Large-scale study of clinical and biochemical characteristics of Chinese patients diagnosed with Krabbe disease

Krabbe disease (KD) is a rare disease caused by the deficiency of β-galactocerebrosidase. This study investigated 22 unrelated Chinese patients, including their clinical presentations, plasma psychosine levels and β-galactocerebrosidase gene mutations. We found the late-onset form of KD present in 82% of the patients in our study, which was more prevalent than in patients from other populations. Plasma psychosine levels were elevated in KD, which were correlated with the severity of clinical presentations. Sanger sequencing identified 8 novel mutations, including 7 missense mutations, p.H253Y, p.S259L, p.P318L, p.F350V, p.T428A, p.L530P, p.G586D, and 1 splicing mutation, c.1251+1G>A. Quantitative real-time polymerase chain reaction (PCR) and multiplex ligation-dependent probe amplification identified a novel exon 12 and 14 deletion, separately. Next generation sequencing, applied at the final step, revealed 2 missense mutant alleles missed using Sanger sequencing. The most common mutation in Chinese population is p.P154H, which accounts for 20.5% of alleles. Consistent with the higher prevalence of the late-onset form of KD, missense mutations predominated in our study, different with the common mutation types in Europe and Japan. This work was the first large-scale study of Chinese KD patients describing their clinical, biochemical and genetic characteristics, which furthered our understanding of this classical neurological lysosomal storage disease.

Radiation reduction of minimally invasive transforaminal lumbar interbody fusion with localisation system in overweight patients: practical technique

AIMS

Minimally invasive transforaminal lumbar interbody fusion (MITLIF) has been well validated in overweight and obese patients who are consequently subject to a higher radiation exposure. This prospective multicentre study aimed to investigate the efficacy of a novel lumbar localisation system for MITLIF in overweight patients.

PATIENTS AND METHODS

The initial study group consisted of 175 patients. After excluding 49 patients for various reasons, 126 patients were divided into two groups. Those in Group A were treated using the localisation system while those in Group B were treated by conventional means. The primary outcomes were the effective radiation dosage to the surgeon and the exposure time.

RESULTS

There were 62 patients in Group A and 64 in Group B. The mean effective dosage was 0.0217 mSv (standard deviation (sd) 0.0079) in Group A and 0.0383 mSv (sd 0.0104) in Group B (p < 0.001). The mean fluoroscopy exposure time was 26.42 seconds (sd 5.91) in Group A and 40.67 seconds (sd 8.18) in Group B (p < 0.001). The operating time was 175.56 minutes (sd 32.23) and 206.08 minutes (sd 30.15) (p < 0.001), respectively. The mean pre-operative localisation time was 4.73 minutes (sd 0.84) in Group A and 7.03 minutes (sd 1.51) in Group B (p < 0.001). The mean screw placement time was 47.37 minutes (sd 10.43) in Group A and 67.86 minutes (sd 14.15) in Group B (p < 0.001). The pedicle screw violation rate was 0.35% (one out of 283) in Group A and 2.79% (eight out of 287) in Group B (p = 0.020).

CONCLUSION

The study shows that the localisation system can effectively reduce radiation exposure, exposure time, operating time, pre-operative localisation time, and screw placement time in overweight patients undergoing MITLIF. Cite this article: Bone Joint J 2017;99-B:944-50.

Next Generation Driver for Attosecond and Laser-plasma Physics

The observation and manipulation of electron dynamics in matter call for attosecond light pulses, routinely available from high-order harmonic generation driven by few-femtosecond lasers. However, the energy limitation of these lasers supports only weak sources and correspondingly linear attosecond studies. Here we report on an optical parametric synthesizer designed for nonlinear attosecond optics and relativistic laser-plasma physics. This synthesizer uniquely combines ultra-relativistic focused intensities of about 10²⁰ W/cm² with a pulse duration of sub-two carrier-wave cycles. The coherent combination of two sequentially amplified and complementary spectral ranges yields sub-5-fs pulses with multi-TW peak power. The application of this source allows the generation of a broad spectral continuum at 100-eV photon energy in gases as well as high-order harmonics in relativistic plasmas. Unprecedented spatio-temporal confinement of light now permits the investigation of electric-field-driven electron phenomena in the relativistic regime and ultimately the rise of next-generation intense isolated attosecond sources.

