Abstract P2-05-14: Young breast cancer patients (<40 yo) have unfavorable subtypes, higher stage and worse survival

BACKGROUND:

Over the last 40 years, the incidence of breast cancer in young women in the U.S. has been relatively low and stable, but the absolute number of young women with breast cancer is increasing because of the growing population. Some epidemiological studies have shown that breast cancer diagnosed before age 40 have significantly worse overall 5-year survival. Disease free survival is also inferior in young women, and they have more aggressive cancers in general. This study aims to validate these findings using genomic analysis of large databases.

MATERIALS AND METHODS:

The Cancer Genome Atlas (TCGA; n= 1095) and the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC; n=1894) were used for analysis. We divided the database into the Young (<40 yo) and Non-Young (>40 yo) cohorts, based on age at diagnosis. The following analysis will give the TCGA and METABRIC results in each category, respectively.

RESULTS:

There were 8.9% (98) and 6% (116) patients who were found to be Young. In the Young cohort, 69.5% (64) and 37.9% (44) were ER(+), whereas 77.9% (742) and 79.5% (1415) in the Non-Young cohort were ER(+). Further, 60.8% (56) and 31.9% (37) were PR(+) in the Young cohort, compared to 68.4% (641) and 54.4% (972) in the Non-Young cohort. Her2(+) cancers were noted in 22.2% (12) and 25% (29) in the Young cohort, whereas 22.6% (152) and 11.6% (207) were Her2(+) in the Non-Young cohort. Our group developed a pipeline to calculate PAM50 from the RNA-Seq dataset. Utilizing this calculated PAM50 in TCGA, we found that there were less Luminal A and B patients in the Young cohort, 41.6% (42) and 17.8% (18) compared to 49.7% (377) and 22.9% (174) in the Non-Young cohort. This was also the case in METABRIC where 17.2% (20) and 9.5% (11) were Luminal A and B, compared to 36.9% (659) and 25.2% (450) in the Non-Young group. In contrast, there were more basal-like subtypes in the Young group, 17.8% (18) and 28.4% (33), as compared to the Non-Young group, 16.1% (122) and 9.3% (166). These results agree with previous epidemiological studies that showed that hormone receptor positive tumors increase and basal-like subtypes decrease with age. The number of Stage I patients was lower in Young patients 13.5% (13) and 25.3% (22), than in Non-Young patients 17.3% (169) and 34.4% (453). Similarly, there were less Stage II patients in the Young 54.2% (52) and 58.6% (51) compared to 58.3% (569) and 56.9% (749) in the Non-Young. This reverses in Stage III where the incidence is increased in the Young at 31.2% (30) and 16.1% (14) compared to 22.4% (219) and 7.7% (101) in the Non-Young. Young patients had a lower median disease-free survival than Non-Young patients (NA vs 214.7 mo, p=0.027); however, there was no statistical significance in median survival. Young patients had a lower median disease-specific survival than non-young patients of 221.1 months vs 282.6 months (p=0.00123) in METABRIC.

CONCLUSION: We used large datasets to examine survival in very young breast cancer patients (<40 yo) vs older patients and found that young patients are likely to have unfavorable subtypes, higher stage, and a lower overall survival and DFS as compared to their older counterparts. Further analysis with genomics is needed.

Citation Format: Young JS, Kawaguchi T, Yan L, Qi Q, Liu S, Takabe K. Young breast cancer patients (<40 yo) have unfavorable subtypes, higher stage and worse survival [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-14.

Abstract P1-07-31: Integrated transcriptomics analyses identify novel three microRNAs signature to predict poor prognosis and metastasis in breast cancer

Backgrounds: MicroRNA (miRNA) play a crucial role in cancer progression, and altered miRNA expression has been demonstrated to be associated with breast cancer. MiRNA is also known to be stably detectable not only in tissue but peripheral circulation; therefore it could be a feasible and potential biomarker of breast cancer in clinical settings. However, few studies have been reported to identify promising miRNA profiles as predictive biomarker using statistically satisfied large cohorts of breast cancer patients. The aim of this study is to identify miRNA signature that can predict patient survival utilizing integrated and unbiased transcriptomics analyses.

Methods: Integrated and unbiased transcriptomics approach was conducted on genomic and clinicopathological information of 2580 breast cancer patients. We utilized The cancer Genome Atlas (TCGA) to identify miRNA signature that could significantly associated with clinical relevance including prognosis and metastatic information, followed by validation analyses with the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and Gene Expression Omnibus (GEO)

Results: A novel risk scoring model including three miRNAs signature (miR-19a, miR-93, and miR-106a) was identified using Cox model. This miRNA score was able to extract the patient population with extremely poor prognosis in TCGA (5-yr overall survival rate, 49.2 %, p=0.0005). This result was validated with another three completely independent cohorts with microarray dataset accompanied with sufficient clinical information and miRNA expression (GSE19536, n=96, p=0.0009; GSE22220, n=210, p=0.0003; METABRIC, n=1223, p=0,0023). Interestingly, the subtype stratification with PAM-50 classification using bioinformatics pipeline demonstrated that this miRNA score could predict poor overall or disease-free survival especially in the population with luminal A, B or normal like subtype (p=0.0300 and p=0.0001, respectively). In addition, competing risk analysis for tumor recurrences demonstrated that the risk scoring using three miRNAs signature could be significantly associated with bone metastasis (p=0.0052). Finally, Gene Set Enrichment Analysis (GSEA) identified that high risk score using three miRNAs associated significantly with several critical gene sets related to metastatic formation such as angiogenesis (p <0.0001), epithelial mesenchymal transition (EMT) (p = 0.0155), focal adhesion (p <0.0001), TGF-beta signaling pathway (p = 0.0025), and ECM receptor interaction (p = 0.0068).

Conclusions: We demonstrated a promising miRNAs signature score system for predicting extremely poor prognosis and metastatic potentiality in breast cancer using novel integrated transcriptomics concept.

Citation Format: Takabe K, Kawaguchi T, Yan L, Qi Q, Peng X, Young J, Liu S. Integrated transcriptomics analyses identify novel three microRNAs signature to predict poor prognosis and metastasis in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-31.

