Characterizing diversity in the tumor-immune microenvironment of distinct subclasses of gastroesophageal adenocarcinomas

BACKGROUND

Gastroesophageal adenocarcinomas (GEAs) are heterogeneous cancers where immune checkpoint inhibitors have robust efficacy in heavily inflamed microsatellite instability (MSI) or Epstein-Barr virus (EBV)-positive subtypes. Immune checkpoint inhibitor responses are markedly lower in diffuse/genome stable (GS) and chromosomal instable (CIN) GEAs. In contrast to EBV and MSI subtypes, the tumor microenvironment of CIN and GS GEAs have not been fully characterized to date, which limits our ability to improve immunotherapeutic strategies.

PATIENTS AND METHODS

Here we aimed to identify tumor-immune cell association across GEA subclasses using data from The Cancer Genome Atlas (N = 453 GEAs) and archival GEA resection specimen (N = 71). The Cancer Genome Atlas RNAseq data were used for computational inferences of immune cell subsets, which were correlated to tumor characteristics within and between subtypes. Archival tissues were used for more spatial immune characterization spanning immunohistochemistry and mRNA expression analyses.

RESULTS

Our results confirmed substantial heterogeneity in the tumor microenvironment between distinct subtypes. While MSI-high and EBV+ GEAs harbored most intense T cell infiltrates, the GS group showed enrichment of CD4+ T cells, macrophages and B cells and, in ∼50% of cases, evidence for tertiary lymphoid structures. In contrast, CIN cancers possessed CD8+ T cells predominantly at the invasive margin while tumor-associated macrophages showed tumor infiltrating capacity. Relatively T cell-rich 'hot' CIN GEAs were often from Western patients, while immunological 'cold' CIN GEAs showed enrichment of MYC and cell cycle pathways, including amplification of CCNE1.

CONCLUSIONS

These results reveal the diversity of immune phenotypes of GEA. Half of GS gastric cancers have tertiary lymphoid structures and are therefore promising candidates for immunotherapy. The majority of CIN GEAs, however, exhibit T cell exclusion and infiltrating macrophages. Associations of immune-poor CIN GEAs with MYC activity and CCNE1 amplification may enable new studies to determine precise mechanisms of immune evasion, ultimately inspiring new therapeutic modalities.

Chromodynamic multirelaxation-time lattice Boltzmann scheme for fluids with density difference

We develop, after Dellar [Phys. Rev. E. 65, 036309 (2002)10.1103/PhysRevE.65.036309; J. Comput. Phys. 190, 351 (2003)10.1016/S0021-9991(03)00279-1], a multiple-relaxation-time (MRT), chromodynamic, multicomponent lattice Boltzmann equation (MCLBE) scheme for simulation of isothermal, immiscible fluid flow with a density contrast. It is based on Lishchuk's method [Brackbill, Kothe, and Zemach, J. Comp. Phys. 100, 335 (1992)10.1016/0021-9991(92)90240-Y; Lishchuk, Care, and Halliday, Phys. Rev. E. 67, 036701, (2003)10.1103/PhysRevE.76.036701] and the segregation of d'Ortona et al. [Phys. Rev. E. 51, 3718, (1995)10.1103/PhysRevE.51.3718]. We focus on fundamental model verifiability but do relate some of our data to that from previous approaches, due to Ba et al. [Phys. Rev. E 94, 023310 (2016)10.1103/PhysRevE.94.023310] and earlier Liu et al. [Phys. Rev. E 85, 046309 (2012)10.1103/PhysRevE.85.046309], who pioneered large density difference chromodynamic MCLBE and showed the practical benefits of an MRT collision model. Specifically, we test the extent to which chromodynamic MCLBE MRT schemes comply with the kinematic condition of mutual impenetrability and the continuous traction condition by developing analytical benchmarking flows. We conclude that our data, taken with those of Ba et al., verify the utility of MRT chromodynamic MCLBE.

Magnesium-Dependent Promotion of H2O2 Production Increases Ecological Competitiveness of Oral Commensal Streptococci

The pyruvate oxidase (SpxB)-dependent production of H₂O₂ is widely distributed among oral commensal streptococci. Several studies confirmed the ability of H₂O₂ to antagonize susceptible oral bacterial species, including caries-associated Streptococcus mutans as well as several periodontal pathobionts. Here we report a potential mechanism to bolster oral commensal streptococcal H₂O₂ production by magnesium (Mg²⁺) supplementation. Magnesium is a cofactor for SpxB catalytic activity, and supplementation increases the production of H₂O₂ in vitro. We demonstrate that Mg²⁺ affects spxB transcription and SpxB abundance in Streptococcus sanguinis and Streptococcus gordonii. The competitiveness of low-passage commensal streptococcal clinical isolates is positively influenced in antagonism assays against S. mutans. In growth conditions normally selective for S. mutans, Mg²⁺ supplementation is able to increase the abundance of S. sanguinis in dual-species biofilms. Using an in vivo biophotonic imaging platform, we further demonstrate that dietary Mg²⁺ supplementation significantly improves S. gordonii oral colonization in mice. In summary, our results support a role for Mg²⁺ supplementation as a potential prebiotic to promote establishment of oral health-associated commensal streptococci.

miR-485-5p improves the progression of ovarian cancer by targeting SRC in vitro and in vivo

miR-485-5p is involved in many tumors, but its role in ovarian cancer has been rarely reported. This paper mainly studied the expression and mechanism of miR-485-5p in ovarian cancer. The expression of miR-485-5p in ovarian cancer was compared with that in adjacent tissues, and the expression of miR-485-5p in various ovarian cancer cell lines was detected by RT-PCR. miR-485-5p mimics and pcDNA plasmid or pcDNA-SRC were transfected into SKOV3 cells. Cell proliferation was detected by CCK-8, cell cycle and apoptosis were detected by flow cytometry, and cell migration and invasion were detected by wound assay and transwell assay. Nude mice were inoculated with SKOV3 cells to detect the effect of miR-485-5p on xenograft. SRC and its downstream proteins were detected by western blot. Our data suggested that the expression of miR-485-5p was low in ovarian cancer tissues and ovarian cancer cell lines. miR-485-5p mimics can inhibit the proliferation, migration, invasion, and the induction of cycle arrest and apoptosis of SKOV3 cells in vivo and in vitro, and pcDNA-SRC can reverse the effect of miR-485-5p mimics on ovarian cancer. Our findings suggest that miR-485-5p could inhibit the progression of ovarian cancer by targeting SRC, which might be a new target for ovarian cancer therapy as the SRC inhibitor.