Porous monolith microfluidics for bacterial cell-to-cell communication assays

Genetically engineered bacteria can be used for a wide range of applications, from monitoring environmental toxins to studying complex communication networks in the human digestive system. Although great strides have been made in studying single strains of bacteria in well-controlled microfluidic environments, there remains a need for tools to reliably control and measure communication between multiple discrete bacterial populations. Stable long-term experiments (e.g., days) with controlled population sizes and regulated input (e.g., concentration) and output measurements can reveal fundamental limits of cell-to-cell communication. In this work, we developed a microfluidic platform that utilizes a porous monolith to reliably and stably partition adjacent strains of bacteria while allowing molecular communication between them for several days. We measured small molecule production by the bacterial populations in response to stimuli using analytical chemistry methods and measured fluorescent output. The results are compared with communication and diffusion delay models. This porous monolith microfluidic system enables bacterial cell-to-cell communication assays with dynamic control of inputs, relatively long-term experimentation with no cross contamination, and stable bacterial population size. This system can serve as a valuable tool in understanding bacterial communication and improving biosensor design capabilities.

[Study on the serum 25-hydroxyvitamin D levels of benign paroxysmal positional vertigo patients]

Objective:To study whether serum 25-hydroxy vitamin D can be used as an independent indicator of prognosis in patients with benign paroxysmal positional vertigo. Method:Two hundred and two patients with BPPV were collected and divided into vitamin D deficiency group and control group according to their serum 25-OHD level. The severity of the symptoms and the recurrence rate were compared between the two groups. Result:Compared with the control group, patients with vitamin D deficiency group showed severer symptoms, either in longer duration of vertigo, lower success rate of repositioning maneuver treatment at the first time, or higher recurrence rate within six months. Conclusion:Serum 25-OHD level was negatively correlated with the severity and prognosis of BPPV, and could be used as an important index to evaluate the prognosis of BPPV.

[Comparison of ablation of left-sided accessory pathway by atrial septal and retrograde arterial approach]

Objective: To compare the advantages and disadvantages of radiofrequency ablation of left-sided accessory pathways by via atrial septal approach with retrograde through aortic approach. Methods: A total of 184 patients of left-side accessory pathways were treated in Taizhou People's Hospital and the Subei People's Hospital from March 2012 to August 2015.A total of 103 cases were treated by aortic retrograde approach as through arterial group, 81 cases were treated by punctured atrial septal to left atrial for mapping and ablation as through atrial septal group.Comparison of ablation procedure time, total and pathways of different parts(subgroup) at instant success and relapse rates, safety (serious complications), and statistics other complications in operation and postoperative. Results: Through arterial group and through atrial septal group were no significant difference (P>0.05) in the ablation procedure time((25±18 ) vs (22±15)min ), instant success(98.1% vs 97.5%) and relapse rates(1.0% vs 1.2%), security(1 vs 0 case). There was no statistical difference in septal part subgroups (all P>0.05) in the ablation procedure time((22±18)vs (25±19)min), instant success(91.7% vs 89.9 %) and relapse rates(0 vs 11.1%); posterior wall subgroup had no statistical difference in the ablation procedure time((18±15)vs (16±12)min), instant success(100% vs 100 %) and relapse rates(0 vs 0)(all P>0.05); side wall subgroup had no statistical difference in the ablation procedure time((29±20)vs (21±18) min), instant success (98.3% vs 98.1%)and relapse rates(1.7% vs 0%)(all P>0.05). Conclusion: Ablation of left-sided accessory pathways by transseptal approach and transaortic approach has no statistical difference in the procedure time, instant success and relapse rates, security.In a particular case, there is a certain complementarity between the two methods.

Abstract P1-08-08: Identification of tumor-promoting and tumor-inhibiting genes with age dependent expression in breast cancer patients

Age is the number one risk factor for breast cancer development. The breast cancer incidence rate increases with age, following beta distribution, which is approximately linear in range from 30 to 70 years old [1]. Transcriptome alterations have been shown to promote tumorigenesis for many types of cancers. Therefore, we hypothesize that the genes with altered expression during aging may promote breast cancer development and/or progression. Using The Cancer Genome Atlas data, we extracted whole transcriptome profiling data of matched normal tissues from 82 female patients with age at diagnosis and menopausal status available. First, we applied simple linear regression to study the association between gene expression level and age at diagnosis on all the 82 patients. 258 upregulated and 240 downregulated genes are identified, which are associated with age. Secondly, 493 upregulated and 254 downregulated genes are identified that are altered by menopause by comparing post-menopausal to pre-menopausal patients (FDR &lt; 0.05). Exclusion of these menopause affected genes from those genes affected by age (258 upregulated and 240 downregulated) results in 148 upregulated and 189 downregulated genes during aging. Thirdly, by comparing matched tumor and adjacent normal samples, 3356 upregulated and 3124 downregulated genes are found to be associated with tumorigenesis. Overlapping of tumorigenesis associated genes with age dependent genes result in 14 upregulated and 24 downregulated genes that are both age and tumorigenesis associated. This discovery is being validated with normal breast tissues from donors in GTEx cohort. Experimental manipulation of the upregulated genes in seven breast cancer cell lines, representing five subtypes of breast cancer, demonstrated their essential role in promoting tumor malignancy, suggesting the upregulation is not merely passenger event. In a large mixed cohort, this panel of genes have significant predictive value in relapse free survival of breast cancer patients.