Abstract P5-07-07: Prognostic relevance of microRNA-155 and microRNA-21 in breast cancer patients

Introduction

MicroRNAs (miRNAs) are short noncoding RNA sequences that degrade or prevent the translation of their target messenger RNA (mRNA). Altered regulation of miRNAs is implicated in different cellular processes. Some miRNAs, such as miRNA-155 (miR155) and miRNA-21 (miR21), are implicated in both immunity and cancer progression. Previous studies show that both miR155 and -21 are oncogenic, as their overexpression promotes invasion, proliferation and migration of breast cancer cells in vitro. Their overexpression within patient cohorts (n= 40-173 patients) reveals a worse prognosis for miR21 and varying associations with prognosis for miR155. By using the Cancer Genome Atlas (TCGA), which contains data from over a thousand patients, we want to clarify whether high expression of miR155 or -21 is associated with an improved or worse survival within breast tumor samples. Because both miR155 and -21 are described as oncogenic, we hypothesize that high expression of these miRNAs would portend a worse survival.

Methods

Within the breast cohort, 1052/1097 patients within TCGA contained both clinical and miRNA sequence data, acquired via the Genomic Data Common (GDC) data portal. The patients were separated into a high and low expression group for both miR155 and miR21, and associations with overall survival were obtained using the Cox proportional hazard model. Furthermore, a sub-analysis was conducted based on estrogen, progesterone and Her-2 receptor status (ER, PR, Her-2) as well as TNM staging (AJCC 7th edition).

Results

General patient characteristics within the breast cancer cohort of TCGA included: 70% Caucasian, 73% >50 years old, 75% with TNM stage I and II breast cancers, 74% ER positive, and 33% Her-2 positive. We unexpectedly found that miR155 and miR21 high expression was associated with an improved survival (p=0.05 and 0.038 respectively). In the sub-analysis, a positive association with survival was seen for miR155 high expression in ER negative, and Stage I-II breast cancers (p=0.025, 0.0013 respectively), but not in Stage III-IV. The sub-analysis for miR21 found an association with improved survival for miR21 high expression in ER negative, and stage I-II patients (p=0.033, 0.0015 respectively), but not in Stage III-IV. Although not statistically significant, a trend towards improved survival was found in ER and PR positive subgroups, for both miR155 and -21. For the Her-2 negative subgroup, there was a trend for improved survival in miR155 high expression, but not in miR21 high expression. Knowing that ER negative tumors can attract more immune cells, and that miR155 and -21 can be expressed in immune cells and tumor associated fibroblasts respectively, we speculate that their high expression was concentrated within cells from the tumor microenvironment rather than the cancer cells.

Conclusion

Using TCGA as a large validation cohort, we found that high expression of miR155 and miR21 was associated with an improved survival, which was contrary to what we predicted. Future experiments using computational biology to determine the cell type composition within the TCGA tumor samples will be performed in an effort to determine whether the tumor microenvironment influenced the survival patterns we observed in the high expression groups of miR155 and -21.

Citation Format: Kim SY, Kawaguchi T, Yan L, Young J, Qi Q, Takabe K. Prognostic relevance of microRNA-155 and microRNA-21 in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-07-07.

Abstract P5-07-08: Survival relevance of tamoxifen sensitivity-related microRNAs, miR-342 and miR-221/222, in breast cancer patients

BACKGROUND: MicroRNAs (miRNAs) are small noncoding RNAs, which regulate the expression of target genes post-transcriptionally by RNA interference. They have emerged as one of the crucial regulators of cancer progression. Some miRNAs are reported to be related to the response of breast cancer to tamoxifen (TAM). In this study, we investigated whether the levels of TAM-resistant miRNA (miR-221/222) and TAM-sensitive miRNA (miR-342) translate to breast cancer patient survival, using multiple large databases.

MATERIALS AND METHODS: The Cancer Genome Atlas (TCGA; n=1049), Gene Expression Omnibus (GEO; GSE19536 n=96, GSE22220 n=210), and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC; n=2509) datasets were used and Gene Set Enrichment Analysis (GSEA) was performed.

RESULTS: MiR-342 was identified as a TAM-sensitive miRNA, and miR-221/222 were identified as TAM-resistant miRNAs by literature search. Patients with high expression of miR-342 were shown to have better survival in TCGA (OS, p=0.02; DFS, p=0.03, respectively) and in two other independent GEO cohorts (OS, p=0.02 and p=0.0007, respectively) as well as in the METABRIC cohort (OS, miR-342-3p, p=0.006; miR-342-5p, p=0.00009). By subtype analyses, high expression of miR-342 was significantly associated with better survival in ER-positive patients (p=0.04), but not in ER-negative or triple negative patients in the TCGA cohort. This association was not observed in the METABRIC cohort. Within TCGA cohort, expression of TAM-resistant miR-221/222 did not significantly impact survival. Unexpectedly, increased expression of miR-221 was shown to have increased overall survival in all patients (p=0.00904) as well as in ER-negative patients (p=0.0479) and non-triple negative patients (p=0.0106) within the METABRIC cohort. On the other hand, low expression of miR-222 was associated with increased survival of all patients (p=0.00802) as well as in non-triple negative patients (p=0.041). Lastly, GSEA demonstrated that lower miR-342 expression was significantly seen in TAM-resistant gene sets, and higher miR-342 expression was seen TAM-sensitive gene sets, but miR-221/222 did not show any significant enrichment with TAM-resistant or TAM-sensitive gene sets. Taken together with survival data, expression levels of miR-342 reflect its TAM-sensitivity related function, however, that of miR-221/222 reflect other functions in breast cancer patients.

CONCLUSION: For the first time, we used “big data” from the TCGA, GEO and METABRIC cohorts to analyze multiple miRNAs with respect to TAM sensitivities and its survival impact. We demonstrated that expression of miR-342 reflected the sensitivity of the cancer cells to TAM sensitivity, however, that of miR-221/222 reflected other functions in breast cancer patients.

Citation Format: Young JS, Kawaguchi T, Yan L, Qi Q, Liu S, Takabe K. Survival relevance of tamoxifen sensitivity-related microRNAs, miR-342 and miR-221/222, in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-07-08.

Abstract P6-06-06: Immunogenomics approach elucidating clinical significance of DNA repair genes and tumor infiltrating immune cells in breast cancer

Backgrounds: Evading the immune system is one of the Hallmarks of Cancer. Indeed, tumor infiltrating immune cells has been shown to play critical roles in suppression of cancer progression. Genetic aberration of DNA repair genes is known to increase immunogenicity in breast cancer. However, the patient survival relevance of tumor infiltrating immune cells in regard to DNA repair genes has not yet elucidated in large cohort of breast cancer patients. We hypothesized that DNA repair gene deficiency is related to increased global genomic instability that leads to increased mutation burden, which recruits infiltrating immune cells to tumor microenvironment that result in better prognosis of breast cancer.

