[Research progress on the pathogenic mechanisms, diagnosis and treatment of McCune-Albright syndrome]

McCune-Albright syndrome is a rare chimeric disorder due to mutations in the postzygotic GNAS gene. It belongs to the group of guanine nucleotide-binding protein diseases, affecting a wide range of individuals. It is characterized by fibrous dysplasia, café-au-lait skin macules, and precocious puberty with other variable clinical manifestations. At present, there are difficulties in the molecular diagnosis of McCune-Albright syndrome, and there is a lack of effective clinical treatments to halt or reverse the course and regression of the disease. This article summarizes the clinical manifestations, diagnosis, pathogenic molecular mechanisms, treatment and relevant fertility guidelines of McCune-Albright syndrome, with a view to further research and therapy of McCune-Albright syndrome.

Effect of Different Postures on Intraocular Pressure in Open-Angle Glaucoma

INTRODUCTION

This study aims to investigate the pattern of intraocular pressure (IOP) changes in different postures among patients with open-angle glaucoma (OAG).

METHODS

A observational study was conducted on a total of 74 patients with OAG (148 eyes). IOP measurements were taken in a variety of positions, including supine, left lateral decubitus, right lateral decubitus, head tilted downwards position with immediate head-up (transient head tilted downwards), seated, seated with head tilted downwards, standing, and walking. Each position was held for 5 min before measurement. In all positions, the patient maintains both eyes looking forward and remains alert. In the head tilted downwards position, the angle of head tilt with respect to the sagittal plane was 30°.

RESULTS

The overall trend of IOP changes showed a significant decrease with an increase in the position height (r = 0.037, p < 0.001). The IOP was significantly higher in the supine, left lateral decubitus, right lateral decubitus, and head tilted downwards positions than in the seated position (p < 0.001). Compared with the seated position with eyes at primary gaze, IOP decreased significantly when standing (p = 0.008) or walking (p < 0.001). The IOP in the left lateral decubitus and right lateral decubitus was significantly higher than in the supine position (p = 0.008, p = 0.001, respectively). The IOP decreased significantly during walking compared with standing (p < 0.001).

CONCLUSIONS

The magnitude of IOP strongly correlates with the body position during IOP measurement. The head tilted downwards, supine, left lateral decubitus, and right lateral decubitus positions result in a higher IOP than IOP at the seated position. Patients with OAG can potentially reduce IOP fluctuations by adjusting their daily postures.

[Epidemiological characteristics of severe fever with thtrombocytopenia syndrome in China, 2011-2021]

Objective: To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS. Methods: The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS. Results: From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% (P=0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males (χ²=13 185.21, P<0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females (χ²=12 939.83, P<0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males (χ²=115.70, P<0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females (χ²=103.42, P<0.001). Conclusion: From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.

Simple and rapid detection Aspergillus fumigatus by loop-mediated isothermal amplification coupled with lateral flow biosensor assay

AIMS

We have developed a new diagnostic technique, termed loop-mediated isothermal amplification coupled with lateral flow biosensor (LAMP-LFB), which has been successfully applied to the detection of Aspergillus fumigatus.

MATERIAL AND METHODS

A set of six LAMP primers was designed according to the A. fumigatus-specific anxC4 gene, which specifically recognized eight different regions of the target sequence. The LFB was employed for reporting the A. fumigatus-LAMP results, and the visual readouts were obtained within 2 min. The strains of A. fumigatus species and non-A. fumigatus species were used to test the assay's sensitivity and examine the analytical specificity of the target assay. Optimal LAMP conditions were 66°C for 50 min. The limit of detection is 100 fg. No cross-reactions were obtained, and the specificity of LAMP-LFB assay was 100%. The whole process of the assay, including 20 min of DNA preparation, 50 min of constant temperature amplification, and 2 min of detection by the sensor strip, took a total of 72 min (less than 75 min). Among 89 sputum specimens for clinical evaluation, 10 (11·23%) samples were A. fumigatus-positive by LAMP-LFB and traditional culture method, 9 (10·11%) samples were A. fumigatus-positive by PCR method. Compared with culture method, the diagnostic accuracy of LAMP-LFB method was 100%.