[Pathological changes of the spleen in ten patients with coronavirus disease 2019(COVID-19) by postmortem needle autopsy]

Objective: To study the pathological changes of the spleen in patients with COVID-19 and to analyze the relationship between the weakened immune system and splenic lesions. Methods: Postmortem needle autopsies from the spleen were carried out on 10 patients who died from COVID-19 in Wuhan. Routine hematoxylin and eosin (HE) staining was used to observe the pathological changes. The changes of lymphocytes were studied further with immunohistochemistry.RT-PCR was used to detect 2019-nCoV RNA in the spleen. In addition,the Epstein-Barr virus (EBV) was detected by in situ hybridization, and coronavirus particles were detected by transmission electron microscopy in 2 cases. Results: There were 7 males and 3 females, with an average age of 68.3 years.Of the 10 cases, 4 had cancer history and another 4 had other underlying diseases respectively.Cough, fever, malaise and dyspnea were the main clinical symptoms.The time from onset to death was 15-45 days.Ten cases patients had normal or slight increase in peripheral blood leukocyte count in the early stage of the disease, 6 cases had significant increase before death. Five patients' peripheral blood lymphocyte count decreased in the early stage of the disease, and 10 patients' peripheral blood lymphocyte count decreased significantly before the disease progressed or died. Seven cases were treated with corticosteroid (methylprednisolone ≤40 mg/d, not more than 5 days). Histopathological examination showed that the cell composition of the spleen decreased, white pulp atrophied at different levels, meanwhile lymphoid follicles decreased or absent;in addition, the ratio of red pulp to white pulp increased with varying degrees. In 7 cases, more neutrophil infiltration was found, and in 5 cases, scattered plasma cell infiltration was found. Macrophage proliferation and hemophagocytic phenomena in a few cells were found in a case. Meanwhile, necrosis and lymphocyte apoptosis were detected in 2 cases, small artery thrombosis and spleen infarction in 1 case, and fungal infection in 1 case. The results of immunohistochemistry showed that the T and B lymphocyte components of the spleen in all cases decreased in varying degrees. CD20(+) B cells were found to accumulate in the lymphoid sheath around the splenic artery in 8 cases. However, CD20 and CD21 immunostaining in 2 cases showed that the number of white pulp was almost normal, and splenic nodules were atrophic. CD3(+), CD4(+) and CD8(+)T cells were decreased. In 9 cases,CD68(+) macrophages were no significant changes in the distribution and quantity. While more CD68(+) cells were found in the medullary sinuses of 1 case (related to fungal infection). Few CD56(+) cells were found. EBV was negative by in situ hybridization. RT-PCR was used to detect the nucleic acid of 2019-nCoV. One of 10 cases was positive, 39 years old,who was the youngest patient in this group, and the other 9 cases were negative. Coronavirus particles were found in the cytoplasm of macrophage under electron microscope in 2 cases. Conclusions: The death of COVID-19 occurs mainly in the elderly, and some cases have no underlying diseases. Spleen may be one of the organs directly attacked by the virus in some patients who died from COVID-19. T and B lymphocyte in the spleen decrease in varying degrees, lymphoid follicles are atrophied, decreased or absent, and the number of NK cells do not change significantly. And the pathological changes of the spleen are not related to the use of low dose corticosteroid, which may be related to the direct attack of virus and the attack of immune system on its own tissues.

CCL3/CCR1 mediates CD14+CD16- circulating monocyte recruitment in knee osteoarthritis progression

OBJECTIVES

Monocyte-derived macrophages, as the predominant immune cell type that is increased in inflamed synovium, play a vital role during knee osteoarthritis (KOA) progression. However, the mechanisms underlying the recruitment of circulating monocytes to osteoarthritic knees remain uncertain. Based on previous data obtained from plasma, we investigated the contributions of CCL2, CCL3, CCL4 and their cognate receptors in circulating monocyte chemotaxis and KOA development.

METHODS

Using flow cytometry staining, we characterized the expression patterns of the chemokine receptors in CD14⁺CD16^- circulating monocytes from KOA patients and healthy volunteers. The expression of chemokines in synovial fluids, synovium and cartilage was investigated in KOA patients and in patients without KOA. The role of chemokines and their cognate receptors in the chemotaxis of CD14⁺CD16^- circulating monocytes was assessed using chemokine neutralizing antibodies (NA) and receptor antagonists in vitro and in vivo.

RESULTS

The majority of CD14⁺CD16^- circulating monocytes were CCR1-and CCR2-positive. CCL2, CCL3 and CCL4 were elevated in synovial fluid of KOA patients compared with that of controls. The most likely source of these chemokines is inflamed synovium and cartilage in the osteoarthritic knee. The CCL3/CCR1 and CCL2/CCR2 axes showed substantial ability to recruit CD14⁺CD16^- monocytes in transwell assays. Similar results were confirmed in a mouse model of collagenase-induced KOA (CIA) in which blocking either the CCL3/CCR1 axis or the CCL2/CCR2 axis reduced synovial hyperplasia and F4/80⁺ macrophage infiltration.

CONCLUSIONS

Our findings suggested that, analogous to the CCL2/CCR2 axis, CCL3 produced in osteoarthritic knees can chemoattract circulating monocytes to the inflamed synovium through CCR1.

Umbilical Cord-derived Mesenchymal Stem Cells for COVID-19 Patients with Acute Respiratory Distress Syndrome (ARDS)