Patients and Methods: Integrated and unbiased transcriptomics approach was conducted on genomic and clinicopathological information of 3614 breast cancer patients. We utilized The cancer Genome Atlas (TCGA) and the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) to evaluate the association between the aberration of DNA repair genes and tumor infiltrating immune cell composition in breast cancer tumors, as well as its significant clinical relevance, utilizing bioinformatics and biostatistics pipelines.

Results:Low expression level of double-strand break repair genes; BRCA1, PRKDC, and RECQL4,demonstrated significantlybetter prognosis in TCGA cohort (p=0.018, p=0.036, and p=0.0002, respectively). This result was consistent in METABRIC cohort (p=0.021, p=0.00021, and p<0.000001, respectively). Utilizing CIBERSORT system that estimate the fraction of 22 immune cell types, we found that low expression of BRCA1 significantly associated with high levels of CD8 positive cell composition in both cohorts (TCGA, p=4.67E-08; METABRIC, p=0.0038), which implicate that tumor infiltrating lymphocytes are attracted to BRCA1 low expressing tumors. Further, low expression of BRCA1 showed significantly better survival in HER2 positive subtype population, but not in the other populations (TCGA, p=0.027; METABRIC, p=0.13). Finally, significantly poor prognosis was observed in breast cancers low in immune-response markers; PD-1, PD-L1, TIM3, LAG3, and CTLA4, in combination with high expression of BRCA1 (p=0.0016, p=0.0041, p=0.015, p=0.0041, and p=0.0043, respectively), which is in agreement with the dogma that intact DNA repair induce less immune-response that result is worse survival.

Conclusions: We conclude that our immunogenomics approach identify the interplay between DNA repair genes, especially gene expression of BRCA1, and tumor infiltrating immune cells, and it could have significant prognostic relevance in breast cancer.

Citation Format: Takabe K, Kawaguchi T, Yan L, Peng X, Qi Q, Okano M, Young J, Liu S. Immunogenomics approach elucidating clinical significance of DNA repair genes and tumor infiltrating immune cells in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-06-06.

[A comparison of clinical characteristics between 2 pedigrees of multiple endocrine neoplasia type 2A with different RET mutations]

Multiple endocrine neoplasia type 2A (MEN2A) is a hereditary syndrome. Here, two different RET proto-oncogen mutation were identified from family members of two MEN2A pedigrees by genetic screening. One RET mutations were found at codons 1893 and 1895 in exon 11 (1893-1895delCGA) from pedigree 1, which is a novel mutation, the other occurs at codon 634 (Cys634Arg) in exon 11 from pedigree 2. However, the clinical characteristics were similar in the patients of the two pedigrees. All the patients were in middle-age at onset. Most of them were firstly diagnosed with bilateral adrenal pheochromocytoma with different degrees of thyroid abnormalities (elevated serum calcitonin with or without thyroid mass, or had been diagnosed with medullary thyroid carcinoma). Some family members were with elevated serum parathyroid hormone but with no other evidences for hyperparathyroidism.

GEM detector performance with innovative micro-TPC readout in high magnetic field

Gas detector development is one of the pillars of the research in fundamental physics. Since several years, a new concept of detectors, called Micro Pattern Gas Detector (MPGD), allowed to overcome several problems related to other types of commonly used detectors, like drift chamber and micro strips detectors, reducing the rate of discharges and providing better radiation tolerance. Among the most used MPGDs are the Gas Electron Multipliers (GEMs). Invented by Sauli in 1997, nowadays GEMs have become an important reality for particle detectors in high energy physics. Commonly deployed as fast timing detectors and triggers, their fast response, high rate capability and high radiation hardness make them also suitable as tracking detectors. The readout scheme is one of the most important features in tracking technology. Analog readout based on the calculation of the center of gravity technique allows to overcome the limit imposed by digital pads, whose spatial resolution is limited by the pitch dimensions. However, the presence of high external magnetic fields can distort the electronic cloud and affect the performance. The development of the micro-TPC reconstruction method brings GEM detectors into a new prospective, improving significantly the spatial resolutionin presence of high magnetic fields. This innovative technique allows to reconstruct the 3-dimensional particle position, as Time Projection Chamber, but within a drift gap of a few millimeters. In these report, the charge centroid and micro-TPC methods are described in details. We discuss the results of several test beams performed with planar chambers in magnetic field. These results are one of the first developments of micro-TPC technique for GEM detectors, which allows to reach unprecedented performance in a high magnetic field of 1 T.

[Comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy in pancreatic ductal adenocarcinoma]

Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226.6±56.8) min (P<0.05). The operative hemorrhage, postoperative exhaust time, recovery eating time, the whole and postoperative hospitalization time of LDP group were (188.7±108.9) ml, (2.2±1.3) d, (2.9±1.1) d, (13.2±10.4) d and (9.3±8.1) d, respectively, dramatically shorter than those of ODP group (625.2±982.1) ml, (4.3±1.7) d, (5.2±1.8) d, (20.7±8.7) d and (14.9±7.8) d, respectively (all of P<0.05). There were no intraoperative blood transfusion case in LDP group, however, 13 patients in ODP group received intraoperative blood transfusion, without significant difference (P=0.207). Alternatively, 6 cases occurred pancreatic fistula in LDP group, among them, 5 cases were grade A and 1 case was grade B; In ODP group, 17 cases occurred pancreatic fistula, among them 13 cases were grade A, 1 case was grade B and 3 cases were grade C, without significant differences (P=0.130). There were 2 cases of delayed gastric empty, 1 case of pulmonary infection in LDP group. In ODP group, there were 5 cases of postoperative delayed gastric empty, 3 cases of pulmonary infection and 6 cases of intra-abdominal infection, without significant differences (P>0.05). In both LDP group and ODP group, none occurred percutaneous drainage, re-admissions, second operation or perioperative death. Conclusions: Compared to ODP, LDP is much safer and more steady in perioperative periodand operation. Patients of pancreatic ductal adenocarcinoma received LDP can acquire more benefit and recovery sooner, and LDP is a safe and effective operative method.

