili Zhou Employee of: AbbVie, Ana Biljan Shareholder of: AbbVie, Employee of: AbbVie, Christopher Saffore Shareholder of: AbbVie, Employee of: AbbVie

Figure 1.

Drought conditions appraisal using geoinformatics and multi-influencing factors

The world including South Africa is faced with unprecedented environmental changes, which can be linked to climate-related disasters such as drought and extreme heat. Several studies have indicated that these changes are likely to accelerate in the future and cause an adverse impact on the environment. The Eastern Cape Province of South Africa, especially Amathole District Municipality (ADM), has recorded a high number of climate change-related disasters including prolonged drought conditions witnessed during the winter season of 2008, 2009, 2014 and 2015 among others. Consequently, this study aimed at exploring remote sensing information to assess and document drought occurrences in the ADM from 2007 to 2017. To accomplish the aim, the Normalized Difference Vegetation Index, Land Surface Temperature and Precipitation were utilised to access drought spatiotemporal variations. For the analysis, a total of 396 satellite imageries (MODIS and TRMM) were used. The results revealed that different correlations exist between the three variables. The significance of correlations differed from one season to another. Furthermore, it was revealed that the drought conditions in the district differed in the spatial distribution. The study accurately identified the drought episodes that occurred in the ADM in the years 2008, 2009, 2014, 2015 and 2016. The chosen methodology and variables proved to be suitable for analysing drought conditions offering space and temporal variation dimension, which is vital in monitoring drought events.

Association between household debt and depressive mood among Chinese residents

OBJECTIVES

The aim of this study was to examine the association of household debt and depressive mood among Chinese adults and to evaluate whether the association varies across types of debt.

STUDY DESIGN

This is a secondary data analysis of a nationally representative survey.

METHODS

A prospective cohort study of participants was drawn from the China Family Panel Studies (CFPS). In total, 5135 participants had their depressive mood measured in the CFPS starting from 2014 to 2016 and had participated in the biennial survey. We used logistic regression models to identify predictors of depressive mood with debts, sociodemographic factors, health status factors and health behaviors factors. Adjusted for all measured covariates, we conducted an independent analysis for the experience of housing loans from formal institutions (HLFI), other loans from formal institutions (OLFI), housing loans from relatives and friends (HLRF) and other loans from relatives and friends (OLRF).

RESULTS

Multiple logistic regression analyses revealed that household debt was a significant risk factor for depressive mood (1.35; 95% confidence interval [CI], 1.19-1.54), after controlling for potential confounders. Independent analysis revealed that HLFI was not a significant predictor, while HLRF (1.26; 95% CI, 1.08-1.48), OLFI (1.45; 95% CI, 1.13-1.87) and OLRF (1.23; 95% CI, 1.02-1.47) remained significant risk factors.

CONCLUSION

OLFI, HLRF and OLRF were associated with depressive mood, while HLFI was not. To address the problem of individual depressive mood, its apparent association with household debt should be paid more attention.