The coronavirus SARS-CoV-2 is cause of a global pandemic of a pneumonia-like disease termed Coronavirus Disease 2019 (COVID-19). COVID-19 presents a high mortality rate, estimated at 3.4%. More than 1 out of 4 hospitalized COVID-19 patients require admission to an Intensive Care Unit (ICU) for respiratory support, and a large proportion of these ICU-COVID-19 patients, between 17% and 46%, have died. In these patients COVID-19 infection causes an inflammatory response in the lungs that can progress to inflammation with cytokine storm, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), thromboembolic events, disseminated intravascular coagulation, organ failure, and death. Mesenchymal Stem Cells (MSCs) are potent immunomodulatory cells that recognize sites of injury, limit effector T cell reactions, and positively modulate regulatory cell populations. MSCs also stimulate local tissue regeneration via paracrine effects inducing angiogenic, anti-fibrotic and remodeling responses. MSCs can be derived in large number from the Umbilical Cord (UC). UC-MSCs, utilized in the allogeneic setting, have demonstrated safety and efficacy in clinical trials for a number of disease conditions including inflammatory and immune-based diseases. UC-MSCs have been shown to inhibit inflammation and fibrosis in the lungs and have been utilized to treat patients with severe COVID-19 in pilot, uncontrolled clinical trials, that reported promising results. UC-MSCs processed at our facility have been authorized by the FDA for clinical trials in patients with an Alzheimer's Disease, and in patients with Type 1 Diabetes (T1D). We hypothesize that UC-MSC will also exert beneficial therapeutic effects in COVID-19 patients with cytokine storm and ARDS. We propose an early phase controlled, randomized clinical trial in COVID-19 patients with ALI/ARDS. Subjects in the treatment group will be treated with two doses of UC-MSC (l00 × 10⁶ cells). The first dose will be infused within 24 hours following study enrollment. A second dose will be administered 72 ± 6 hours after the first infusion. Subject in the control group will receive infusion of vehicle (DPBS supplemented with 1% HSA and 70 U/kg unfractionated Heparin, delivered IV) following the same timeline. Subjects will be evaluated daily during the first 6 days, then at 14, 28, 60, and 90 days following enrollment (see Schedule of Assessment for time window details). Safety will be determined by adverse events (AEs) and serious adverse events (SAEs) during the follow-up period. Efficacy will be defined by clinical outcomes, as well as a variety of pulmonary, biochemical and immunological tests. Success of the current study will provide a framework for larger controlled, randomized clinical trials and a means of accelerating a possible solution for this urgent but unmet medical need. The proposed early phase clinical trial will be performed at the University of Miami (UM), in the facilities of the Diabetes Research Institute (DRI), UHealth Intensive Care Unit (ICU) and the Clinical Translational Research Site (CTRS) at the University of Miami Miller School of Medicine and at the Jackson Memorial Hospital (JMH).

[A summary of ocular fundus diseases in China over the past 70 years]

After 70 years of development, China has become a global leader in the academic research and clinical practice of fundus diseases. The dramatic progress is mainly attributable to the relentless efforts of generations of fundus ophthalmologists. We are moving forward to incorporate new technologies such as AI and big data into the treatment of fundus diseases. The summary is intended to commemorate the past masters and to inspire the young ophthalmologists. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. (Chin J Ophthalmol, 2020, 56:241-245).

Functional characterization of the cis-regulatory region for the vitellogenin gene in Plutella xylostella

The vitellogenin gene promoter (VgP) is an essential cis-regulatory element that plays a significant role in transcription of the vitellogenin (Vg) gene, leading to the production of yolk protein in insects, including lepidopterans. However, the function of VgP is still not clear in Plutella xylostella. Here, we cloned a 5.1 kb DNA fragment of the cis-regulatory region adjacent to the 5' end of the Vg gene of P. xylostella (PxVg). We identified two promoter sites in that 5' upstream sequence of PxVg and performed in vitro analysis of two promoter sequences (PxVgP1, 4.9 kb, and PxVgP2, 2.9 kb) in the embryonic cell line of P. xylostella. PxVgP2 exhibited higher enhanced green fluorescent protein (EGFP) expression, so PxVgP2 was used for in vivo analysis. Strong EGFP fluorescence was observed in adult females and the fat body of females, with low expression in embryos. Our results suggest that PxVgP is an important stage-, tissue- and sex-specific endogenous cis-regulatory element in P. xylostella.

HIV infection and electrocardiogram abnormalities: baseline assessment from the CHART cohort

OBJECTIVES

To investigate the prevalence of various electrocardiogram (ECG) abnormalities among HIV-positive and HIV-negative individuals.

METHODS

This cross-sectional evaluation included 1412 HIV-positive and 2824 HIV-negative participants aged 18 to 75 years and frequency matched by age and sex, derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China, between February and December 2017.

RESULTS

HIV-positive individuals had higher prevalence of sinus tachycardia (5.6% (79/1412) vs. 1.3% (36/2824), p < 0.001) and ST/T wave abnormalities (14.9% (211/1412) vs. 9.4% (264/1412), p < 0.001) but lower prevalence of sinus bradycardia (4.8% (68/1412) vs. 7.5% (211/2824), p 0.001); such associations remained statistically significant after adjusting for traditional risk factors (respectively, adjusted odds ratio (aOR) 4.68, 95% confidence interval (CI) 3.06-7.17; aOR 1.89, 95% CI 1.54-2.34; aOR 0.60, 95% CI 0.44-0.80). In adjusted models, being in higher carotid intima-media thickness categories was significantly associated with ST/T abnormalities in HIV-positive individuals only (0.78-1.00 mm: aOR 1.46, 95% CI 1.01-2.12; >1.00 mm: aOR 2.18, 95% CI 1.39-3.42), whereas being in higher blood pressure categories was significantly associated with both sinus tachycardia (prehypertension: aOR 5.61, 95% CI 1.76-17.91; hypertension: aOR 12.62, 95% CI 3.60-44.27) and ST/T abnormalities (hypertension: aOR 2.04, 95% CI 1.41-2.95) in HIV-negative individuals only. Longer duration of known HIV infection was the only HIV-specific factor of ST/T abnormalities (aOR 1.61, 95% CI 1.17-2.22), with none for sinus tachycardia.

CONCLUSIONS

HIV infection is independently associated with sinus tachycardia and ST/T abnormalities. Further research is needed to investigate specific mechanisms by which HIV infection leads to ECG abnormalities and to evaluate whether inclusion of ECG parameters improves cardiovascular disease prediction. Integrating ECG screening into routine HIV care is recommended in China.

Porphyromonas gingivalis Induces Insulin Resistance by Increasing BCAA Levels in Mice

Insulin resistance is one of the critical pathogeneses of type 2 diabetes mellitus (T2DM). Elevated levels of plasma branched-chain amino acids (BCAAs) are associated with insulin resistance. Recent studies have demonstrated the role of Porphyromonas gingivalis in the development of insulin resistance. However, the mechanisms by which P. gingivalis induces insulin resistance are still unclear. The purpose of this study was to investigate whether P. gingivalis induces insulin resistance through BCAA biosynthesis. We established a murine model of periodontitis by infecting mice with P. gingivalis. Alveolar bone loss, insulin sensitivity, and the plasma level of BCAAs were measured. A P. gingivalis BCAA aminotransferase-deficient strain (∆bcat) was constructed, and its kinetic growth, biofilm formation, and in vivo colonization were compared with its wild-type strain. Alveolar bone loss, insulin sensitivity, and the plasma level of BCAAs of the mice infected with either wild-type strain or ∆bcat strain were further measured. We found that periodontal infection with P. gingivalis significantly upregulated the plasma level of BCAAs and aggravated the high-fat diet (HFD)-induced insulin resistance. Bcat deletion did not alter the growth, biofilm formation, and in vivo colonization of P. gingivalis. More important, the ∆bcat strain was unable to upregulate the plasma level of BCAAs and induce insulin resistance in HFD-fed mice. These findings suggest that the BCAA biosynthesis of P. gingivalis plays a critical role in the development of insulin resistance in the HFD-fed mice. The BCAA biosynthesis pathways may provide a potential target for the disruption of linkage between periodontitis and T2DM.