Melanoma arising from a plaque-type blue naevus with subcutaneous cellular nodules of the scalp

Plaque-type blue naevus (PTBN) is a very rare variant of blue naevus (BN). The potential malignancy of subcutaneous cellular nodules (SCN) in PTBN was discovered in 2012, and there is currently no clear consensus on prognostic factors or management guidelines of such lesions. PTBN on the scalp have not been described in the literature. We report the clinical, histopathological and immunohistological features of a 50-year-old man who presented with a 30-year history of scalp PTBN, with malignant proliferation of nodular elements and fatal outcome 8 years later. This case suggests that long-term monitoring of patients with PTBN is required. Early surgical removal of such lesions should be considered, especially in the presence of any case of enlargement or change.

Illuminating gravitational waves: A concordant picture of photons from a neutron star merger

Merging neutron stars offer an excellent laboratory for simultaneously studying strong-field gravity and matter in extreme environments. We establish the physical association of an electromagnetic counterpart (EM170817) with gravitational waves (GW170817) detected from merging neutron stars. By synthesizing a panchromatic data set, we demonstrate that merging neutron stars are a long-sought production site forging heavy elements by r-process nucleosynthesis. The weak gamma rays seen in EM170817 are dissimilar to classical short gamma-ray bursts with ultrarelativistic jets. Instead, we suggest that breakout of a wide-angle, mildly relativistic cocoon engulfing the jet explains the low-luminosity gamma rays, the high-luminosity ultraviolet-optical-infrared, and the delayed radio and x-ray emission. We posit that all neutron star mergers may lead to a wide-angle cocoon breakout, sometimes accompanied by a successful jet and sometimes by a choked jet.

Increases in the expression of Na+ /H+ exchanger 1 and 3 are associated with insulin signalling in the ruminal epithelium

Na⁺ /H⁺ exchanger (NHE), which catalyses the exchange of extracellular Na⁺ for intracellular H⁺ , is of importance in the maintenance of Na⁺ and pH homoeostasis for rumen epithelial cells. Studies in ruminants showed that high concentrate diets could increase the expression of NHE in ruminal epithelium. Results of recent studies further indicated that insulin, as an important hormone closely related to dietary concentrate, could enhance the expression of NHE. In this study, we have investigated the mechanisms of insulin regulating the expression of NHE in rumen epithelial cells and its potential role in dietary modulation of NHE expression in ruminal epithelium of cows. In primary culture, insulin increased phosphorylation of ERK 1/2 and AKT in rumen epithelial cells. However, this promotion was diminished by insulin receptor inhibitor. Insulin also stimulated NHE1 and NHE3 expression. But this increase was suppressed by insulin receptor inhibitor, ERK inhibitor and AKT inhibitor. In the present animal experiment, NHE1 and NHE3 expression increased in rumen epithelium of cows ingesting a high concentrate diet (HC, 60% concentrate), accompanied by increased insulin concentration in plasma, compared to those feeding a low concentrate diet (LC, 20% concentrate). Furthermore, the phosphorylation of ERK1/2 and AKT was higher in the rumen epithelium of the HC group than those in the LC group. Collectively, these results indicate that diet-dependent change of NHE1 and NHE3 abundance was mediated, at least in part, by plasma insulin through the ERK and AKT pathway.

Heuristics for precise supramolecular control of soft matter structure and properties - 2,3,4-tris(dodecyloxy)benzenesulfonates with alkaline and organic cations

Comprehensive analysis of the structure and phase behavior for a number of 2,3,4-tris(dodecyloxy)benzenesulfonates with alkali metal and organic focal groups revealed that the shape of the mesogenic group plays a decisive role in phase behavior of the material. Cubic and layered types of packing prevail when the size of the cation is small and, thus, the shape of the mesogenic molecule is close to conic one. With increasing cation size, the shape becomes more tapered, and columnar mesophases appear to be more stable. Interactions of the focal groups however determine the stability of mesophases. Comparatively strong interactions may, morever, provide substantial deviations from a phase diagram plotting the transition temperatures versus the radius of focal group, as in the case of pyridinium 2,3,4-tris(dodecyloxy)benzenesulfonate.

Down-regulation of single-stranded DNA-binding protein 1 expression induced by HCMV infection promotes lipid accumulation in cells

The objective of this study was to observe the infection of human cytomegalovirus (HCMV) to human umbilical vein endothelial cells, and its effect on the expression of single-stranded DNA-binding protein (SSBP1) and on lipid metabolism in endothelial cells. We screened the differential expression of mRNAs after HCMV infection by suppression subtractive hybridization and the expression levels of SSBP1 mRNA and protein after HCMV infection by real-time PCR and western blot. After verification of successful infection by indirect immunofluorescent staining and RT-PCR, we found a differential expression of lipid metabolism-related genes including LDLR, SCARB, CETP, HMGCR, ApoB and LPL induced by HCMV infection. The expression levels of SSBP1 mRNA and protein after HCMV infection were significantly down-regulated. Furthermore, we found that upregulation of SSBP1 inhibited the expression of atherosclerosis-associated LDLR, SCARB, HMGCR, CETP as well as the accumulation of lipids in the cells. The results showed that the inhibition of SSBP1 by HCMV infection promotes lipid accumulation in the cells.

CDKN2B deletion is essential for pancreatic cancer development instead of unmeaningful co-deletion due to juxtaposition to CDKN2A

Pancreatic cancer is among the deadliest malignancies; however, the genetic events that lead to pancreatic carcinogenesis in adults remain unclear. In vivo models in which these genetic alterations occur in adult animals may more accurately reflect the features of human cancer. In this study, we demonstrate that inactivation of Cdkn2b (p15ink4b) is necessary for induction of pancreatic cancer by oncogenic KRAS^G12D expression and inactivation of Tp53 and Cdkn2a in adult mouse pancreatic ductal cells (P60 or older). KRAS^G12D overexpression in these cells activated transforming growth factor-β signaling and expression of CDKN2B, which, along with CDKN2A, led to cellular senescence and protected cells from KRAS-mediated transformation via inhibition of retinoblastoma phosphorylation. These results show a critical role of CDKN2B inactivation in pancreatic carcinogenesis, and provide a useful adult animal model by genetic engineering via lentiviral delivery.