CONCLUSIONS

The novel LAMP-LFB detection technology established in the current research is a rapid and reliable detection tool for A. fumigatus.

SIGNIFICANCE AND IMPACT OF THE STUDY

This novel LAMP-LFB assay can quickly, specifically and sensitively detect A. fumigatus, thereby speeding up the detection process and increasing the detection rate. In addition, it can also be used as a new molecular method for detection of A. fumigatus in clinical and laboratory areas.

Nosocomial infection by Klebsiella pneumoniae among neonates: a molecular epidemiological study

BACKGROUND

Nosocomial infection by Klebsiella pneumoniae (Kp) and drug resistance of Kp among neonates is a major concern. Hypervirulent K. pneumoniae (hvKp) infections are gradually increasing worldwide. Carbapenem-resistant hvKp infection has brought challenges to clinical treatment.

AIM

To evaluate the changes in drug resistance trends of Kp strains in neonatal intensive care unit (NICU) nosocomial infections, to analyse drug resistance genes and virulence genes of carbapenem-resistant K. pneumoniae (CRKP) and to identify whether these CRKP strains are hvKp.

METHODS

A total of 80 neonates with Kp nosocomial infections from 2013 to 2018 were retrospectively studied. Drug susceptibility testing was performed on 80 Kp strains, among which the 12 CRKP strains were further studied.

FINDINGS

Kp accounted for 26.9% of nosocomial infections in the NICU. CRKP strains accounted for 15.0%. Among the 80 nosocomial infection Kp strains, CRKP strains accounted for 33.3% and 53.3% in 2017 and 2018 respectively. One of the 12 CRKP strains was positive in the drawing test. The 12 CRKP strains were divided into four complete genome sequence types: cgST1 (N = 2), cgST2 (N = 1), cgST3 (N = 1), and cgST4 (N = 8). Among genes that mediated carbapenem resistance, strains of cgST4 carried NDM-5, strains of cgST2 and cgST3 carried NDM-1, and strains of cgST1 carried IMP-4. None of the 12 CRKP strains carried rmpA/rmpA2 (highly related with hvKp).

CONCLUSION

Nosocomial infections of CRKP among neonates are becoming common, but no hvKp was found among the CRKP strains in this study.

Profiling the effects of physicochemical indexes on the microbial diversity and its aroma substances in pit mud

Microbial diversity of pit mud (PM) plays a significant role in Baijiu's flavour. Here we explored the microbial community structures and aroma substances of Wenwang Winery with high-throughput sequencing coupling with headspace solid-phase microextraction-gas chromatography-mass spectrometry. We discovered that the odorant was mainly derived from 14 aroma compounds because of their OAVs ≥ 1 (OAV, the ratio of substance concentration to aroma threshold; s, on behalf of the plural), such as ethyl hexanoate (2438), ethyl octanoate (975), caproic acid (52) and etc. Moreover we also revealed that Lactobacillaceae (97·08%) was the mainly bacterial microbial community in 2-year-old PM, companied by the primarily fungi including Aspergillaceae (55·45%), Unclassified Ascomycota (11·13%) and Dipodascaceae (5·72%). Compared with the 2-year-old PM, bacterial floras in 20-year-old PM and 30-year-old PM were more abundant (i.e. Dysgonomonadaceae, Clostridium and Synerggstaceas), while no fungi were detected. Besides, the physicochemical analysis showed that the content of Lactobacillaceae was inversely associated with moisture, pH and ammonia nitrogen. By further Spearman's correlation coefficient analysis, we verified that the content of Lactobacillaceae was positively correlated with ethyl hexanoate, while negatively correlated with ethyl octanoate and caproic acid. Meanwhile, ethyl octanoate and caproic acid were positively correlated with most flora including Ruminococcaceae, Dysgonomonadaceae and Clostridiacea, which were related to physicochemical indexes. This work demonstrates promise for adjusting the physicochemical indexes of PM to affect the micro-organisms and aroma, which may provide a reference for the production of high-quality Baijiu.