Chinese expert group consensus on diagnosis and clinical management of osteoradionecrosis of the mandible

Osteoradionecrosis of the mandible (MORN) is one of the most devastating complications caused by radiation therapy in the head and neck region. It is characterized by infection and chronic necrosis of the mandible as the main manifestation. Clinically, MORN-related symptoms include swelling, pain, dysphagia, trismus, masticatory or speech disorders, refractory orocutaneous fistula, bone exposure, and even pathological fracture. MORN has become a challenging clinical problem for oral and maxillofacial surgeons to deal with, but thus far, this problem has not been solved due to the lack of widely accepted treatment algorithms or guidelines. Because of the nonexistence of standardized treatment criteria, most clinical treatment against MORN nowadays is largely based on controversial empirical understandings, while recommendations on post-therapeutic evaluations are scarce. Therefore, to further unify and standardize the diagnosis and treatment of MORN, to decrease the huge waste of medical resources, and ultimately, to improve the wellbeing of the patients, the Chinese Society of Oral and Maxillofacial Surgery (CSOMS) convened an expert panel specialized in MORN from 16 domestic medical colleges and affiliated hospitals to discuss the spectrum of diagnosis and and formulate treatment. In addition, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research pearls. This 'expert consensus statement on diagnosis and clinical management of MORN' is for clinical reference.

Dexmedetomidine elevates the lethal dose threshold of bupivacaine in rats: A dosing study

Dexmedetomidine (DMED), an alpha-2 adrenoreceptor agonist, has been widely used in regional anesthesia procedures. However, the effect of DMED on local anesthetic cardiotoxicity has not been well delineated. This study consisted of two experiments. In experiment A, 42 Sprague–Dawley (SD) rats were randomly divided into 6 groups ( n = 7), each group was pretreated with DMED 0 μg kg−1 (D0 group), 1 μg kg−1 (D1 group), 3 μg kg−1 (D3 group), 6 μg kg−1 (D6 group), 12 μg kg−1 (D12 group), and 24 μg kg−1 (D24 group), administered through the right femoral vein. In experiment B, 20 SD rats were randomly divided into 4 groups ( n = 5), such as control group, DMED group, yohimbine (YOH) group, and DMED + YOH group. Each subgroup in experiment B was also pretreated similarly as in experiment A. After pretreatment of rats as described above (in experiments A and B), bupivacaine 2.5 mg kg−1 min−1 was infused to induce cardiac arrest. In experiment A, the lethal dose threshold of bupivacaine and plasma bupivacaine concentration in D3 and D6 group were higher than the other groups. In experiment B, there was no interaction between DMED and YOH in lethal dose threshold, arrhythmia time, plasma concentration of bupivacaine, and myocardial content of bupivacaine. DMED doses of 3–6 μg kg−1 elevated the lethal dose threshold of bupivacaine without involvement of the alpha-2 adrenoceptors.

Genetic variants in the folate metabolic pathway genes predict cutaneous melanoma-specific survival

BACKGROUND

Folate metabolism plays an important role in DNA methylation and nucleic acid synthesis and thus may function as a regulatory factor in cancer development. Genome-wide association studies (GWASs) have identified some single-nucleotide polymorphisms (SNPs) associated with cutaneous melanoma-specific survival (CMSS), but no SNPs were found in genes involved in the folate metabolic pathway.

OBJECTIVES

To examine associations between SNPs in folate metabolic pathway genes and CMSS.

METHODS

We comprehensively evaluated 2645 (422 genotyped and 2223 imputed) common SNPs in folate metabolic pathway genes from a published GWAS of 858 patients from The University of Texas MD Anderson Cancer Center and performed the validation in another GWAS of 409 patients from the Nurses' Health Study and Health Professionals Follow-up Study, in which 95/858 (11·1%) and 48/409 (11·7%) patients died of cutaneous melanoma, respectively.

RESULTS

We identified two independent SNPs (MTHFD1 rs1950902 G>A and ALPL rs10917006 C>T) to be associated with CMSS in both datasets, and their meta-analysis yielded an allelic hazards ratio of 1·75 (95% confidence interval 1·32-2·32, P = 9·96 × 10^-5 ) and 2·05 (1·39-3·01, P = 2·84 × 10^-4 ), respectively. The genotype-phenotype correlation analyses provided additional support for the biological plausibility of these two variants' roles in tumour progression, suggesting that variation in SNP-related mRNA expression levels is likely to be the mechanism underlying the observed associations with CMSS.

CONCLUSIONS

Two possibly functional genetic variants, MTHFD1 rs1950902 and ALPL rs10917006, were likely to be independently or jointly associated with CMSS, which may add to personalized treatment in the future, once further validated. What is already known about this topic? Existing data show that survival rates vary among patients with melanoma with similar clinical characteristics; therefore, it is necessary to identify additional complementary biomarkers for melanoma-specific prognosis. A hypothesis-driven approach, by pooling the effects of single-nucleotide polymorphisms (SNPs) in a specific biological pathway as genetic risk scores, may provide a prognostic utility, and genetic variants of genes in folate metabolism have been reported to be associated with cancer risk. What does this study add? Two genetic variants in the folate metabolic pathway genes, MTHFD1 rs1950902 and ALPL rs10917006, are significantly associated with cutaneous melanoma-specific survival (CMSS). What is the translational message? The identification of genetic variants will make a risk-prediction model possible for CMSS. The SNPs in the folate metabolic pathway genes, once validated in larger studies, may be useful in the personalized management and treatment of patients with cutaneous melanoma.