[Accelerated transepithelial corneal collagen cross-linking for progressive keratoconus with a thin cornea: one-year results]

Objective: To evaluate the clinical results of keratoconic eyes with a thin cornea treated with accelerated transepithelial corneal collagen cross-linking (A-TE-CXL) within 1 year. Methods: Nineteen eyes of 19 patients with progressive keratoconus with a minimum corneal thickness from 380 μm to 420 μm (including the epithelium) were included in this prospective, nonrandomized clinical study and treated with A-TE-CXL. Scoring of pain and foreign body sensation, slit lamp examination, uncorrected visual acuity, best corrected distance visual acuity, corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy and endothelial cell count were assessed before surgery and at 1, 3, 6 and 12 months postoperatively. Paired t test was applied for statistical analysis. Results: Mild pain and moderate foreign body sensation were reported by most patients within postoperative 24 hours, but rapidly disappeared on day 2. Extremely mild epithelial damage was observed within postoperative 24 hours, and the epithelium fully recovered on day 2. Improvement of visual acuity was recorded at 3 and 12 months. Pentacam corneal topography revealed a significant reduction of the thickness of the thinnest location from(395.2±13.8)μm preoperatively to (378.9±17.1)μm at 1 month postoperatively (t=2.982, P<0.01). Front curvature values were reduced postoperatively. K(MAX) was significantly decreased at 12 months (55.67±4.91) compared with (57.35±5.54) preoperatively, while K2 was also significantly decreased at 12 months (52.18±3.70) compared with (52.70±3.56) preoperatively (K(MAX), t=3.044, P<0.01. K2, t=2.384, P<0.05) . Within 1 month postoperatively, optical coherence tomography exhibited an increase of reflectance with a demarcation line in the anterior stroma. In vivo confocal microscopy also showed significant thickening and increased connections of collagen fibers with a maximal depth at about 90 to 120 μm. The corneal endothelial cell density remained stable (t=0.692, P>0.05). None of the patients showed postoperative complications such as corneal infection, scarring and ulceration. Conclusions: Within 1 year postoperatively, A-TE-CXL was effective and safe for the management of progressive keratoconus with a thin cornea. A-TE-CXL showed the advantages of very short time consuming in surgery, rapid recovery and very few complications, and had the potential to become a valid alternative for the treatment of keratoconus. (Chin J Ophthalmol, 2017, 53: 694-700).

Effects of mine strata thermal behavior and mine initial temperatures on mobile refuge alternative temperature

Federal regulations require the installation of refuge alternatives (RAs) in underground coal mines. Mobile RAs have a limited ability to dissipate heat, and heat buildup can lead to a life-threatening condition as the RA internal air temperature and relative humidity increase. The U.S. National Institute for Occupational Safety and Health (NIOSH) performed heat testing on a 10-person tent-type training RA and contracted ThermoAnalytics Inc. to develop a validated thermal simulation model of the tested RA. The model was used to examine the effects of the constant mine strata temperature assumption, initial mine air temperature, initial mine strata surface temperature (MSST), initial mine strata temperature at depth (MSTD) and mine strata thermal behavior on RA internal air temperature using 117 W (400 Btu/h) of sensible heat input per simulated miner. For the studied RA, when the mine strata temperature was treated as a constant, the final predicted RA internal air temperature was 7.1°C (12.8°F) lower than it was when the mine strata thermal behavior was included in the model. A 5.6°C (10.0°F) increase in the initial MSST resulted in a 3.9°C (7.1°F) increase in the final RA internal air temperature, whereas a 5.6°C (10°F) increase in the initial MSTD yielded a 1.4°C (2.5°F) increase in the final RA internal air temperature. The results indicate that mine strata temperature increases and mine strata initial temperatures must be accounted for in the physical testing or thermal simulations of RAs.

[Evaluation of health effect among occupational population exposed to nano-titanium dioxide: a cross-sectional study]

Objective: To characterize the health effects of nano-titanium dioxide exposure in an occupational cohort. Methods: Eighty-five male employees of a nano-titanium dioxide manufacturing enterprise in Shandong Province were evaluated in September 2014. Forty-four were exposed to nano-titanium dioxide (exposure group), and 41 were not exposed to nano-titanium dioxide (control group). We collected employees' basic information, smoking and drinking history, previous medical history, family history, and occupational history. Differences in blood pressure, hematological parameters, and blood biochemistry between the two groups were analyzed and compared. Multiple linear regression analysis was used to investigate the effect of nano-titanium dioxide exposure on blood pressure, hematological parameters, and blood biochemistry indices after controlling for age, smoking, drinking, and body mass index (BMI). Twenty-five employees from the exposure group and 25 employees from the control group were selected at random for measurement of genetic damage by cytokinesis-block micronucleus assay. Poisson regression analysis was used to investigate the effect of nano-titanium dioxide exposure on micronucleus frequency or micronucleus cell frequency after controlling for age, smoking, drinking, and BMI. Results: The median (P₂₅-P₇₅) surface area concentration of particles deposited in the tracheobronchial region, the surface area concentration of particles deposited in the alveolar region, and particle number concentration in the exposure group were 35.35(24.31-57.42) μ m²/cm³, 173.09(116.27-270.72) μ m²/cm³, and 40 244.00 (17 803.50-78 679.00) /cm³, respectively. These values were significantly higher than those in the control group 33.90 (27.44-43.29) μm²/cm³, 150.50(125.82-192.87)μm²/cm³, and 18 721.00 (12 721.00-51 898.50)/cm³, respectively. Z values were 15.47, 15.96, and 14.54, respectively (P<0.001 for all three values). Multiple linear regression analysis showed that exposure to nano-titanium dioxide contributed most to the alteration of mean corpuscular hemoglobin concentration, creatinine, and LDL-C, with standardized regression coefficients of 0.23, -0.51, and 0.30, respectively (P<0.05 for all three values), after adjusting for age, smoking, drinking, and BMI. There were no significant differences in micronucleus frequency and micronucleus cell frequency between the exposure group (3.00‰ (1.50‰-5.00‰) and 3.00‰ (2.00‰-4.00‰), respectively) and control group (2.00‰ (1.00‰-4.50‰) and 2.00‰ (1.00‰-4.00‰), respectively); P>0.05 for all comparisons. Poisson regression analysis showed that after adjusting for age, smoking, drinking, and BMI, there was still no statistically significant correlation between nano-titanium dioxide exposure and micronucleus frequency (OR=1.11, 95% CI: 0.81-1.54) or micronucleus cell frequency (OR=1.07, 95% CI: 0.75-1.51); P>0.05 for all comparisons. Conclusion: Nano-titanium dioxide particles exerted some health effects on the occupationally-exposed cohort, whose hematological parameters and blood biochemistry were influenced to some degree. However, a potential link between occupational exposure to nano-titanium dioxide and blood pressure or induction of genetic damage or was not found.

