AB0347 INCREASING TO OPTIMAL METHOTREXATE DOSE MIGHT BE A BETTER TRADITIONAL DMARD STRATEGY IN RA TREATMENTS: A RANDOMIZED CASE-CONTROL TRIAL OF HAKKA PEOPLE IN SOUTHERN CHINA

Background:

The optimal methotrexate (MTX) dose is defined as 0.3mg/kg/week or ≥ 20mg/week at 6 months. [1] Considering average weight of Chinese, [2] the optimal MTX should be >15mg/w. However, not more than 30% in 25191 RA cases ever had MTX treatment in CREDIT (Chinese Registry of Rheumatoid arthritis). [3] The biggest concern is side effects of MTX. Our study is to investigate whether increasing MTX would get better results accompanied with more side effects to Chinese people.

Objectives:

Hakka people have the purest genes of the majority people-Han in China. It is planned to recruit 160 RA patients in Meizhou, where is a gathering place of Hakka people.

Methods:

The RA volunteers had no relief with 10 mg/w oral dose of MTX with/without other 1-2 inadequate dose of DMARDs for at least 3 months. They were randomly divided into 1:1 groups*. The experimental group would be treated with original DMARDs and incremental MTX (gradually increased to the optimal oral dose (0.3 mg/k/w) in the first 12 weeks and folic acid (the dose adjusted on demand with range from 5 mg/w to 5mg tid). While the control group would be treated with original MTX dose(10mg/w) but incremental original DMARDs(gradually increased to the maximum dose in the first 12 weeks). The two groups would keep the treatment at 12thweek last to the 36thweek, and the efficacy and safety indexes would be evaluated during the whole study.

Results:

1)We planned to recruit 160 RA patients in our study. 46 Hakka RA patients were enrolled in the study so far. 2 of 46 finished the 24thweek visit and 24 finished the 36thweek visit. The average age is 54.2± 9.3 years old, the average weight is 59.1±11.1kg, and the female to male ratio is 41:5.

2)The average Folic acid dose is 14.4±9.5mg/w in the experimental group at the 12thweek.

3)The morning stiffness time, PGA, PhGA, HAQ, DAS28 were better in experimental group after 12 weeks though slightly worse during 0-12 weeks. 100%(12) patients in experimental group, while 66.67%(8/12) in control group reach ACR20.

4) Only 1 case(5.9%,1/23)had adverse event while 6 cases (26%,6/23) occurred adverse events. All events were mild level. 1 case (4.2%,1/23) in control group withdrew from the study because the disease was getting worse during 0-24 weeks.

Conclusion:

Hakka patients in China might have better outcomes due to increasing MTX to the 0.3mg/kg/w dose than increasing the other DMARDs. Therefore, We recommended the Chinses patients choose MTX as first incremental DMARD. The appropriate dose of Folic acid plus with the optimal dose of MTX in our study is higher than previous studies (such as 13.0±4.8mg/w reported by Gaujoux-Viala, 2018[1]). We recommended Chinese patients take 15mg/w folic acid to prevent MTX side effects in view of lower folic acid level in Chinese population.[3]

References:

[1]Gaujoux-Viala C, Rincheval N, Dougados M, et al. Optimal methotrexate dose is associated with better clinical outcomes than non-optimal dose in daily practice: results from the ESPOIR early arthritis cohort. Ann Rheum Dis. 2017 Dec;76(12):2054-2060.

[2]Nan Jiang, Mengtao Li, Yanhong Wang, et al. Baseline characteristics and treatments among patients with rheumatoid arthritis: the CREDIT study in China, 2016-2018. Ann Rheum Dis. 2019 Jun; 78 (Suppl 2) 1404-1405.

[3]He Y, Pan A, Hu FB,et al. Folic acid supplementation, birth defects, and adverse pregnancy outcomes in Chinese women: a population-based mega-cohort study, Lancet, 2016 Oct,Volume 388, Number 1, pp. S91-S91-(1)

Disclosure of Interests:

None declared

New Imaging Findings of Incomplete Partition Type III Inner Ear Malformation and Literature Review

Incomplete partition type III, also referred to as X-linked deafness, is a rare genetic inner ear malformation. Its characteristic CT findings, including bulbous dilation of the internal auditory canal and absence of the modiolus with the interscalar septa present, have been well-recognized. In this series of 19 cases, we report the abnormalities of the vestibule and semicircular canals and provide a comprehensive description of their CT and MR imaging findings. The inner ear malformations in incomplete partition type III were bilateral and basically symmetric, with involvement of the internal auditory canal, nerve canals in the fundus, cochlea, vestibule, semicircular canals, vestibular aqueduct, otic capsule, round window, oval window, and stapes. An irregular vestibule with a cystic appearance is also a distinctive imaging feature, which could be seen in about 90% of our patients, with a cystic appearance of the semicircular canals present in nearly half of the cases.

[Clinical and pathological analysis of 64 patients with primary neoplasms of the lacrimal drainage system]