The temporal-spatial patterns, polymorphisms and association analysis with meat quality traits of FABP1 gene in domestic pigeons (Columba livia)

1. Fatty acid-binding proteins (FABP) are members of lipid-binding proteins, which participate in the metabolism and intracellular transportation of lipids. This study was designed to investigate the expression patterns, polymorphisms and associations with meat quality traits of the FABP1 gene in pigeons. 2. The temporal-spatial expression patterns showed FABP1 was widely expressed in all eleven tissues from 0-4 weeks of age, the expression level in the liver was the highest, followed by the small intestine and subcutaneous fat. 3. Five novel SNPs were found; all of them were synonymous and in Hardy-Weinberg equilibrium. Association analysis revealed that for the SNP of G161C, the AB and BB genotypes had higher (P ≤ 0.01) inosinic acid concentrations in breast muscle than the AA genotype. The BB genotype showed the highest (P < 0.01) intramuscular fat among the three genotypes, and significantly greater FABP1 mRNA levels were observed in the breast muscle of the BB genotype than in the AA and AB genotypes (P < 0.01). In the SNP C1376T, the AB and BB genotypes showed higher (P < 0.01) intramuscular fat than the AA genotype, and the relative mRNA expression level of the BB (P < 0.01) and AB (P < 0.05) genotypes was higher than that of the AA genotype in breast muscle. Correlation analysis implied that the FABP1 mRNA expression level was closely related to the inosinic acid (P < 0.05) and intramuscular fat content (P < 0.01). Oil red O staining of frozen sections of breast muscle on d 28 for SNPs G161C and C1376T also indicated that the BB genotype had the highest intramuscular fat content in both SNPs. In addition, correlation analysis implied the FABP1 mRNA expression level was closely related to inosinic acid (P < 0.05) and intramuscular fat content (P < 0.01). 4. The results suggested that FABP1 could be a potential candidate gene in marker-assisted selection for breeding pigeons with high-quality meat.

Immediate early response protein 2 promotes the migration and invasion of hepatocellular carcinoma cells via regulating the activity of Rho GTPases

Human immediate early response 2 (IER2) has been implicated in tumor cell motility and metastasis; however, the underlying mechanisms in hepatocellular carcinoma (HCC) metastasis remain to be clarified. In this study, we demonstrate that dysregulation of IER2 was shown in HCC clinical samples, and IER2 expression resulted in the promotion of cell migration and invasion in vitro, and HCC tumor growth and pulmonary metastasis in vivo. Moreover, we showed that IER2 expression altered assembly of the actin cytoskeleton rearrangement. Furthermore, MAPK and PI3K/Akt signaling pathways induced by IER2 were confirmed to be probably involved in regulating the activity of Rho GTPases, such as RhoA, Rac1 and Cdc42. Collectively, our results indicated a significant role of IER2 in the HCC cell motility and metastasis through MAPK and PI3K/Akt signaling pathways to regulate the activity of Rho GTPases, thereby modulating actin cytoskeleton rearrangement, unveiling a novel mechanism of cell motility regulation induced by IER2.

Decrease in the proportion of CD24hi CD38hi B cells and impairment of their regulatory capacity in type 1 diabetes patients

B10 cells restore immune balance by producing interleukin (IL)-10. Impaired B10 cell responses are related to numerous autoimmune diseases. However, the function of B10 cells in type 1 diabetes (T1D) patients is controversial. We hypothesized that there are numerical and functional defects of B10 cells in T1D. Sixty-two patients with T1D and 74 healthy volunteers were included in our study. We showed that B10 cells in human peripheral blood belong to a CD24^hi CD38^hi B cell subpopulation. CD24^hi CD38^hi B cells from healthy individuals possessed regulatory capacity, suppressed interferon (IFN)-γ, tumor necrosis factor (TNF)-α and IL-17A production and promoted IL-4 production and forkhead box protein 3 (FoxP3) expression in CD4⁺ T cells through an IL-10-dependent mechanism. Compared to healthy controls, B10 cell percentages in T1D were significantly lower (5·6 ± 3·5 versus 6·9 ± 3·3%; P < 0·05), produced less IL-10 (15·4 ± 4·3 versus 29·0 ± 4·5%; P < 0·001) and lacked regulatory capacity. In addition, Pearson's correlation analysis showed that the frequency of circulating B10 cells was negatively correlated with the frequency of CD4⁺ IFN-γ⁺ and CD4⁺ TNF-α⁺ T cells (r = -0·248 and r = -0·283, P = 0·008 and P = 0·017, respectively), positively correlating with the frequency of CD4⁺ CD25⁺ FoxP3⁺ T cells (r = 0·247, P = 0·001). These data offer direct proof that there is a deficiency of circulating CD24^hi CD38^hi B cells in peripheral blood of patients with T1D, which participate in the T1D immune imbalance involved in the development of T1D.

Deep Transfer Learning and Radiomics Feature Prediction of Survival of Patients with High-Grade Gliomas

BACKGROUND AND PURPOSE

Patient survival in high-grade glioma remains poor, despite the recent developments in cancer treatment. As new chemo-, targeted molecular, and immune therapies emerge and show promising results in clinical trials, image-based methods for early prediction of treatment response are needed. Deep learning models that incorporate radiomics features promise to extract information from brain MR imaging that correlates with response and prognosis. We report initial production of a combined deep learning and radiomics model to predict overall survival in a clinically heterogeneous cohort of patients with high-grade gliomas.

MATERIALS AND METHODS

Fifty patients with high-grade gliomas from our hospital and 128 patients with high-grade glioma from The Cancer Genome Atlas were included. For each patient, we calculated 348 hand-crafted radiomics features and 8192 deep features generated by a pretrained convolutional neural network. We then applied feature selection and Elastic Net-Cox modeling to differentiate patients into long- and short-term survivors.

RESULTS

In the 50 patients with high-grade gliomas from our institution, the combined feature analysis framework classified the patients into long- and short-term survivor groups with a log-rank test P value < .001. In the 128 patients from The Cancer Genome Atlas, the framework classified patients into long- and short-term survivors with a log-rank test P value of .014. For the mixed cohort of 50 patients from our institution and 58 patients from The Cancer Genome Atlas, it yielded a log-rank test P value of .035.

CONCLUSIONS

A deep learning model combining deep and radiomics features can dichotomize patients with high-grade gliomas into long- and short-term survivors.

Psychometric assessment and application of the Chinese version of the Compliance with Annual Diabetic Eye Exams Survey in people with diabetic retinopathy

AIM

To translate the Compliance with Annual Diabetic Eye Exams Survey (CADEES) into Chinese, allowing assessment of its reliability and validity, and to identify variables that predict attendance at annual eye examinations.

METHODS

People with vision-threatening diabetic retinopathy were recruited from the Shanghai Diabetic Eye Study. The study involved three phases: (1) translation and cross-cultural adaptation, (2) a pilot study (n = 496) to evaluate the psychometric properties of the Chinese-CADEES, and (3) a primary cross-sectional survey (n = 3818) to assess self-reported attendance at annual eye examinations. Factors related to non-attendance were identified using univariate analysis, and then a multiple logistic regression model. Finally, a component model and individual item models were built to predict attendance.