Factors associated with blindness three months following treatment for acute primary angle glaucoma

AIMS

To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.

METHODS

In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point.

RESULTS

The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours.

CONCLUSIONS AND RELEVANCE

Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.

Accuracy of interferon-γ-induced protein 10 for diagnosing latent tuberculosis infection: a systematic review and meta-analysis

BACKGROUND

Effective diagnostic methods for detecting latent tuberculosis infection (LTBI) are important for its eradication. A number of studies have evaluated the use of interferon-γ-induced protein 10 (IP-10), which is elevated after tuberculosis infection, as a biomarker for LTBI, but conclusive results regarding its effectiveness have not been reported.

OBJECTIVES

Our objective was to assess the diagnostic value of IP-10 for LTBI.

DATA SOURCES

We searched the PubMed, Embase, the Cochrane Library and Web of Science databases to find eligible studies.

STUDY ELIGIBILITY CRITERIA

We included cohort, case-control and cross-sectional studies that evaluated IP-10 in LTBI participants in comparison with tuberculin skin tests (TST) and interferon-γ release assays (IGRA).

PARTICIPANTS

Individuals with LTBI and uninfected participants.

INTERVENTIONS

IP-10 (index test) compared with TST and IGRA (reference standard) for diagnosing LTBI.

METHODS

PubMed, Embase, the Cochrane Library, and Web of Science databases were searched up to June 2018. A hierarchical summary receiver operating characteristic (HSROC) model was used to evaluate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and HSROC curve for the diagnostic efficiency of IP-10.

RESULTS

Twelve studies including 1023 participants and 1122 samples were included. The overall pooled sensitivity was 0.85 (95% CI 0.80-0.88), specificity was 0.89 (95% CI 0.84-0.92), PLR was 7.55 (95% CI 5.20-10.97), NLR was 0.17 (95% CI 0.13-0.22) and DOR was 44.23 (95% CI 28.86-67.79), indicating a high accuracy for diagnosing LTBI. Based on a meta-regression analysis, high-burden countries, study design, IP-10 method, reference standard and the IP-10 cut-off could not explain the heterogeneity (p >0.05).

CONCLUSIONS

Our results suggested that IP-10 is a promising biomarker for the diagnosis of LTBI.

[Analysis on the epidemiological features of human brucellosis in northern and southern areas of China, 2015-2016]

Different epidemiological features of human brucellosis appeared in both northern and southern areas of China. The disease was seen endemic in the northern and dispersal in the southern provinces. Appropriate strategies for brucellosis prevention and control should be developed, according to the different epidemiological characteristics in the northern or southern areas.

Exosome-associated AAV vector as a robust and convenient neuroscience tool

Adeno-associated virus (AAV) vectors are showing promise in gene therapy trials and have proven to be extremely efficient biological tools in basic neuroscience research. One major limitation to their widespread use in the neuroscience laboratory is the cost, labor, skill, and time intense purification process of AAV. We have recently shown that AAV can associate with exosomes (exo-AAV) when vector is isolated from conditioned media of producer cells, and the exo-AAV is more resistant to neutralizing anti-AAV antibodies compared to standard AAV. Here we demonstrate that simple pelleting of exo-AAV from media via ultracentrifugation, results in high-titer vector preparations capable of efficient transduction of central nervous system (CNS) cells after systemic injection in mice. We observed that exo-AAV is more efficient at gene delivery to the brain at low vector doses relative to conventional AAV, even when derived from a serotype that does not normally efficiently cross the blood brain barrier. Similar cell types were transduced by exo-AAV and conventionally purified vector. Importantly, no cellular toxicity was noted in exo-AAV transduced cells. We demonstrated the utility and robustness of exo-AAV-mediated gene delivery by detecting direct GFP fluorescence after systemic injection, allowing 3-dimensional reconstruction of transduced Purkinje cells in the cerebellum using ex-vivo serial 2-photon tomography. The ease of isolation combined with the high efficiency of transgene expression in the CNS, may enable widespread use of exo-AAV as a neuroscience research tool. Furthermore, the ability of exo-AAV to evade neutralizing antibodies while still transducing CNS after peripheral delivery is clinically relevant.