Objective: To analyze the pathological classification and age distribution of primary neoplasms of the lacrimal drainage system. Methods: Retrospective case series study. A total of 64 patients (65 eyes) were diagnosed with primary neoplasms of the lacrimal drainage system and received surgery at Tianjin Eye Hospital from January 2006 to December 2016. All the clinical data of the patients were analyzed, including gender, diseased eye, age, clinical manifestations, composition of benign and malignant masses, and prognosis. The histopathological composition and age distribution of patients with primary lacrimal mass, lacrimal duct mass and lacrimal sac mass were analyzed according to the different diseased sites. Results: Twenty-three patients (24 eyes) were male, and 41 patients (41 eyes) were female. The right eye was involved in 36 patients, the left eye in 27 patients, and both eyes in one patient. The age at diagnosis ranged from 12 to 78 years old [mean, (46±4) years]. The course of disease was (13.1±4.2) months, ranging from 1 month to 7 years. The chief complaint was tear discharge in 43 patients, tumor in 19 patients, and abscess discharge in 2 patients. There were 29 patients with angular displacement and 21 patients with swelling pain. There were 51 patients with benign lesions, 4 with borderline lesions, and 9 with malignantlesions. These neoplasms consisted of primary peripunctal neoplasms in 17 patients, primary canalicular neoplasms in 2 patients, and primary lacrimal sac neoplasms in 45 patients. All primary peripunctal neoplasms (17 cases) were benign, among which nevi (10 cases) occupied the first place. All primary canalicular neoplasms (2 cases) were benign, there were 1 case of epidermoid cysts and 1 case of degenerative disease. Among the primary benign lacrimal sac masses (32 cases), mucous epithelial cysts (9 cases), dermoid cysts (6 cases), and epidermoid cysts (6 cases) occupied the first three places. Among the primary borderlin lacrimal sac masses (4 cases), there were 2 cases of giant cell tumor of soft tissue, 1 case of solitary fibrous tumor, and 1 case of inflammatory myofibroblastic tumor. The primary malignant mass of lacrimal sac (9 cases) was dominated by squamous cell carcinoma (3 cases). In terms of age distribution, the patients with primary peripunctal mass were mainly in the group of 40-59 years old (14 cases). The primary benign mass of lacrimal sac mainly occurred in the group of less than 40 years old (15 cases) and the group of 40-59 years old (11 cases). The patients with primary lacrimal sac borderline and malignant masses were all in the groups of over 40 years old. A total of 49 patients were followed up for 27 months to 16 years. The average follow-up time was (57.2±3.8) months. Lacrimal sac transitional cell carcinoma relapsed 7 months after surgery in one patient, and lacrimal sac melanoma relapsed 1 year after surgery in one patient. The patients did not relapse in 24 months and 38 months after surgery respectively. There were no recurrence of other cases. Conclusions: Primary peripunctal neoplasms are mostly characterized with benign lesions, among which nevi are most common. Mucous epithelial cysts, epidermoid cysts, and dermoid cysts are the major benign lacrimal sac neoplasms. Squamous cell carcinomas are the most common malignant lacrimal sac neoplasms. The malignant tumor of lacrimal sac often occurs in the middle-aged and elderly patients. (Chin J Ophthalmol, 2020, 56: 364-369).

[Influencing factors of postoperative acute kidney injury in patients undergoing cardiac surgery]

Objective: To analyze the influencing factors of acute kidney injury (AKI) in patients after cardiac surgery using levosimendan or dobutamine, and explore the effect of positive inotropic drugs on AKI. Methods: The clinical data of 417 patients undergoing cardiac surgery from January to June 2018 in Beijing Anzhen Hospital and treated with levosimendan or dobutamine during perioperative period were retrospectively reviewed and collected. Patients were divided into AKI group and non-AKI group according to whether AKI occurred. Univariate logistic regression analysis was used to analyze the factors related to the occurrence of AKI. The statistically significant factors (P<0.05) were further included in the multivariate logistic regression analysis. Results: Totally, 417 patients were enrolled in the study, with a mean age of (58.2±10.4) years old and a male rate of 65.0% (n=271), and the AKI incidence rate was 25.2% (105/417). Univariate logistic regression analysis showed that male, chronic kidney disease, high serum creatinine level in preoperative period, aortic obstruction time ≥ 120 minutes and extracorporeal circulation time ≥ 120 minutes were risk factors for AKI (all P<0.05). Vasodilator and levosimendan treatment during perioperative period were protective factors (P<0.05). Multivariate logistic regression analysis showed that chronic kidney disease (OR=17.291, 95%CI: 4.335-68.960, P<0.001) and high serum creatinine level (OR=1.097, 95%CI: 1.074-1.121, P<0.001) in preoperative period were independent risk factors for AKI. Perioperative application of levosimendan (OR=0.533, 95%CI: 0.288-0.984, P=0.044) was an independent protective factor. Conclusions: Risk factors for AKI after cardiac surgery include chronic kidney disease and high serum creatinine level in preoperative period. The use of levosimendan during preoperative period has the potential effect to protect against AKI.

Observation of a Resonant Structure in e^{+}e^{-}→K^{+}K^{-}π^{0}π^{0}

A partial-wave analysis is performed for the process e^{+}e^{-}→K^{+}K^{-}π^{0}π^{0} at the center-of-mass energies ranging from 2.000 to 2.644 GeV. The data samples of e^{+}e^{-} collisions, collected by the BESIII detector at the BEPCII collider with a total integrated luminosity of 300  pb^{-1}, are analyzed. The total Born cross sections for the process e^{+}e^{-}→K^{+}K^{-}π^{0}π^{0}, as well as the Born cross sections for the subprocesses e^{+}e^{-}→ϕπ^{0}π^{0}, K^{+}(1460)K^{-}, K_{1}^{+}(1400)K^{-}, K_{1}^{+}(1270)K^{-}, and K^{*+}(892)K^{*-}(892), are measured versus the center-of-mass energy. The corresponding results for e^{+}e^{-}→K^{+}K^{-}π^{0}π^{0} and ϕπ^{0}π^{0} are consistent with those of BABAR with better precision. By analyzing the cross sections for the four subprocesses, K^{+}(1460)K^{-}, K_{1}^{+}(1400)K^{-}, K_{1}^{+}(1270)K^{-}, and K^{*+}(892)K^{*-}(892), a structure with mass M=(2126.5±16.8±12.4)  MeV/c^{2} and width Γ=(106.9±32.1±28.1)  MeV is observed with an overall statistical significance of 6.3σ, although with very limited significance in the subprocesses e^{+}e^{-}→K_{1}^{+}(1270)K^{-} and K^{*+}(892)K^{*-}(892). The resonant parameters of the observed structure suggest it can be identified with the ϕ(2170), thus the results provide valuable input to the internal nature of the ϕ(2170).