RESULTS

The Chinese-CADEES had satisfactory reliability and validity. The issue of low attendance at annual eye examinations was serious. In addition to 13 health belief items, living in semi-urban suburban areas, shorter duration of diabetes, poor glucose control, lower education level, better presenting visual acuity and milder diabetic retinopathy diagnosis were significantly related to non-attendance. The multivariate predictive model was able to predict, with 64.7% accuracy, whether or not participants were going to attend annual eye examinations and explained ~ 11.3% of the variance in attendance.

CONCLUSIONS

The Chinese-CADEES showed good reliability and validity for predicting attendance at annual eye examinations in people with diabetic retinopathy. Clinicians and researchers can improve attendance by addressing modifiable characteristics and increasing education on diabetic retinopathy and the importance of eye health in people with diabetes.

Apple rootstocks with different phosphorus efficiency exhibit alterations in rhizosphere bacterial structure

AIMS

The purpose of this study was to select phosphorus-efficient apple rootstocks under phosphorus deficiency and to reveal the effects of different apple rootstocks on the rhizosphere bacterial community.

METHODS AND RESULTS

We used 83 hybrid lines of Malus robusta Rehd. × Malling 9 (M.9) to investigate their physiological traits and the phosphorus deficiency phenotypes of leaves in response to phosphorus deficiency (0·1 mmol l^-1 PO₄ ^3- ). All the plants were cultivated in pots in the greenhouse and watered using drip irrigation. In accordance with the results of investigation, we selected the phosphorus-efficient hybrid lines (PE) and the phosphorus-inefficient hybrid lines (PI) to research their root morphology and root hairs (RH). In addition, we used Illumina MiSeq sequencing to determine the bacterial community of the rhizosphere from different rootstocks. The results showed that the PE plants had better growth characteristics and stronger root plasticity than that of the PI plants, and phosphorus deficiency can stimulate the RH growth of PE plants. There was no significant difference in the rhizosphere bacterial diversity, but we found that the bacterial community structure was significantly different at the genus levels; in addition, 89 genera were found to have significant differences between PE and PI plants, especially Bacillus. The PE rhizosphere had more abundant Bacillus compared to the PI. High positive Pearson correlations with the phosphorus concentration in the plantlets of apple rootstocks were detected for the bacterial genera Bacillus (r: 0·776).

CONCLUSIONS

The phosphorus-efficient apple rootstocks adapted to phosphorus deficiency by shaping the root morphology. Notably, different apple rootstocks showed alteration of the microbes in rhizosphere.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study can provide the materials for exploring the mechanism of apple rootstock phosphorus absorption. In accordance with the different bacterial community compositions, we can develop the inoculants to promote nutrient uptake.

Pathological assessment of resection specimens after neoadjuvant therapy for metastatic melanoma

Background

Clinical trials have recently evaluated safety and efficacy of neoadjuvant therapy among patients with surgically resectable regional melanoma metastases. To capture informative prognostic data connected to pathological response in such trials, it is critical to standardize pathologic assessment and reporting of tumor response after this treatment.

Methods

The International Neoadjuvant Melanoma Consortium meetings in 2016 and 2017 assembled pathologists from academic centers to develop consensus guidelines for pathologic examination and reporting of surgical specimens from AJCC (8th edition) stage IIIB/C/D or oligometastatic stage IV melanoma patients treated with neoadjuvant-targeted or immune therapy. Patterns of pathologic response are provided context to inform these guidelines.

Results

Based on our collective experience and guided by efforts in well-established neoadjuvant settings like breast cancer, procedures directing handling of pre- and post-neoadjuvant therapy-treated melanoma specimens are provided to facilitate comparison of findings across different trials and centers. Definitions of pathologic response are provided together with guidelines for reporting and quantifying the extent of pathologic response. Finally, the spectrum of histopathologic responses observed following neoadjuvant-targeted and immune-checkpoint therapy is described and illustrated.

Conclusions

Standardizing pathologic evaluation of resected melanoma metastases following neoadjuvant-targeted or immune-checkpoint therapy allows more robust stratification of patient outcomes. This includes recognizing the spectrum of histopathologic response patterns to neoadjuvant therapy and a standard approach to grading pathologic responses. Such an approach will facilitate comparison of results across clinical trials and inform ongoing correlative studies into the mechanisms of response and resistance to agents applied in the neoadjuvant setting.

Features and clinical significance of the ossification centres in the odontoid process based on micro-computed tomography

BACKGROUND

Microscopic structures of the ossification centres of the odontoid process were studied from the micro-computed tomography (CT) images of the axis, and the potential influence of the ossification centres with different microscopic structures on odontoid process fractures was analysed.

MATERIALS AND METHODS

Eighteen odontoid process specimens were randomly collected and scanned by micro-CT. The obtained images were then input into the software for further observation and measurement. Incomplete absorption of the ossification centres in the base was observed, along with the anatomic structure of the regions with incomplete ossification and structural parameters of the trabecular bones.

RESULTS

The microscopic structures of the trabecular bones in the ossification centres in the base of the odontoid process could be clearly visualised from the micro-CT images. Among the 18 odontoid process specimens, 11 specimens were found with incomplete absorption of the ossification centres in the axis, the prevalence reaching up to 61%. Regions with incomplete ossification varied in size and morphology, and their three-dimensional morphology was predominantly oval. Of all structural parameters examined for the trabecular bones, there were only significant differences in the degree of anisotropy between the regions with incomplete absorption of ossification centres and the average vertebral trabecular bones (p < 0.05).

CONCLUSIONS

Incomplete absorption of the ossification centres in the base of the odontoid process is a relatively prevalent condition. The cavitation effect of the trabecular bones may be the primary cause for odontoid process fractures.

Optical absorption of composition-tunable InGaAs nanowire arrays

InGaAs nanowire (NW) arrays have emerged as important active materials in future photovoltaic and photodetector applications, due to their excellent electronic properties and tunable band gap. Here, we report a systematic investigation of the optical absorption characteristics of composition-tunable vertical InGaAs NW arrays. Using finite-difference time-domain simulations we first study the effect of variable composition (Ga-molar fraction) and NW array geometry (NW diameter, period, fill factor) on the optical generation rate. NWs with typical diameters in the range of ∼100-250 nm lead to generation rates higher than the equivalent bulk case for moderate fill factors (NW period of ∼0.3-0.8 μm), while slightly smaller fill factors and increased diameters are required to maintain high generation rates at increased Ga-molar fraction. The optical absorption was further measured using spectrally resolved ultraviolet-visible-near-infrared (UV-vis-NIR) spectroscopy on NW arrays transferred to transparent substrates. Interestingly, large variations in Ga-molar fraction (0 < x(Ga) < 0.5) have a negligible influence, while minute changes in NW diameter of less than ±20 nm affect the absorption spectra very strongly, leading to pronounced shifts in the peak absorption energies by more than ∼700 meV. These results clearly highlight the much larger sensitivity of the optical absorption behavior to geometric parameters rather than to variations in the electronic band gap of the underlying NW array.