Determination of the Spin and Parity of the Z_{c}(3900)

The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}→π^{+}π^{-}J/ψ. We use a data sample of 1.92  fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst})  MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst})  MeV. We also measure cross sections for the process e^{+}e^{-}→Z_{c}(3900)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}→Z_{c}(4020)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-}.

[Clinical observation on monovision of cataract surgery with different near addition]

Objective: To observe the influence on spectacle independence, satisfaction and visual function after cataract surgery monovision with different ADD. Methods: Prospective clinical study. All patients were collected from the department of ophthalmology, Shanghai JiaoTong University Affiliated Sixth People's Hospital who were diagnosed as bilateral cataract from Oct. 2013 to Mar. 2015. This study comprised 64 cases (128 eyes). All consecutive patients scheduled to undergo bilateral cataract phacoemulsification and implantation of a monofocal AcrySof IQ IOL. The average age of patients was (65.4± 6.0) years old, ranged from 51 to 70 years. 28 males and 36 females. According to the different demands of spectacle independence and living habits of patients, all cases were divided into two groups: MV1 group (32 patients), whose near addition being 1.25-1.75 D and MV2 group (32 patients), whose near addition being 2.25-2.75 D. Parameters 6 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities, stereo vision and refractive states were analyzed. Parameters of spectacle independence, subjective visual symptoms and patient satisfaction according to visual function questionnaire were analyzed at the same time. T test was used to compare uncorrected visual acuity. Whitney U test was operated in stereo vision comparison. Chi-square test was applied in sex-distribution comparison and visual function questionnaire between two groups. Results: The uncorrected distance vision in MV1 group was (0.09±0.09), while it was (0.11±0.08) in MV2 group. The uncorrected intermediate vision in MV1 group was (0.27±0.25), and it was (0.30±0.22) in MV2 group. There were no significant difference between two groups in bilateral uncorrected distance vision (t=1.62, P=0.264, LogMAR), intermediate (t=- 0.23, P=0.876, LogMAR). However, there was significant difference between two groups in uncorrected near vision (t=2.38, P=0.021, LogMAR). It was (0.06±0.06) in MV1 group and (0.02±0.07) in MV2 group. Moreover, near stereo vision was better in MV1 group than MV2 group (Z=- 1.29, P=0.031). On the questionnaire, all patients in two groups had no significant difference in their daily lives discomfort (χ(2)=0.10, P=0.756). In MV2 group, there were 2 patients complained obstacles while walking stairs dimly. In MV1 group, there were 3 patients had to wear low degrees of presbyopic glasses when they were on near work. Percentage of patients spectacle independence was less than 90% in MV1 groups. In MV2 group, one case needed low degrees of myopic glasses when he was on intermediate computer work and playing table games. Conclusion: Different near addition has similar advantages to different patients on spectacle independence, satisfaction and visual function after cataract surgery. (Chin J Ophthalmol,2017,53: 451-454).

[Prevalence and associated factors of female urinary incontinence in Hebei province]

Objective: To estimate the prevalence and associated factors of adult female urinary incontinence in Hebei province. Methods: Stratified and multistage sampling method was used, between January 2016 to May 2016, to investigate the target population in Hebei province. While, logistic regression was used to analyse datas. Results: A population-based survey was conducted in 2 450 women in Hebei province, there were 2 408 effective questionnaires after deleting 48 invalid questionnaires. According to the results, the average age of subjects was (56±15) years old, and the urinary incontinence prevalence of adult female in Hebei province was 27.70% (667/2 408). Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 23.13% (557/2 408), 1.58% (38/2 408) and 2.99% (72/2 408), respectively. There were only 2.85% (19/667) urinary incontinence patients seeking medical help. The results of logistic regression analysis showed that age, daily water intake, pulmonary diseases, urinary tract infection, hypertension, chronic low back pain, dysmenorrhea, vaginitis, abortion, mode of delivery, postpartum infection were statistically significant (all P≤0.05). Among these factors, cesarean section was the protective factor for urinary incontinence (OR=0.365, 95 % CI: 0.195-0.685, P<0.01). Conclusions: The prevalence of urinary incontinence in adult female in Hebei province is high, and there are few patients seeking medical help. It is a common disorder in women and is associated with many factors; among these factors, cesarean section is the protective factor for urinary incontinence.

Effects of space allocations and energy levels on growth performance and nutrient digestibility in growing and finishing pigs

Two experiments were conducted to investigate effects of different space allocations and different dietary metabolizable energy (ME) levels on growth performance and nutrient digestibility in growing and finishing pigs. In experiment 1, a total of 84 growing pigs [(Yorkshire × Landrace) × Duroc] with an initial body weight (BW) of 27.10 ± 1.60 kg were used in a 5-week trial. Pigs were blocked based on initial BW into a 2 × 2 factorial design with the following factors: (i) 0.60 or 0.80 m² /pig space allocations; and (ii) 3,400 or 3,550 kcal/kg ME of diets. In experiment 2, a total of 84 finishing pigs with an initial BW of 67.43 ± 1.97 kg were used in a 10-week trial. Pigs were allotted based on initial BW into a 2 × 2 factorial design with the following factors: (i) 0.81 or 1.08 m² /pig space allocations; and (ii) 3,300 or 3,450 kcal/kg ME of diet. In experiment 1, high ME diet improved gain-to-feed ratio (G:F) in pigs with low space allocation but not in pigs in high space allocation (p < .05). Additionally, high ME diet increased apparent total tract digestibility (ATTD) of nitrogen in low space allocation but decreased ATTD of nitrogen in high space allocation (p < .05). In experiment 2, high ME diet improved average daily gain (ADG) and G:F in early-finishing pigs with low space allocation but not in pigs with high space allocation (p < .05). In conclusion, the provision of high ME diets was not enough to overcome the reduction in growth performance due to low space allocation but can improve feed efficiency in growing pigs and daily gain and feed efficiency early-finishing pigs.