Ethanol combined with coil embolisation for the treatment of arteriovenous malformations in a patient with Parkes Weber syndrome

Parkes Weber syndrome is a rare congenital condition of the vascular system with severe symptoms and life-threatening complications. The challenge is to manage the arteriovenous malformations, and there is no consensus on optimal treatment. We report the case of an 18-year-old woman with Parkes Weber syndrome who was treated with ethanol combined with coil embolisation at an early stage. After two sessions of embolisation, a significant devascularisation was achieved. No sign of recurrence was observed two years after the initial procedure. The patient's symptoms and signs were greatly relieved during the follow-up period. This case raises awareness of Parkes Weber syndrome and highlights the importance of timely intervention, as well as offering a promising therapeutic option for this condition.

Three-field versus two-field lymphadenectomy in transthoracic oesophagectomy for oesophageal squamous cell carcinoma: short-term outcomes of a randomized clinical trial

BACKGROUND

The benefit and harm of three-field lymphadenectomy for oesophageal cancer are still unknown. The aim of this study was to compare overall survival and morbidity and mortality between three- and two-field lymphadenectomy in patients with oesophageal squamous cell carcinoma.

METHODS

Between March 2013 and November 2016, patients with squamous cell carcinoma of the middle or distal oesophagus were assigned randomly to open oesophagectomy with three-field (cervical-thoracic-abdominal) or two-field (thoracic-abdominal) lymphadenectomy. No chemo(radio) therapy was given before surgery. This paper reports on the secondary outcomes of the study: pathology and surgical complications.

RESULTS

Some 400 patients were randomized, 200 in each group. A median of 37 (i.q.r. 30-49) lymph nodes were dissected in the three-field group, compared with 24 (18-30) in the two-field group (P < 0·001). Some 43 of 200 patients (21·5 per cent) in the three-field group had cervical lymph node metastasis. More patients in the three-field group had pN3 disease: 21 of 200 (10·5 per cent) versus 10 of 200 (5·0 per cent) (P = 0·040). The rate and severity of postoperative complications were comparable between the two groups, except that six patients in the three-field arm needed reintubation compared with none in the two-field group (3·0 versus 0 per cent; P = 0·030). The 90-day mortality rate was 0 per cent in the three-field group and 0·5 per cent (1 patient) in the two-field group (P = 1·000).

CONCLUSION

Oesophagectomy with three-field lymphadenectomy increased the number of lymph nodes dissected and led to stage migration owing to a 21·5 per cent rate of cervical lymph node metastasis. Postoperative complications were largely comparable between two- and three-field lymphadenectomy. Registration number: NCT01807936 ( https://www.clinicaltrials.gov).

Cytochrome P450 4B1 (CYP4B1) as a target in cancer treatment

Cytochrome P450 4B1 (CYP4B1) plays crucial roles in biotransforming of xenobiotics. Its predominant extrahepatic expression has been associated with certain tissue-specific toxicities. However, the expressions of CYP4B1 in various cancers and hence their potential roles in cancer development were inclusive. In this work, existing knowledge on expression and regulation of CYP4B1 gene and protein, catalysis of CYP4B1, association of CYP4B1 with cancers, contradicting findings about human CYP4B1 activities as well as the employing CYP4B1 in suicide gene approach for cancer treatment were reviewed. To date, it appears that there is a wide spectrum of tissue distribution of CYP4B1 with lungs as the predominant sites. Several nuclear receptors are possibly responsible for regulating its gene expression. The involvement of CYP4B1 in cancer was considered via activation of procarcinogens and neovascularization. However, human CYP4B1 was found to be inactive due to a substitution of proline with serine at position 427. Suicide gene approach combining reengineered CYP4B1 and prodrug 4-ipomeanol (4-IPO) has shown a promising potential for targeted cancer therapy. Further studies should focus on the verification of human CYP4B1 catalytic activities. More compounds with similar structure as 4-IPO should be tested to identify more alternative agents for the suicide gene approach in cancer treatment.

The relationship between regulatory T cells and radiation therapy

Radiation therapy (RT) is an effective treatment for cancer. Approximately, 70% of cancer patients receive RT in China. The immune-modulating effect of radiation therapy have gained considerable interest in recent years and there have been multiple reports of synergy between radiation and immunotherapy. Regulatory T cells (Tregs) are a group of T cell subsets with immunosuppressive function, which is correlated with cancer. Tregs are involved in the pathogenesis, development, treatment and prognosis of tumors by cell-cell contact, cytokines, and cell metabolism. Based on the immunological characteristics of Tregs, this article reviews the interaction between RT and immune molecules, aiming to provide new ideas for RT combined with immunotherapy.

Measurement of Proton Electromagnetic Form Factors in e^{+}e^{-}→pp[over ¯] in the Energy Region 2.00-3.08 GeV

The process of e^{+}e^{-}→pp[over ¯] is studied at 22 center-of-mass energy points (sqrt[s]) from 2.00 to 3.08 GeV, exploiting 688.5  pb^{-1} of data collected with the BESIII detector operating at the BEPCII collider. The Born cross section (σ_{pp[over ¯]}) of e^{+}e^{-}→pp[over ¯] is measured with the energy-scan technique and it is found to be consistent with previously published data, but with much improved accuracy. In addition, the electromagnetic form-factor ratio (|G_{E}/G_{M}|) and the value of the effective (|G_{eff}|), electric (|G_{E}|), and magnetic (|G_{M}|) form factors are measured by studying the helicity angle of the proton at 16 center-of-mass energy points. |G_{E}/G_{M}| and |G_{M}| are determined with high accuracy, providing uncertainties comparable to data in the spacelike region, and |G_{E}| is measured for the first time. We reach unprecedented accuracy, and precision results in the timelike region provide information to improve our understanding of the proton inner structure and to test theoretical models which depend on nonperturbative quantum chromodynamics.