Efficacy of Beef Crust from Dry-Aged Beef Loins as Novel Functional Ingredient

ObjectivesDry-aging is a traditional butchery process, but currently, it has been more practiced in a niche market as a value-adding process. As dry aging involves placing primal/sub-primal sections under a controlled refrigerated condition without packaging materials, the formation of the dried surface (crust) is inevitable due to moisture evaporation. A considerable portion of the crust is to be trimmed off as waste, which is one of the major drawbacks of dry aging. While the beef crust may still exert its functional/technological properties, no information is available regarding the efficacy of utilizing beef crust as a potential food ingredient. Thus, the objective of this study was to determine the physicochemical and functional properties of beef crust from dry-aged beef loins processed under various dry-aging conditions.Materials and MethodsPaired bone-in beef shell loins from 13 cull cow carcasses (C-maturity) were obtained at 5d postmortem, divided into 2 sections and assigned to four aging treatments: wet-aging (WA), dry-aging (DA), dry-aging in water-permeable bag (DWA) and dry-aging under UV-light (UDA; 5 J/s/12 h per day). Beef sections were aged for 28d at 2°C, 65% RH and 0.8 m/s air flow. After aging, the crusts were separated and beef samples from WA and initial (aged for 0 d, INI) were collected for comparison. In three independent batches, the crust samples were freeze-dried and powdered. Moisture contents of samples were measured before lyophilization. Emulsification capacity, salt-soluble protein solubility, emulsifying activity index, and surface hydrophobicity were determined. CIE* color attributes, lipid oxidation (TBARS), and protein oxidation (carbonyl and thiol contents) were measured. The PROC MIXED procedure of SAS was used to analyze the data. Significance level of least square means was set at the confidence level of 95%.ResultsBeef crusts from dry-aged loins had lower moisture contents compared with WA and INI (P < 0.05), while no difference between dry-aging methods was found (P > 0.05). The crust samples had lower L* and chroma values than WA and INI (P < 0.05). Emulsification capacity of DA, DWA, and UDA were lower than WA and INI (P < 0.05), with DA being the lowest (P < 0.05). In general, the crust had a significantly higher salt-soluble protein solubility compared to WA, while no difference between crusts and INI was found (P > 0.05). For emulsifying activity index, DA exhibited higher values than DWA, UDA and WA (P < 0.05), and was comparable to INI (P > 0.05). DA and INI had higher surface hydrophobicity values than the other samples, which could possibly explain the results of emulsifying activity index. A trend of higher TBARS values was found in all dry-aged crusts than WA and INI (P = 0.0688). The crust from dry aging had a higher carbonyl content compared to WA (P < 0.05), while thiol contents were not affected by the treatment (P = 0.1092).ConclusionThe results from the current study indicate that beef crusts exert its functional and technological properties, which could be superior or at least equivalent to wet-aged or unaged beef samples. This study provides novel insight into the potential feasibility and utilization of beef crust from dry-aged beef as a value-added product. Further studies determining the practical application of beef crust as a novel food ingredient (e.g., meat emulsion or beef patty) are in progress.

Effects of recombinant activated coagulation factor VII on apoptosis and expressions of Bcl-2 and Bax in rats with intracerebral hemorrhage

OBJECTIVE

To investigate the effects of recombinant activated coagulation factor VII (rFVIIa) on apoptosis and the expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax) in rats with intracerebral hemorrhage (ICH).

MATERIALS AND METHODS

A total of 90 8-week-old male Sprague-Dawley (SD) rats with similar weight were selected and randomly divided into normal group (n=30), ICH control group (n=30), and rFVIIa treatment group (n=30). Five days later, hematoxylin-eosin (HE) staining was applied to observe pathological changes in rat brain in three groups. Cell apoptosis in rat brain was detected at 6 h, 12 h, 24 h, 48 h, 72 h, and 120 h, respectively. The relative expression levels of Bcl-2 and Bax in brain tissues were measured via fluorescence quantitative Polymerase Chain Reaction (qPCR) and Western blotting, respectively.

RESULTS

Compared with those in ICH control group, rats in rFVIIa treatment group had fewer degenerated and necrotic nerve cells and milder pathological changes in the marginal zone. The number of apoptotic cells in ICH control group and rFVIIa group was gradually increased in a time-dependent manner, and achieved the peak at 72 h. The number of apoptotic cells in treatment group was significantly lower than that in ICH control group after 24 h (p<0.05). Both fluorescence qPCR and Western blotting results proved that in comparison with ICH control group, rFVIIa group had a higher relative expression level of Bcl-2 (p<0.05) and a lower expression level of Bax (p<0.05).

CONCLUSIONS

Apoptosis mechanism may be involved in secondary brain injury after ICH. RFVIIa may have an important protective effect on neuronal injury after ICH by promoting the expression of Bcl-2 and inhibiting the expression of Bax protein.

Semaphorin-7A contributes to growth, migration and invasion of oral tongue squamous cell carcinoma through TGF-β-mediated EMT signaling pathway

OBJECTIVE

Oral tongue squamous cell carcinoma (OTSCC) is the most frequently encountered malignant epithelial tumors. Semaphorin-7A is a membrane-associated/secreted protein that plays an essential role in the migration and progression of human malignancies. We aimed to investigate the mechanisms of Semaphorin-7A in the growth and migration of OTSCC.

MATERIALS AND METHODS

The expressions of Semaphorin-7A in cells were tested by RT-PCR, Western blot, and Immunofluorescence, separately. The activities of OTSCC cells (HSC-3 and Tca8113) were analyzed by MTT, following treatment with Semaphorin-7A or PBS. The migration, invasion, and apoptosis of cells were also determined. The protein expressions of epithelial mesenchymal transition (EMT) pathway were analyzed by Western blot, after treated with Semaphorin-7A in vitro and in vivo. Finally, the mouse model of OTSCC was treated with antibody target for Semaphorin-7A (AntiSema-7A), Semaphorin-7A or PBS, then the tumor size was determined, and histopathological examination and western blot was applied for further confirmation.