Contrast-enhanced ultrasound in the diagnosis of orbital space-occupying lesions

AIM

To summarise the sonographic findings and assess the feasibility of contrast-enhanced ultrasound (CEUS) as an imaging method for the diagnosis of orbital space-occupying lesions.

MATERIALS AND METHODS

This was a prospective study of 53 patients who underwent orbital ultrasound at Xijing Hospital. Two-dimensional ultrasound, colour Doppler flow imaging (CDFI), and CEUS imaging were obtained and compared in patients with orbital haemangioma, pseudotumour, melanoma of the choroid, and retinoblastoma.

RESULTS

CEUS imaging cannot only visualise the location, shape, border, acoustic properties of a lesion, and interactions between the lesion and surrounding tissues, but also display the microvasculature and tissue perfusion within the lesion. The information obtained from CEUS imaging is valuable for diagnosis and differential diagnosis of orbital space-occupying lesions.

CONCLUSION

CEUS imaging allowed better visualisation of the lesions, enabled detection of vascular changes, increased the signal-to-noise ratio, and increased the sensitivity of detection of changes in perfusion in the microcirculation. It has relatively high sensitivity and specificity in the diagnosis of orbital space-occupying lesions and increases the accuracy of diagnosis.

Comparison of Upper Midline Incision With and Without Laparoscopic Assistance for Living-Donor Right Hepatectomy

BACKGROUND

Since minimally invasive procedures for living-donor right hepatectomy (LDRH) became popular in recent years, several studies comparing the outcomes of donors undergoing an upper midline incision (UMI) under laparoscopic assistance for LDRH with those undergoing the traditional open LDRH have been published. However, there are very few comparative studies of outcomes for a UMI for LDRH with and without laparoscopic-assistance. We designed the present study to compare the benefits and shortcomings of a UMI for LDRH with and without laparoscopic assistance.

METHODS

Forty-eight patients in our center were included in the study: group hybrid (n = 28) versus group UMI (n = 20). Their surgical outcomes, postoperative course, and cosmetic outcomes were studied from medical records.

RESULTS

No differences existed between the 2 groups regarding their baseline characteristics except that group Hybrid had more donors with positive hepatitis B core antibody. No difference was observed in operative time, graft weight, warm ischemia time, blood loss, incision length, liver and coagulation function test results, postoperative complications, or cosmetic parameters. No deaths occurred in both groups. The length of postoperative hospital stay was similar for both groups, but the hospital cost was significantly lower for group UMI than for group hybrid (6,906.7 ± 777.4 USD vs 7,643.3 ± 918.6 USD; P = .005).

CONCLUSIONS

An UMI without laparoscopic assistance can be considered as the first-line incision of choice for LDRH.

iPTF16geu: A multiply imaged, gravitationally lensed type Ia supernova

We report the discovery of a multiply imaged, gravitationally lensed type Ia supernova, iPTF16geu (SN 2016geu), at redshift z = 0.409. This phenomenon was identified because the light from the stellar explosion was magnified more than 50 times by the curvature of space around matter in an intervening galaxy. We used high-spatial-resolution observations to resolve four images of the lensed supernova, approximately 0.3 arc seconds from the center of the foreground galaxy. The observations probe a physical scale of ~1 kiloparsec, smaller than is typical in other studies of extragalactic gravitational lensing. The large magnification and symmetric image configuration imply close alignment between the lines of sight to the supernova and to the lens. The relative magnifications of the four images provide evidence for substructures in the lensing galaxy.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

The inhibitory effect of resveratrol on COX-2 expression in human colorectal cancer: a promising therapeutic strategy

OBJECTIVE

The objective of this study is to investigate the mechanism of resveratrol (RSVL) on the inhibitory effect on the expression of COX-2 in human colorectal cancer.

MATERIALS AND METHODS

In this study, we used the HCT-116 cells as the observation group, and the normal cells as the control group. The inhibitory effect induced by RSVL on the COX-2 expression in human colorectal cancer was investigated. For the observation group, cells were cultured in the nutrition solution with RSVL, while the cells in both control group (normal colon epithelial cells) and blank control group (none-treated HCT-116 cells) were cultured in the regular nutrition solution. We assayed the mRNA expression and the protein expression of COX-2 in different groups using Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot methods, respectively. Also, we measured the cell growth and apoptosis in different treatment groups by using methyl thiazolyl tetrazolium assay (MTT) method, and detected the differences in COX-2 expression among different groups through immunohistochemistry staining RESULTS: Compared with blank control group, the rate of cell proliferation in the observation group treated with RSVL was significantly reduced. The results of RT-qPCR revealed that the mRNA expression of COX-2 of the observation group was affected compared with the blank control group. According to the results from enzyme-linked immunosorbent assay (ELISA) and Western blot, the expression of the COX-2 protein in the observation group treated with RSVL was significantly lower than that in the blank control group; however, results from the observation group and the control group were similar. Also, the immunohistochemistry results showed the positive rate of COX-2 expression in the observation group was significantly lower than that in the control group.

CONCLUSIONS

RSVL (in a certain concentration) can suppress the human colorectal cancer through inhibition of COX-2 expression.

[Influence of short-term intensive insulin therapy on plasma concentration of lipoprotein-associated phospholipase A(2) and secretory phospholipase A(2) in newly diagnosed type 2 diabetic patients]

The aim of the study was to explore the effect and its clinical relevance of short-term intensive insulin treatment on plasma concentrations of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and secretory phospholipase A(2) (sPLA(2)) in newly diagnosed type 2 diabetes mellitus (T2DM). Ninety newly diagnosed T2DM patients were recruited and received continuous subcutaneous insulin infusion (CSII) for about 2 weeks. After CSII, sPLA(2) levels [173.78 (80.95, 278.09) μg/L] were significantly decreased compared with the levels before [219.33 (130.03, 337.30) μg/L], P<0.01, while no statistic significant changes could be viewed in Lp-PLA(2) levels. Correlation analysis showed that the changes of Lp-PLA(2) and sPLA(2) were both positively correlated with the changes of homeostasis model assessment of insulin resistance(HOMA-IR)after CSII (r=0.537, 0.493 respectively, all P<0.05). The Lp-PLA(2) and sPLA(2) level reduction after CSII might help to protect the patients from diabetic macroangiopathy. Trial registration Chinese Clinical Trial Registry, ChiCTR-TRC-10001618.