Neurodevelopmental delay with critical congenital heart disease is mainly from prenatal injury not infant cardiac surgery: current evidence based on a meta-analysis of functional magnetic resonance imaging

OBJECTIVE

No consensus has been reached regarding whether brain injury related to congenital heart disease (CHD) is caused by infant cardiac surgery and/or prenatal injury resulting from the CHD. We performed this meta-analysis to identify the likely cause of neurodevelopmental delay in CHD patients.

METHODS

We carried out a literature search without language restriction in December 2013, retrieving records from PubMed, EMBASE, the Cochrane Library and the World Health Organization trials center, to identify studies applying functional magnetic resonance imaging (fMRI) evaluation of brain function before surgery and, in some cases, after surgery (both immediate term and short term postoperatively). The preoperative and postoperative fMRI results were extracted, and meta-analysis was performed using Revman 5.1.1 and STATA 11.0, according to the guidelines from the Cochrane review and MOOSE groups.

RESULTS

The electronic search yielded 937 citations. Full text was retrieved for 15 articles and eight articles (nine studies) were eligible for inclusion: six studies (n = 312 cases) with fMRI analysis before surgery and three (n = 36 cases) with complete perioperative fMRI analysis. The overall average diffusivity of CHD cases was significantly higher than that of controls, with a summarized standard (std) mean difference of 1.39 (95% CI, 0.70-2.08), and the fractional anisotropy was lower in CHD cases, with a summarized mean difference of -1.43 (95% CI, -1.95 to -0.91). N-acetylaspartate (NAA)/choline (Cho) for the whole brain was significantly lower in CHD cases compared with healthy ones, while lactate/Cho was significantly higher in CHD cases. Immediate term postoperatively, significant changes in NAA/creatine and NAA/Cho, relative to preoperative values, were found. However, the difference did not persist at the short-term follow-up.

CONCLUSION

This meta-analysis suggests that the delay in neurological development in newborns with CHD is due mainly to prenatal injury, and cardiac surgery might lead to mild brain injuries postoperatively, but fMRI shows recovery within a short period.

[Relationship between serum histamine levels and ST-segment resolution in patients with acute myocardial infarction treated with primary percutaneous coronary intervention]

OBJECTIVE

To investigate the dynamic changes in serum histamine levels and their association with ST-segment resolution in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

METHODS

A total of 84 consecutive STEMI patients who received primary PCI were enrolled in this study. The dynamic changes in serum histamine levels were observed from before PCI to 1 week after PCI. Factors associated with ST-segment resolution were identified by multivariate regression analysis.

RESULTS

The serum histamine levels of STEMI patients decreased during the first week after PCI. Multivariate regression analysis showed that the factors associated with ST-segment resolution 2 h after PCI were: the histamine level 2 h after PCI (r=-0.361, P=0.001), pain to balloon time, infarct related artery, and thrombolysis in myocardial infarction (TIMI) flow grade after PCI.

CONCLUSION

The higher histamine level 2 h after PCI was independently associated with poor myocardial reperfusion in STEMI patients.