Measurement of the Cross Section for e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+} and Observation of an Excited Ξ Baryon

Using a total of 11.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.009 and 4.6 GeV and collected with the BESIII detector at BEPCII, we measure fifteen exclusive cross sections and effective form factors for the process e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+} by means of a single baryon-tag method. After performing a fit to the dressed cross section of e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+}, no significant ψ(4230) or ψ(4260) resonance is observed in the Ξ^{-}Ξ[over ¯]^{+} final states, and upper limits at the 90% confidence level on Γ_{ee}B for the processes ψ(4230)/ψ(4260)→Ξ^{-}Ξ[over ¯]^{+} are determined. In addition, an excited Ξ baryon at 1820  MeV/c^{2} is observed with a statistical significance of 6.2-6.5σ by including the systematic uncertainty, and the mass and width are measured to be M=(1825.5±4.7±4.7)  MeV/c^{2} and Γ=(17.0±15.0±7.9)  MeV, which confirms the existence of the J^{P}=3/2^{-} state Ξ(1820).

ETph: enhancers and their targets in pig and human database

Enhancers, as the genomic non-coding sequences, play a key role in the activation of gene expression. They have been widely identified in the human genome. Pig is an important biomedical model for human health. Few studies have been performed to explore the enhancers in the pig genome. The human enhancer information may be useful to identify enhancers in the pig genome. In addition, the genetic background of pig traits could be useful to annotate human enhancers and diseases. Thus, in order to further study enhancers and their potential roles in human and pig, we developed a public database, ETph (Enhancers and their Targets in pig and human). ETph integrates the information on human enhancers, pig putative enhancers, target genes, pig QTL terms, human diseases, GO terms and the KEGG pathway. A total of 25 182 enhancers were identified in the pig genome using the human homology sequence information. Among them, 6232 high-confidence enhancers were used to build the ETph. ETph provides a convenient platform to search, browse and download data. Moreover, a web-based analytical tool was designed to visualize networks and topology graphs among pig putative enhancers, target genes, pig QTL traits and human diseases. ETph might provide a useful tool for researchers to investigate the genetic background of pig traits and human diseases. ETph is freely accessible at http://klab.sjtu.edu.cn/enhancer/.

Research Progress and Forensic Identification of Alcoholic Cardiomyopathy

Abstract

With the rapid development of the social economy in China, the incidence of diseases caused by excessive drinking is gradually increasing as well. Alcoholic cardiomyopathy refers to long-term high intake of ethanol, and has typical dilated cardiomyopathy characteristics, such as, hemodynamic changes, symptoms, signs, and morphological features. It is a kind of cardiomyopathy that excludes other causes of dilated cardiomyopathy. Due to the lack of specific pathological changes, the forensic pathological identification of alcoholic cardiomyopathy can only be based on the patient's medical history and by ruling out other causes of cardiomyopathy. This paper reviews the pathogenesis and forensic identification of alcoholic cardiomyopathy in order to provide reference for forensic pathologists and clinicians.

Observation of the Semileptonic D^{+} Decay into the K[over ¯]_{1}(1270)^{0} Axial-Vector Meson

By analyzing a 2.93  fb^{-1} data sample of e^{+}e^{-} collisions, recorded at a center-of-mass energy of 3.773 GeV with the BESIII detector operated at the BEPCII collider, we report the first observation of the semileptonic D^{+} transition into the axial-vector meson D^{+}→K[over ¯]_{1}(1270)^{0}e^{+}ν_{e} with a statistical significance greater than 10σ. Its decay branching fraction is determined to be B[D^{+}→K[over ¯]_{1}(1270)^{0}e^{+}ν_{e}]=(2.30±0.26_{-0.21}^{+0.18}±0.25)×10^{-3}, where the first and second uncertainties are statistical and systematic, respectively, and the third originates from the input branching fraction of K[over ¯]_{1}(1270)^{0}→K^{-}π^{+}π^{0}.

Serum Metrnl Level is Correlated with Insulin Resistance, But Not with β-Cell Function in Type 2 Diabetics

Background

Metrnl is a novel identified adipomyokine which might have therapeutic potential for metabolic and inflammatory diseases, including type 2 diabetes mellitus. We aimed to explore the associations of circulating Metrnl level with β-cell function and insulin resistance (IR) and further explore the possible correlation between Metrnl and another adipomyokine named irisin in patients diagnosed type 2 diabetes.

Material/Methods

Our study recruited 59 participants with type 2 diabetes and 30 normal glucose tolerance (NGT) participants. We used enzyme-linked immunosorbent assay (ELISA) to measure serum levels of Metrnl and irisin. The associations of Metrnl level with indexes of β-cell function and IR and irisin level were analyzed by multiple linear regression analysis or spearman correlation analysis.

Results

Compared with NGT participants, serum Metrnl level was elevated in participants with type 2 diabetes: 210.30 pg/mL (range 105.94–323.91 pg/mL) versus 132.02 pg/mL (range 104.93–195.92 pg/mL). Metrnl level did not show significant correlation with β-cell function-related indicators, but positively correlated with HOMA2-IR and negatively correlated with HOMA2-%S after controlling multiple covariates in participants with type 2 diabetes. Metrnl level was also not associated with obesity-related indicators (body mass index, waist circumference, body fat percentage, and visceral adipose tissue area) in the type 2 diabetes group. In addition, the correlation between Metrnl and irisin level was also not present (r=−0.159, P=0.229) in type 2 diabetes group.

Conclusions

Serum Metrnl level was associated with IR, but not with β-cell function in participants with diagnosed type 2 diabetes.

Observation of the Leptonic Decay D^{+}→τ^{+}ν_{τ}

We report the first observation of D^{+}→τ^{+}ν_{τ} with a significance of 5.1σ. We measure B(D^{+}→τ^{+}ν_{τ})=(1.20±0.24_{stat}±0.12_{syst})×10^{-3}. Taking the world average B(D^{+}→μ^{+}ν_{μ})=(3.74±0.17)×10^{-4}, we obtain R_{τ/μ}=Γ(D^{+}→τ^{+}ν_{τ})/Γ(D^{+}→μ^{+}ν_{μ})=3.21±0.64_{stat}±0.43_{syst}., which is consistent with the standard model expectation of lepton flavor universality. Using external inputs, our results give values for the D^{+} decay constant f_{D^{+}} and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cd}| that are consistent with, but less precise than, other determinations.