Funding: CPRIT Research Training Award (RP140105); NIH R01CA192564

Reference:

Francesco Pompei and Richard Wilson (2001). Age Distribution of Cancer: The incidence Turnover at Old Age. Human and Ecological Risk Assessment: Vol. 7, No. 6, pp. 1619-1650.

Citation Format: Gu X, Zhu H, Sun L. Identification of tumor-promoting and tumor-inhibiting genes with age dependent expression in breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-08-08.

Low levels of plasma galanin in obese subjects with hypertension

BACKGROUND

Obesity is strongly linked to increased blood pressure, which increases the risk of cardiovascular diseases. To our knowledge, little literature reported the information about galanin levels in obese individuals with hypertension. Therefore, the aim of this study was to investigate the possible involvement of galanin in the pathogenesis of obese subjects with hypertension.

METHODS

We measured body mass index and blood pressure of 38 obese patients with hypertension, 44 obese controls with normal blood pressure and 44 lean controls with normal blood pressure. Blood samples from all cases were collected at 8:00 a.m. after an overnight fast to determine the fasting plasma concentration of galanin, glucose, insulin, triglyceride, total cholesterol, high- and low-density lipoprotein cholesterol.

RESULTS

We found that plasma galanin levels were significantly decreased in obese patients with hypertension compared with the obese control group, whereas the galanin levels were significantly increased in obese controls compared with lean controls. Furthermore, in both obese groups the galanin levels were negatively correlative to diastolic blood pressure and positively correlative to insulin and triglyceride levels, but not to heart rate.

CONCLUSIONS

Low galanin levels were one of characters of obese patients with high blood pressure, and this levels may be taken as a novel biomarker to predict the development of high blood pressure in obese patients.

[The characteristic of lexical tone perception in native Mandarin speakers with mild and moderate sensorineural hearing loss]

Objective:To explore the characteristic of lexical tone perception in native-Mandarin speakers with mild to moderate sensorineural hearing loss. Method:Three types of continuum(Tone1/tone2, tone1/tone4 and tone2/tone3) were constructed and each of them includes a 15 stimuli. All speech stimuli in these three continua were resynthesized by applying the Pitch-Synchronous OverLap and Add(PSOLA) method implemented in Praat to the same mandarin syllable, /a/, with a high level tone produced by a female native-mandarin speaker. Twenty-three native-mandarin sensory hearing loss people were recruited for this study and identification task was used to acquire the tonal perceptual data. SPSS 19.0 software was used to get the fitting curves of lexical tone perception. Result:①Each tone perception curves owns the characteristic of categorical perception, including an obvious boundary, a definite intersection and the abrupt performance change at intersection. The tone perception curves were S-shape in SNHL people which were same as that in normal hearing people.②No significant performance difference of each continuum was observed between SNHL and NH in this study(P=0.811 in T1/T2 continuum, P=0.528 in T1/T4 continuum, P=0.555 in T2/T3 continuum). Conclusion:There is the categorical perception of lexical tone identification in native-mandarin sensorineural hearing loss people. The slight damage in peripheral auditory system did not changed characteristic of lexical tone perception.

Two Genotypes of Coxsackievirus A2 Associated with Hand, Foot, and Mouth Disease Circulating in China since 2008

Coxsackievirus A2 (CV-A2) has been frequently detected and commonly associated with hand, foot, and mouth disease (HFMD) in China since 2008. However, limited sequences of CV-A2 are currently available. As a result, we have been focusing on the genetic characteristics of CV-A2 in the mainland of China during 2008-2015 based on national HFMD surveillance. In this study, 20 CV-A2 strains were isolated and phylogenetic analyses of the VP1 sequences were performed. Full-length genome sequences of two representative CV-A2 isolates were acquired and similarity plot and bootscanning analyses were performed. The phylogenetic dendrogram indicated that all CV-A2 strains could be divided into four genotypes (Genotypes A-D). The CV-A2 prototype strain (Fleetwood) was the sole member of genotype A. From 2008 to 2015, the CV-A2 strains isolated in China dispersed into two different genotypes (B and D). And the genotype D became the dominant circulating strains in China. Strains isolated in Russia and India from 2005 to 2011 converged into genotype C. Intertypic recombination occurred between the Chinese CV-A2 strains and other enterovirus-A donor sequences. This result reconfirmed that recombination is a common phenomenon among enteroviruses. This study helps expand the numbers of whole virus genome sequence and entire VP1 sequence of CV-A2 in the GenBank database for further researcher.