RESULTS

In OTSCC cells, Semaphorin-7A was highly expressed, and Semaphorin-7A promoted growth in multiple metastatic OTSCC cell lines. Further study indicated that Semaphorin-7A resulted in up-regulation of Snail, N-cadherin and Vimentin expression, and downregulating of E-cadherin. In addition, The Ets2-repressor factor (ERF) expression was down-regulated, and transforming growth factor (TGF-β)-induced EMT was promoted in OTSCC cells. Then, the proteins of collagen types I (CT-I) and fibronectin (FIB) were also up-regulated after Semaphorin-7A treatment. Furthermore, our results indicated that inhibition of Semaphorin-7A by antibody target for Semaphorin-7A (AntiSema-7A) suppressed OTSCC growth and increased survival in a mouse model of OTSCC. Histopathological examination confirmed the inhibitory effects in vivo.

CONCLUSIONS

Semaphorin-7A promoted growth and migration of OTSCC by regulating TGF-β-induced EMT signaling pathway in OTSCC cells, which provided a new interconnection between the Semaphorin-7A and TGF-β-induced EMT signaling pathway.

Downregulation of HOTTIP regulates insulin secretion and cell cycle in islet β cells via inhibiting MEK/ERK pathway

OBJECTIVE

To investigate the effect of long non-coding RNA (lncRNA) HOTTIP on islet β cells and its underlying mechanism.

MATERIALS AND METHODS

The expressions of HOTTIP in different organs of db/db mice and C57BL/6J mice were detected by quantitative Real-time polymerase chain reaction (qRT-PCR). Effects of HOTTIP on the proliferation, insulin secretion and apoptosis of islet β cells transfected with lentivirus were detected by cell counting kit-8 (CCK-8) assay, enzyme-linked immunosorbent assay (ELISA) and flow cytometry, respectively. We also assessed the protein expressions of key genes in MEK/ERK pathway by using Western blot.

RESULTS

HOTTIP was upregulated in normal islet tissues of C57BL/6J mice but downregulated in islet tissues of diabetic mice. Inhibition of HOTTIP attenuated insulin secretion and reduced expressions of Pdx1 and MafA. Downregulation of HOTTIP also inhibited cell proliferation and reduced expressions of CyclinDl, CyclinD2, CyclinE1 and CyclinE2. Moreover, islet β cells were arrested in G0/G1 phase after HOTTIP knockdown. Our data showed that the biological function of HOTTIP in regulating insulin secretion and cell cycle in islet β cells might be related to the MEK/ERK pathway.

CONCLUSIONS

Downregulation of HOTTIP inhibits insulin secretion and cell cycle in islet β cells via MEK/ERK pathway.

[Risk factors for visual field loss progression in patients with primary open-angle glaucoma in Wenzhou area]

Objective: To evaluate risk factors for visual field (VF) loss progression in primary open-angle glaucoma patients. Methods: A prospective nested case-control study. Patients were collected from the Wenzhou glaucoma progression study in the Eye Hospital of Wenzhou Medical University during March 2014 and April 2018. In this study, the eyes were divided into a progression group and a non-progression group using the glaucoma progression analysis methods to analyze the risk factors for glaucomatous VF loss progression. Axial length (AL) and central corneal thickness (CCT) were measured using the Lenstar LS900. The baseline, fluctuation (standard deviation), mean, maximum, minimum and range of intraocular pressure (IOP) during the follow-up period were determined based on IOP measured at each follow-up. The IOP measurements were included from the baseline to the last visit (for the non-progression group), or to the visit at which VF loss progression was determined (for the progression group). The independent sample t-test, Mann-Whitney U inspection and Cox proportional hazards models were used for statistical analysis. Results: A total of 140 patients (140 eyes) were enrolled, including 67 males and 73 females. There were 19.3% of the eyes (27 of 140 eyes) showing VF loss progression. The median time to the endpoint for progression was 24.0 (16.0, 40.0) months. The AL in the progression group and non-progression group were 23.58 (23.05, 24.24) mm and 23.91 (23.10, 24.91) mm (P=0.111). The CCT in the two groups were 531.0 (512.0, 565.0) μm and 535.0 (518.5, 552.0) μm, respectively (P=0.897). The baseline age in the progression group and non-progression group was 71.0 (68.0, 74.0) years and 68.0 (58.0, 72.0) years, respectively (Z=-2.872, P=0.004). The slope of visual field index in the two groups was -3.50 (-7.10, -1.80)%/year and 0.40 (-0.60, 1.40)%/year, respectively (Z=-6.823, P<0.01). The mean IOP during the follow-up was (16.2±2.7) mmHg (1 mmHg=0.133 kPa) in the progression group and (15.1±2.4) mmHg in the non-progression group (t=-2.215, P=0.028). The IOP fluctuation in the progression group and non-progression group was (2.6±1.3) mmHg and (2.0±0.7) mmHg, respectively (t=-2.175, P=0.038). In the multivariate model, older baseline age (HR=1.080; 95%CI:1.019-1.143), higher baseline IOP (HR=1.120; 95%CI:1.016-1.236), higher mean IOP (HR=1.145; 95%CI:1.001-1.309) and higher IOP fluctuation (HR=1.750; 95%CI:1.193-2.566) were all significantly predictive risk factors for glaucomatous VF loss progression. Longer AL (HR=0.725; 95%CI:0.532-0.988) was a protective factor against VF loss progression. However, CCT was found to be not associated with VF loss progression. Conclusion: Baseline age, baseline IOP, mean IOP, IOP fluctuation and shorter AL are found to be risk factors for glaucomatous VF loss progression among eyes with primary open-angle glaucoma in Wenzhou. (Chin J Ophthalmol, 2019, 55: 777-784).

[Strengthening the understanding of the pathological evolution of myopia]

The concern of high myopia in adolescents is increasingly prominent, because of the high prevalence and early onset of myopia in younger children. High myopia increases the risk of various fundus complications, resulting in serious damage to the vision of the working population. The mechanisms underlying the fundus pathology in high myopia remain unknown, although some studies have indicated the initial thinning of the choroid during the myopia progression might count a lot. The thinning of the choroid would influence the blood supply of the retina and sclera and accelerate the progression of myopia to high myopia, inducing the pathologic changes of the fundus. Since the treatment for pathological myopia is limited and cannot reverse the already existed visual impairment, preventive measures are necessary, including the attempts to delay the onset of myopia, to retard progression from mild myopia to high myopia and to retard the pathological changes of high myopia. Future researches should strengthen the understanding of the characteristics of pathologic changes of myopia, establish a predictive index system and a health management system to monitor early pathological changes, and promote early detection and intervention, so as to prevent fundus complications related to high myopia in multiple ways and avoid blindness and visual impairment caused by pathological fundus changes of myopia. (Chin J Ophthalmol, 2019, 55:721-725).