[Dietary intake of sodium and potassium among adult inhabitants and evaluation of survey methods in Tianjin in 2015]

Objective: To understand the status and food sources of daily dietary intake of sodium and potassium among adult inhabitants in Tianjin city, and to compare the consistence of sodium and potassium intake determined by combination of 3 consecutive 24-hour recalls and weighing family condiments (3 d dietary survey method) with 24 h urine sodium and potassium determination. Methods: Multistage cluster sampling method was applied to select 1 955 adult inhabitants from 840 households of 7 districts in Tianjin in 2015. Questionnaire survey was used to obtain basic information, 3 d dietary method was used to obtain dietary information, and 450 subjects was selected by systematic random sampling method for 24 h urine collection and determination of sodium and potassium, and 153 complete 24 h urine samples were selected by the coefficient of urinary creatinine excretion, then the consistence of the determination was compared with 3 d dietary survey method. Results: 1 828 subjects were enrolled in this study with age of (54.6±14.7) years, among which 858 were male (46.9%). The average standard intake of sodium and potassium per people per day were (5 631.2±3 372.1) mg and (1 662.1±750.5) mg, while the average actual daily intake were (5 315.8±3 196.5) mg and (1 560.7±696.8) mg. 98.7% (1 804/1 828) of the subjects had dietary sodium intake exceeding the recommended adequate intake of China residents(1 300-1 500 mg/d), while 78.5% (1 435/1 828) consumed dietary potassium below the recommended adequate intake(2 000 mg/d). The main resource of sodium was condiments, among which cooking salt accounted for 61.5%, soy sauce accounted for 11.2%. Potassium mainly came from cereals (32.4%) and vegetables (18.1%). Compared with the 24 h urine sodium method, 3 d dietary method overestimated the sodium intake with a gap [median (P(25), P(75))] as 401.7 (-1 130.6, 1 939.5) mg/d with statistical difference (P<0.05). The gap [median (P(25)-P(75))] for potassium between the two methods was 79.1 (-577.5, 565.2) mg/d, without statistical difference (P>0.05). Conclusion: The dietary intake of sodium is high while potassium is low among adults inhabitants in Tianjin city. Compared with the 24 h urine sodium and potassium determination, the 3 d dietary method has a good consistency in evaluating the dietary potassium intake level of the population, but overestimates the dietary sodium intake.

Estramustine phosphate induces prostate cancer cell line PC3 apoptosis by down-regulating miR-31 levels

OBJECTIVE

Prostate cancer seriously threats to patient's life and health. Estramustine phosphate (EP) is one of the most important drugs in the clinical treatment of prostate cancer. This study aims to explore the molecular mechanism of estramustine phosphate in regulating PC3 cell growth and survive through mediating miR-31.

MATERIALS AND METHODS

Estramustine phosphate was used to treat prostate cancer cell line PC3. Flow cytometry was applied to detect PC3 cell growth and apoptosis. RT-PCR was performed to test miR-31 level. Prostate cancer tissue and paracarcinoma tissue were collected to test miR-31 level. PC3 cells were transfected with miR-31 or control microRNA by lipofectamine, and followed treated by estramustine phosphate.

RESULTS

PC3 cell appeared growth restrain and apoptosis after treated by estramustine phosphate. MiR-31 level decreased after estramustine phosphate treatment. Prostate cancer tissue presented higher miR-31 level than paracarcinoma tissue. MiR-31 over-expression inhibited estramustine phosphate induced PC3 cell apoptosis.

CONCLUSIONS

Estramustine phosphate induces prostate cancer cell line PC3 apoptosis through reducing miR-31.

56The SGLT2 inhibitor empagliflozin reduces mortality in experimental pulmonary hypertension

Introduction

Empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, enhances urinary glucose excretion and profoundly reduces hospitalisation for heart failure and cardiovascular mortality in individuals with type 2 diabetes. While empagliflozin has been reported to reduce blood pressure, its effect on pulmonary arterial hypertension (PAH) is unknown. PAH is a serious and progressive disease that is characterised by pulmonary artery vasoconstriction, vascular remodelling, right ventricular hypertrophy, and ultimately heart failure.

Purpose

To investigate the impact of empagliflozin on PAH-associated mortality and the progression as well as reversal of PAH in monocrotaline (MCT)-treated Sprague-Dawley rats.

Methods

A total of 66 male rats (220–250 g) were randomly assigned to one of three studies. PAH was induced with a single intraperitoneal injection of MCT on day 0 and empagliflozin (10 mg/kg) was administered daily by oral gavage. Survival study: PAH was induced with 60 mg/kg MCT. Starting on day 1, rats were treated with empagliflozin (n=8) or vehicle (n=8) for 28 days and monitored for up to 45 days post-MCT injection. Prevention study: Rats were administered 60 mg/kg MCT and treated with empagliflozin (n=12) or vehicle (n=12) for 20 days from day 1 onwards. Reversal study: 21 days after being injected with 40 mg/kg MCT, rats were given empagliflozin (n=8) or vehicle (n=8) for 14 days. At the end of the treatment window, rats in the latter two studies underwent haemodynamic assessments before their tissues were harvested for histological review.

Results

Mortality rates between the two groups were significantly different (median survival 24 vs 33 days for vehicle vs empagliflozin; p<0.05). Compared to the MCT-vehicle-treated rats, the MCT-empagliflozin group had significantly lower mean pulmonary artery pressure (77.4±8.6 vs 51.0±4.9 mmHg [Prevention study]; 56.0±4.3 vs 43.0±3.4 mmHg [Reversal study]); higher pulmonary acceleration time (21.0±0.8 vs 27.4±1.4 ms [Prevention study] and 27.1±1.0 vs 33.4±1.3 ms [Reversal study]); and less right ventricular hypertrophy (0.52±0.01 vs 0.41±0.04 [Prevention study]). Histological assessments revealed significantly less medial wall thickening (50.8±2.2 vs 44.7±1.1 mm) and muscularisation (53.2±1.3 vs 43.6±2.1 mm) in pulmonary arterioles from the empagliflozin- vs vehicle-treated rats (p<0.001 for both).