The neuroprotective role and mechanisms of TERT in neurons with oxygen-glucose deprivation

Telomerase reverse transcriptase (TERT) is reported to protect neurons from apoptosis induced by various stresses including hypoxia-ischemia (HI). However, the mechanisms by which TERT exerts its anti-apoptotic role in neurons with HI injury remain unclear. In this study, we examined the protective role and explored the possible mechanisms of TERT in neurons with HI injury in vitro. Primary cultured neurons were exposed to oxygen and glucose deprivation (OGD) for 3h followed by reperfusion to mimic HI injury in vivo. Plasmids containing TERT antisense, sense nucleotides, or mock were transduced into neurons at 48h before OGD. Expression and distribution of TERT were measured by immunofluorescence labeling and western blot. The expression of cleaved caspase 3 (CC3), Bcl-2 and Bax were detected by western blot. Neuronal apoptosis was measured with terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). The mitochondrial reactive oxygen species (ROS) were measured by MitoSOX Red staining. Fluorescent probe JC-1 was used to measure the mitochondrial membrane potential (ΔΨm). We found that TERT expression increased at 8h and peaked at 24h in neurons after OGD. CC3 expression and neuronal apoptosis were induced and peaked at 24h after OGD. TERT inhibition significantly increased CC3 expression and neuronal apoptosis after OGD treatment. Additionally, TERT inhibition decreased the expression ratio of Bcl-2/Bax, and enhanced ROS production and ΔΨm dissipation after OGD. These data suggest that TERT plays a neuroprotective role via anti-apoptosis in neurons after OGD. The underlying mechanisms may be associated with regulating Bcl-2/Bax expression ratio, attenuating ROS generation, and increasing mitochondrial membrane potential.

Efficacy of goniosynechialysis for advanced chronic angle-closure glaucoma

Purpose:

To evaluate the intraocular pressure (IOP)-lowering efficacy of goniosynechialysis (GSL) for advanced chronic angle-closure glaucoma (CACG) using a simplified slit-lamp technique.

Patients and methods:

Patients with CACG with one severely affected eye with best-corrected visual acuity below 20/200 and a mildly or functionally unaffected fellow eye were enrolled in this study. All patients underwent ophthalmologic examinations including measurement of visual acuity, best-corrected visual acuity, and IOP; biomicroscopy; specular microscopy; fundus examination; and gonioscopy followed by anterior chamber paracentesis and GSL for nasal peripheral anterior synechiae in the eye with severe CACG.

Results:

Thirty patients (18 men, 12 women) were identified as having CACG with an initial mean IOP of 47.1 ± 6.7 mmHg (range 39–61 mmHg) in the severely affected eye. One week after GSL, the mean IOP of the treated eyes decreased to 19.3 ± 2.8 mmHg (range 14–26 mmHg) without antiglaucoma medication (average decrease 27.7 ± 6.5 mmHg; range 16–41 mmHg), which was significant (P < 0.00001) compared with baseline. After an average follow-up period of 36.6 ± 1.0 months (range 35–38 months), the mean IOP stabilized at 17.4 ± 2.2 mmHg (range 12–21 mmHg). The nasal angle recess did not close again in any one of the patients during the follow-up period. The average significant (P < 0.00001) decrease in corneal endothelial cell density in the treated eyes was 260 ± 183 cells/mm² (range 191–328 cells/mm²).

Conclusions:

Anterior chamber paracentesis and GSL lowers IOP in advanced CACG, though it may lead to mild corneal endothelial cell loss.

Comparison of the diagnostic value of 3-deoxy-3-18F-fluorothymidine and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the assessment of regional lymph node in thoracic esophageal squamous cell carcinoma: a pilot study