Glucagon-like peptide 1 improves insulin resistance in vitro through anti-inflammation of macrophages

Glucagon-like peptide 1 (GLP-1), a kind of gut hormone, is used in the treatment of type 2 diabetes (T2D). Emerging evidence indicates that GLP-1 has anti-inflammatory activity. Chronic inflammation in the adipose tissue of obese individuals is a cause of insulin resistance and T2D. We hypothesized that GLP-1 analogue therapy in patients with T2D could suppress the inflammatory response of macrophages, and therefore inhibit insulin resistance. Our results showed that GLP-1 agonist (exendin-4) not only attenuated macrophage infiltration, but also inhibited the macrophage secretion of inflammatory cytokines including TNF-β, IL-6, and IL-1β. Furthermore, we observed that lipopolysaccharide (LPS)-induced macrophage conditioned media could impair insulin-stimulated glucose uptake. This effect was compensated by treatment with the conditioned media from macrophages treated with the combination of LPS and exendin-4. It was also observed that exendin-4 directly inhibited the activation of NF-κB in macrophages. In conclusion, our results indicated that GLP-1 improved inflammatory macrophage-derived insulin resistance by inhibiting NF-κB pathway and secretion of inflammatory cytokines in macrophages. Furthermore, our observations suggested that the anti-inflammatory effect of GLP-1 on macrophages can contribute to GLP-1 analogue therapy of T2D.

[Epidemiology Characteristics and Pathogen Surveillance of Hand, Foot and Mouth Disease in Guangdong Province, China, 2008～2015]

To understand the epidemiological etiology characteristics of hand, foot and mouth disease(HFMD)in Guangdong province, and to explore the risk change trend of the whole province. By using the descriptive epidemiological methods, the whole province’s incidence trend, population distribution and pathogenic form of HFMD were analyzed with the HFMD surveillance data,population data and geographic information of Guangdong province from 2008 to 2015.The analysis results show: A total of 2,133,722 cases of HFMD, including 5,066 severe cases and 259 death cases were reported in Guangdong province from 2008 to 2015.All the cities of Guangdong had HFMD cases, especially the Pearl River Delta Regions, which were on high-risk areas. There were two peaks every year, with the main peak of incidence occurred in spring and summer, and the sub peak occurred in autumn.Most cases were children aged<5years old, the proportion of this group in overall infections, the severe and death cases were 90.58%,95.93%and 97.30%,respectively,while the proportion for the children less than 3years old were 77.32% and 81.85%,respectively. The incidence of this disease among men was higher than that of women. Dynamic changes were presented between different years and seasons:CV-A16 was more popular in 2009,and enterovirus that none EV-A71 and none CV-A16 were predominant strains in 2013 and 2015.Especially in 2015,the proportion of other EV ranged as high as 71.97%.Besides,EV-A71 was the absolute predominance pathogen within death cases and was important pathogen in severe cases. This study suggests that HFMD epidemiology and laboratory monitoring in Guangdong Province should be strengthened, and provides scientific data support for further improvement of HFMD prevention and control strategies in Guangdong Province.

[The Epidemiology and Etiology Characteristics of Hand-foot-mouth Disease in Chongqing, China,2014～2015]

In this study, the epidemiology of Hand-foot-mouth disease(HFMD)composition of enterovirus (EV) pathogen and VP1 coding gene of Enterovirus A71(EV-A71)were analyzed in Chongqing from 2014 to 2015,to provide a scientific basis for strategies of prevention and control of HFMD in Chongqing. It is reported that there were a total of 100,176 cases of HFMD, of which 284 cases of severe,37 cases of death in Chongqing.39counties(autonomous counties)of Chongqing have reported cases, and the urbans reported incidence rate(298.83/100,000)was significantly higher than the suburbs(103.37/100,000),children 3and under 3years old accounted for 83.21%%,and 5and under 5years old accounted for 95.64%of reported cases, the big peak of epidemics of HFMD was from April to July and the small peak took shape from October to November. Severe cases(96.83%)and deaths(100%)were concentrated in the age group of 5years old and below. The severe cases were mainly in the three districts, WanZhou District, Liangping County and FuLing District, accounting for 74.65% of reported cases, and death cases were widely distributed, scattered in 17 counties.7503nucleic acid of clinical specimens of HFMD were detected, suggested that EV-A71,CV-A16,non-EV-A71/CV-A16 of other EV accounted for 23.54%,33.21%,43.25% respectively,Non-EV-A71/ CV-A16 of other EV became the dominant pathogen of HFMD in Chongqing, but EV-A71 was still the dominant pathogen in severe and death cases. The results showed that 54 strains belonged to C4a and one strain belonged to B5 in the analyses of the VP1 sequences of 55 strains during2014-2015 in Chongqing. This study provides important epidemiological and etiological data for HFMD prevention and control strategies and reduction of severe and death caused by EV-A71 in Chongqing.