Conclusion

This is the first study demonstrating that SGLT2 inhibition with empagliflozin lowers mortality in experimental pulmonary hypertension in part via reduced pulmonary vascular remodelling.

Acknowledgement/Funding

This study was supported by grants from the Canadian Institutes of Health Research.

Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.

Amplitude Analysis of D_{s}^{+}→π^{+}π^{0}η and First Observation of the W-Annihilation Dominant Decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}

We present the first amplitude analysis of the decay D_{s}^{+}→π^{+}π^{0}η. We use an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 3.19  fb^{-1} collected with the BESIII detector at a center-of-mass energy of 4.178 GeV. We observe for the first time the W-annihilation dominant decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}. We measure the absolute branching fraction B(D_{s}^{+}→a_{0}(980)^{+(0)}π^{0^{(}+)},a_{0}(980)^{+(0)}→π^{+(0)}η)=(1.46±0.15_{stat}±0.23_{sys})%, which is larger than the branching fractions of other measured pure W-annihilation decays by at least one order of magnitude. In addition, we measure the branching fraction of D_{s}^{+}→π^{+}π^{0}η with significantly improved precision.

Control of Direct Written Ink Droplets Using Electrowetting

Here, we investigate the feasibility and effectiveness of electrowetting in the motion control of droplets of different liquids, which are widely used as inks in direct writing (DW)-based three-dimensional (3D) printing processes for various applications. To control the movement of DW ink droplets on dielectric substrates, the electrodes were embedded in the substrate. It is demonstrated that droplets of pure liquid inks, aqueous polymer solution inks, and carbon fiber suspension inks can be moved on multi-angled surfaces. Also, experimental results reveal that droplets of a commercial hydrogel, agar-agar, alginate, xanthan gum, and gum arabic can be moved by electrowetting. Droplets of sizes 200 μm-3 mm were manipulated and moved by the electric field on different dielectric substrates accurately and repeatedly. Effective electrowetting-based control and movement of droplets were observed on horizontal, vertical, and even inverted substrates. These findings imply the feasibility and potential application of electrowetting as a flexible, rapid, and new method for ink droplet control in 3D printing processes.

Overview of recycled concrete research through development years (2004-2018)

Along with the urbanization process, large amount of construction and demolition (C&D) waste during the construction, reconstruction, expansion or demolition of buildings is generated. Meanwhile, the impact on environment due to natural aggregate mining has become increasingly significant. These factors have driven the building industry to look for environmentally friendly materials and focusing on sustainable construction. Through nearly a decade of research, recycled concrete (RC) made with recycled aggregates manufactured from construction and demolition (C&D) waste has shown a competitive performance compared to natural materials and has already achieved industrial application. Researches on sustainably recycled concrete have become an essential part of sustainable development and continue to play a vital role for future research.

This paper engages in the discussion and the overview of research done by the Research Group for Recycled Concrete Structures and Construction at Tongji University, Shanghai. The first part discusses the necessary mechanical and durability properties of recycled concrete with recycled aggregate as well as recycled powder focusing on workability, strength, Poisson’s ratio, stress-strain behaviour along with carbonation, chloride penetration shrinkage and creep. The second part throws light on the elements and structures made with recycled aggregate concrete (RAC), discussing the behaviours of RAC components and structures.

Study of e^{+}e^{-}→γωJ/ψ and Observation of X(3872)→ωJ/ψ

We study the e^{+}e^{-}→γωJ/ψ process using 11.6  fb^{-1} e^{+}e^{-} annihilation data taken at center-of-mass energies from sqrt[s]=4.008  GeV to 4.600 GeV with the BESIII detector at the BEPCII storage ring. The X(3872) resonance is observed for the first time in the ωJ/ψ system with a significance of more than 5σ. The relative decay ratio of X(3872)→ωJ/ψ and π^{+}π^{-}J/ψ is measured to be R=1.6_{-0.3}^{+0.4}±0.2, where the first uncertainty is statistical and the second systematic (the same hereafter). The sqrt[s]-dependent cross section of e^{+}e^{-}→γX(3872) is also measured and investigated, and it can be described by a single Breit-Wigner resonance, referred to as the Y(4200), with a mass of 4200.6_{-13.3}^{+7.9}±3.0  MeV/c^{2} and a width of 115_{-26}^{+38}±12  MeV. In addition, to describe the ωJ/ψ mass distribution above 3.9  GeV/c^{2}, we need at least one additional Breit-Wigner resonance, labeled as X(3915), in the fit. The mass and width of the X(3915) are determined. The resonant parameters of the X(3915) agree with those of the Y(3940) in B→KωJ/ψ and of the X(3915) in γγ→ωJ/ψ observed by the Belle and BABAR experiments within errors.

Observation of the Decay X(3872)→π^{0}χ_{c1}(1P)

Using a total of 9.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.15 and 4.30 GeV collected by the BESIII detector, we search for the processes e^{+}e^{-}→γX(3872) with X(3872)→π^{0}χ_{cJ} for J=0, 1, 2. We report the first observation of X(3872)→π^{0}χ_{c1}, a new decay mode of the X(3872), with a statistical significance of more than 5σ for all systematic fit variations. Normalizing to the previously established process e^{+}e^{-}→γX(3872) with X(3872)→π^{+}π^{-}J/ψ, we find B(X(3872)→π^{0}χ_{c1})/B(X(3872)→π^{+}π^{-}J/ψ)=0.88_{-0.27}^{+0.33}±0.10, where the first error is statistical and the second is systematic. We set 90% confidence level upper limits on the corresponding ratios for the decays to π^{0}χ_{c0} and π^{0}χ_{c2} of 19 and 1.1, respectively.