Population Pharmacokinetics and Pharmacodynamics of Benralizumab in Healthy Volunteers and Patients With Asthma

Benralizumab is a humanized, afucosylated, anti‐interleukin‐5 receptor α, immunoglobulin G (IgG) ₁ κ monoclonal antibody. We developed a population pharmacokinetic (PK)/pharmacodynamic (PD) model for benralizumab by analyzing PK and blood eosinophil count data from two healthy volunteer studies (N = 48) and four studies in patients with asthma (N = 152). Benralizumab PK was dose‐proportional and adequately described by a two‐compartment model with first‐order elimination from the central compartment and first‐order absorption from the subcutaneous dosing site. The estimated systemic clearance and volume of distribution were typical for human IgG. Body weight and high‐titer antidrug antibodies were identified as relevant covariates influencing the PK of benralizumab. Depletion of blood eosinophil counts was depicted by a modified transit model in which benralizumab induced depletion of eosinophils in each age compartment. Stochastic simulations supported an every‐8‐week dosing schedule of benralizumab for a phase IIb study in patients with uncontrolled asthma.

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

Rural Health Care Workers and Local Residents Health Status in Yulong County of Yunnan Province China and Hat Yai City of Songkhla Mansion Thailand

INTRODUCTION

To compare health status between Hat Yai city of Songkhla Province in Thailand and Yulong county of Yunnan province in China about rural health care workers and local residents, analyzing of both differences, learning from the advanced experience and practice of Thailand, adjusting policy, especially for the implementation of measures to improve the lack of human resources construction of Yulong County rural health, promote the level of rural health service of Lijiang.

METHODS

A qualitative study consisting of focus group discussions and individual in-depth interviews were conducted in Rural Health Care Workers and Local Residents Health Status in Yulong County of Yunnan Province China and Hat Yai City of Songkhla Mansion Thailand from.

RESULTS

Compared to 41(100%) bachelor's degree of medical staffs in Hat Yai, this accounted only 94 (42%) bachelor's degree of medical staffs in Yulong county hospital, and 31 (12%)in townships hospitals. For medical workers in Hat Yai, they have at least one time on-job training per year, but for Yulong county, only 144 (29%)of the medical personnel participated in the training per year. Health expenditures of Yulong county was mainly borne by the local government, and medical insurance coverage rate is 217,107 (99%). Insurance average awareness of Hat Yai is 4449 (66.4%), Yulong County is 62,501 (28.5%), P<0.001, there are statistically significant differences between two cities.

CONCLUSIONS

Thailand has good experience in training, well-paid, motivating and retaining talent for rural health human resources; multi-pronged, mechanism innovation, establish and perfect the system of human resources for health, is the essential way to solve the problem.

Prediction of human core temperature rise and moisture loss in refuge alternatives for underground coal mines

Research by the U.S. National Institute for Occupational Safety and Health (NIOSH) has shown that heat/humidity buildup is a major concern within coal mine refuge alternatives. High temperature and humidity levels inside a refuge alternative may expose occupants to heat stress. Due to the safety risks associated with testing using human subjects, NIOSH partnered with ThermoAnalytics Inc. to create detailed thermal simulation models of refuge alternatives with human occupants. The objective of this effort was to predict a miner's core temperature response and moisture loss in environments that may be encountered in a coal mine refuge alternative. These parameters were studied across a range of temperatures and relative humidity values to determine if the current 35 °C (95 °F) apparent temperature limit for refuge alternatives is reasonable. The results indicate that the apparent temperature limit is protective, provided that miners are supplied with sufficient water. The results also indicate that the body core temperature does not reach dangerous levels even at an apparent temperature of 54 °C (130 °F). However, the results show that moisture loss increases with apparent temperature. Therefore, if the apparent temperature limit were raised, the water provided in a refuge alternative would have to be increased to offset moisture loss.

Validation of temperature and humidity thermal model of 23-person tent-type refuge alternative

U.S. Mine Safety and Health Administration (MSHA) regulations require underground coal mines to use refuge alternatives (RAs) to provide a breathable air environment for 96 hours. One of the main concerns with the use of mobile RAs is heat and humidity buildup inside the RA. The accumulation of heat and humidity can result in miners suffering heat stress or even death. MSHA regulations require that the apparent temperature in an occupied RA not exceed 95 °F. To investigate this, the U.S. National Institute for Occupational Safety and Health (NIOSH) conducted testing on a 23-person tent-type RA in its Experimental Mine in a test area that was isolated from the mine ventilation system. The test results showed that the average measured air temperature within the RA increased by 9.4 °C (17 °F) and the relative humidity approached 94 percent at the end of a 96-hour test. The test results were used to benchmark a thermal simulation model of the tested RA. The validated thermal simulation model predicted the volume-weighted average air temperature inside the RA tent at the end of 96 hours to within 0.06 °C (0.1 °F) of the average measured air temperature.

Correlation of genetic results with testicular histology, hormones and sperm retrieval in nonobstructive azoospermia patients with testis biopsy

To investigate the frequency and types of genetic results in different testicular histology of patients with nonobstructive azoospermia (NOA), and correlated with hormones and sperm retrieval (SR), a retrospective study was conducted in 286 Chinese NOA patients who underwent testis biopsy and 100 age-matched fertile men as the control group. Chromosome karyotype analyses were performed by the peripheral blood chromosome G-band detection method. Screening of Y chromosome microdeletions of azoospermia factor (AZF) region was performed by polymerase chain reaction (PCR) amplification of 11 sequence-tagged sites (STS). The serum levels of follicle-stimulating hormone, luteinising hormone and testosterone (T) and the appearance of scrotal ultrasound were also obtained. In 286 cases of NOA, 14.3% were found to have chromosomal alterations. The incidence of chromosomal abnormality was 2.8%. Sex chromosomal abnormalities were seen in six cases (four cases of Klinefelter's syndrome (47, XXY) and two cases of mosaics). The incidence of polymorphic chromosomal variants was 3% in the normal group and 11.5% in the NOA group. In total, 15.7% of NOA patients were found to have AZF microdeletions and AZF (c + d) was the most frequent one. The results of hormone and SR were found to be significantly different among all testicular histological types, whereas no significant differences were found when it comes to genetic alterations. It is concluded that the rate of cytogenetic alterations was high in NOA patients. So screening for chromosomal alterations and AZF microdeletions would add useful information for genetic counselling in NOA patients with testis biopsy and avoid vertical transmission of genetic defects by assisted reproductive technology.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.