[Clinical features and reasons for missed diagnosis of allergic bronchopulmonary aspergillosis]

Objective: To summarize the clinical features of allergic bronchopulmonary aspergillosis (ABPA) and analyze the common causes of missed diagnosis. Methods: The clinical data of patients with ABPA who were admitted into Qilu Hospital of Shandong University from October 2014 to November 2017 were retrospectively analyzed, including baseline data, eosinophil count in peripheral blood, serum total IgE, A. fumigates-specific antibody (sIgE, sIgG and sIgM), pulmonary function tests and chest CT, etc. Then the correlations between serum total IgE, sIgE and forced expiratory volume in one second (FEV₁) as percentage of predicted value (FEV₁%pred) was conducted, as well as that between serum total IgE, sIgE and FEV₁/forced vital capacity (FEV₁/FVC). The clinical features of the patients were summarized and the causes of missed diagnosis were analyzed. Results: There were 46 patients with ABPA (21 males and 25 females, 48.3±13.2 years old) in total. Only 2 cases (4.3%) were diagnosed after the first symptom onset, and 44 cases (95.7%) were treated repeatedly for many years before being diagnosed. The misdiagnoses were asthma (26 cases, 56.5%), bronchiectasis (13 cases, 28.3%), pneumonia (4 cases, 8.7%), pulmonary tuberculosis (3 cases, 6.5%), and lung cancer (4 cases, 8.7%). Common symptoms of ABPA included cough, expectoration, wheezing, chest tightness, fever, weight loss, chest pain, etc. Peripheral blood eosinophil count increased in 37 patients (80.4%). Serum total IgE in 37 patients (80.4%) were higher than 1 000 U/ml, and 9 cases (19.6%) were less than 1 000 U/ml. The positive rate of sIgE, sIgG and sIgM was 100.0%, 89.1% and 54.3%, respectively. All patients underwent pulmonary function tests and 35 cases (76.1%) had obstructive ventilation dysfunction, 5 cases (10.9%) with mixed ventilation dysfunction, 5 cases (10.9%) were normal and 1 case (2.2%) with restrictive ventilation dysfunction. All patients underwent Chest CT examination, 28 cases (60.9%) showed bronchiectasis, 8 cases (17.4%) manifested mucus plugs (among them, 4 cases with high-attenuation mucus) and 10 cases (21.7%) had other atypical imaging. Serum total IgE and sIgE had no correlations with FEV₁%pred and FEV₁/FVC. Conclusions: ABPA is characterized by recurrent episodes of wheezing, fleeting pulmonary opacities and bronchiectasis. The main reasons of misdiagnosis in ABPA patients were: atypical symptoms, variety of predisposing diseases, early atypical imaging changes, limitations and misunderstandings of screening indicators, interference with tumor markers, and the presence of pulmonary aspergillus overlap syndrome. The severity of asthma attacks is not related to the degree of fungal sensitization.

Genetic parameter estimates for body conformation traits using composite index, principal component, and factor analysis

Information about genetic parameters is population specific and it is crucial for designing animal breeding programs and predicting response to selection. This study was carried out to estimate the genetic parameters for 23 body conformation traits of 45,517 Chinese Holstein reared in Eastern China from 1995 to 2017 with the Bayesian inference method using a linear animal mixed model. The methods to integrate these traits included (1) using the composite index from the Dairy Association of China and (2) applying principal component analysis and factor analysis to explore the relationship between the conformation traits. Estimates of heritability using the composite index were low (0.04; feet and legs) to moderate (0.23; body capacity). Strong genetic correlations were observed between the individual body conformation traits. Both principal components (1 to 7; eigenvalues ≥ 1) and latent factors (1 to 7; eigenvalues ≥ 1) explained 60.37% of total variability. Principal component 1 and factor 1 accounted for the traits that are usually associated with milk production. Moderate to low heritability were estimated through multi-trait analysis for principal components (from 0.07 to 0.21) and latent factors (from 0.07 to 0.23). Genetic correlations among the 2 multivariate techniques are typically lower compared with the one existing among the measured traits. Results from these analyses suggest the possibility of using both principal component analysis and factor analysis in morphological evaluation, simplifying the information given by the body conformation traits into new variables that could be useful for the genetic improvement of the Chinese Holstein population. This information could also be used to avoid analyzing large number of correlated traits, thereby improving precision and reducing computation burdens to analyze large and complex data.

MiR-34a suppresses HNSCC growth through modulating cell cycle arrest and senescence

MiR-34a acts as a tumor suppressor in various malignancies. In HNSCC, the role of miR-34a in proliferation has not been fully elaborated and the target genes are still bind. Here, we addressed that forced miR-34a expression induced cell cycle arrest and senescence. Hypoxia/HIF1α was found to negatively correlate to the expression of miR-34a in HNSCC tissues and partially reverse miR-34a-imposed cell senescence through suppressing miR-34a expression. In order to screen the possible target genes of miR-34a in HNSCC, the differential genes mediated by miR-34a were screened by mRNA microarray. There were 91 genes co-down regulated in two cell lines, which were closely associated with MAPK, ErbB and p53 pathways. Genes, including FUT1, AXL, and MAP2K1 were finally identified as the novel targets of miR-34a by qPCR and luciferase assay. These findings indicate that miR-34a plays an essential role in suppressing HNSCC growth through inducing cell cycle arrest and senescence, by targeting proliferation-associated genes.

Precision Measurement of the Branching Fractions of η^{'} Decays

Based on a sample of (1310.6±7.0)×10^{6}J/ψ events collected with the BESIII detector, we present measurements of J/ψ and η^{'} absolute branching fractions using the process J/ψ→γη^{'}. By analyzing events where the radiative photon converts into an e^{+}e^{-} pair, the branching fraction for J/ψ→γη^{'} is measured to be (5.27±0.03±0.05)×10^{-3}. The absolute branching fractions of the five dominant decay channels of the η^{'} are then measured for the first time and are determined to be B(η^{'}→γπ^{+}π^{-})=(29.90±0.03±0.55)%, B(η^{'}→ηπ^{+}π^{-})=(41.24±0.08±1.24)%, B(η^{'}→ηπ^{0}π^{0})=(21.36±0.10±0.92)%, B(η^{'}→γω)=(2.489±0.018±0.074)%, and B(η^{'}→γγ)=(2.331±0.012±0.035)%, where the first uncertainties are statistical and the second systematic.

[The necessity of artificial kidney seeper in the ultrasonography-guided percutaneous nephrolithotomy: a randomized controlled study]

Objective: To investigate the necessity of artificial kidney seeper which made through inserting a ureteral tube in the ureter to the ultrasonography-guided percutaneous nephrolithotomy (PCNL). Methods: This was a randomized prospective study. Patients who conformed to the inclusion and exclusion criteria were enrolled at Department of Urology, Frist Affiliated Hospital of Wenzhou Medical University from January 2016 to May 2017. Totally 291 patients were included in the study. Patients were randomly assigned into two groups (artificial kidney seeper group and non-artificial kidney seeper group) in different kidney seeper level (5 to <10 mm, 10 to 20 mm) respectively. The artificial kidney seeper group was inserted by a ureteral cathedral, then were underwent the ultrasonography-guided PCNL in prone position. The non-artificial kidney seeper group were underwent the ultrasonography-guided PCNL in prone position directly. The t test, χ(2) test, repeated measure analysis was used to data measurement, respectively. Results: Four patients who diagnosed pyonephrosis were excluded. On the 5 to <10 mm level, fever rate (14.6% vs. 4.8%, χ(2)=5.07, P=0.03), operation time ((65.7±9.9)min vs. (50.3±7.4)min, t=11.47, P=0.00), cost ((18 327±903) yuan vs. (14 583±784) yuan, t=24.50, P=0.00) about artificial kidney seeper group and non-artificial kidney seeper group had statistical differences. And on the 10 to 20 mm level, fever rate (14.5% vs. 3.39%, χ(2)=4.53, P=0.03), operation time ((66.0±9.9)min vs. (52.4±8.9)min, t=8.30, P=0.00), cost ((16 548±537) yuan vs. (13 102±629) yuan, t=32.10, P=0.00) about artificial kidney seeper group and non-artificial kidney seeper group had statistical differences. And there were no statistical differences in the success rate of puncturing, the failures of the treatment to the stone pieces falling into the ureter and clearance rate of the stone and so on. In this study, 2 cases recovered after received transfusion and digital subtraction angiography artery embolization treatments; D-J tube was indwelled into 4 cases guiding by super smooth thread; 4 cases were finished the surgeries with the help of ureteroscopy, because the stone pieces fell into the ureter during the surgeries. And there was no patients developing septic shock, adjacent viscera injury or other serious complications. Conclusion: For seasoned doctors, there is no necessity of regularly artificial kidney seeper for PCNL when the pre-operation seeper ranging from 5 to 20 mm.

Measurement of the Dynamics of the Decays D_{s}^{+}→η^{(')}e^{+}ν_{e}

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 3.19  fb^{-1} collected at a center-of-mass energy of 4.178 GeV with the BESIII detector, we measure the absolute branching fractions B_{D_{s}^{+}→ηe^{+}ν_{e}}=(2.323±0.063_{stat}±0.063_{syst})% and B_{D_{s}^{+}→η^{'}e^{+}ν_{e}}=(0.824±0.073_{stat}±0.027_{syst})% via a tagged analysis technique, where one D_{s} is fully reconstructed in a hadronic mode. Combining these measurements with previous BESIII measurements of B_{D^{+}→η^{(')}e^{+}ν_{e}}, the η-η^{'} mixing angle in the quark flavor basis is determined to be ϕ_{P}=(40.1±2.1_{stat}±0.7_{syst})°. From the first measurements of the dynamics of D_{s}^{+}→η^{(')}e^{+}ν_{e} decays, the products of the hadronic form factors f_{+}^{η^{(')}}(0) and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| are determined with different form factor parametrizations. For the two-parameter series expansion, the results are f_{+}^{η}(0)|V_{cs}|=0.4455±0.0053_{stat}±0.0044_{syst} and f_{+}^{η^{'}}(0)|V_{cs}|=0.477±0.049_{stat}±0.011_{syst}.

Evidence of a Resonant Structure in the e^{+}e^{-}→π^{+}D^{0}D^{*-} Cross Section between 4.05 and 4.60 GeV

The cross section of the process e^{+}e^{-}→π^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3  MeV/c^{2} and a width of 77.0±6.8±6.3  MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.

Determination of the Pseudoscalar Decay Constant f_{D_{s}^{+}} via D_{s}^{+}→μ^{+}ν_{μ}

Using a 3.19  fb^{-1} data sample collected at an e^{+}e^{-} center-of-mass energy of E_{cm}=4.178  GeV with the BESIII detector, we measure the branching fraction of the leptonic decay D_{s}^{+}→μ^{+}ν_{μ} to be B_{D_{s}^{+}→μ^{+}ν_{μ}}=(5.49±0.16_{stat}±0.15_{syst})×10^{-3}. Combining our branching fraction with the masses of the D_{s}^{+} and μ^{+} and the lifetime of the D_{s}^{+}, we determine f_{D_{s}^{+}}|V_{cs}|=246.2±3.6_{stat}±3.5_{syst}  MeV. Using the c→s quark mixing matrix element |V_{cs}| determined from a global standard model fit, we evaluate the D_{s}^{+} decay constant f_{D_{s}^{+}}=252.9±3.7_{stat}±3.6_{syst}  MeV. Alternatively, using the value of f_{D_{s}^{+}} calculated by lattice quantum chromodynamics, we find |V_{cs}|=0.985±0.014_{stat}±0.014_{syst}. These values of B_{D_{s}^{+}→μ^{+}ν_{μ}}, f_{D_{s}^{+}}|V_{cs}|, f_{D_{s}^{+}} and |V_{cs}| are each the most precise results to date.