We used pathological examination as golden standard to determine whether 3-deoxy-3-(18)F-fluorothymidine positron emission tomography/computed tomography (FLT PET/CT) can detect regional lymph node metastasis in untreated thoracic esophageal squamous cell carcinoma and additionally performed (18)F-fluorodeoxyglucose (FDG) PET/CT for direct comparison with that of FLT. Twenty-two patients with thoracic esophageal squamous cell carcinoma underwent dual-tracer PET/CT examinations before surgery. The results of reviewing CT images and side-by-side FDG PET and FLT PET images for the diagnosis of locoregional lymph node metastasis were compared prospectively in relation to pathologic findings. All patients underwent esophagectomy and lymphadenectomy. Pathologic examination confirmed nodes positive for metastasis in 16 patients and 47 of 424 excised nodes. The uptake of FDG (median SUVmax, 5.4; range, 2.4-10.6) in locoregional lymph nodes metastases was significantly higher than that of FLT (median SUVmax, 2.8; range, 1.3-4.6). There were 14 false-positive nodes in FDG PET/CT and only 3 in FLT PET/CT; 8 false-negative nodes in FDG PET/CT, while there were 12 false negative nodes in FLT PET/CT. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FLT PET/CT were 74.47%, 99.20%, 96.46%, 92.11%, and 96.89%, respectively, whereas those of FDG PET/CT were 82.98%, 96.29%, 94.81%, 82.98%, and 96.29%, respectively. P-values were 0.450, 0.014, 0.313, 0.050, and 0.555, respectively. FLT uptake in regional lymph nodes of esophageal carcinoma is significantly lower compared with FDG uptake. FLT PET/CT has fewer false-positive findings and higher specificity compared with FDG PET/CT.

Combining transfer of TTF-1 and Pax-8 gene: a potential strategy to promote radioiodine therapy of thyroid carcinoma

Cotransfer of thyroid-specific transcription factor (TTF)-1 and Pax-8 gene to tumor cells, resulting in the re-expression of iodide metabolism-associated proteins, such as sodium iodide symporter (NIS), thyroglobulin (Tg), thyroperoxidase (TPO), offers the possibility of radioiodine therapy to non-iodide-concentrating tumor because the expression of iodide metabolism-associated proteins in thyroid are mediated by the thyroid transcription factor TTF-1 and Pax-8. The human TTF-1 and Pax-8 gene were transducted into the human thyroid carcinoma (K1 and F133) cells by the recombinant adenovirus, AdTTF-1 and AdPax-8. Re-expression of NIS mRNA and protein, but not TPO and Tg mRNA and protein, was detected in AdTTF-1-infected F133 cells, following with increasing radioiodine uptake (6.1-7.4 times), scarcely iodide organification and rapid iodide efflux (t(1/2) ≈ 8-min in vitro, t(1/2) ≈ 4.7-h in vivo). On contrast, all of the re-expression of NIS, TPO and Tg mRNA and proteins were detected in F133 cells coinfected with AdTTF-1 and AdPax-8. AdTTF-1- and AdPax-8-coinfected K1 and F133 cells could effectively accumulate radioiodine (6.6-7.5 times) and obviously retarded radioiodine retention (t(1/2) ≈ 25-30-min in vitro, t(1/2) ≈ 12-h in vivo) (P<0.05). Accordingly, the effect of radioiodine therapy of TTF-1 and Pax-8 cotransducted K1 and F133 cells (21-25% survival rate in vitro) was better than that of TTF-1-transducted cells (40% survival rate in vitro) (P<0.05). These results indicate that single TTF-1 gene transfer may have limited efficacy of radioiodine therapy because of rapid radioiodine efflux. The cotransduction of TTF-1 and Pax-8 gene, with resulting NIS-mediated radioiodine accumulation and TPO and Tg-mediated radioiodine organification and intracellular retention, may lead to effective radioiodine therapy of thyroid carcinoma.

Radioiodine therapy of thyroid carcinoma following Pax-8 gene transfer

The thyroid transcription factor Pax-8 could bind with the promoter/enhancer of thyroid-specific genes such as thyroglobulin (Tg), thyroperoxidase (TPO) and sodium iodide symporter (NIS), and regulate the expression of these proteins in thyrocyte. Promoting iodide accumulation in tumor cells by re-expression of Pax-8 provides a possible strategy for radioiodine therapy of tumor. Therefore, we investigated the effect of Pax-8 gene transfer on radioiodine therapy of thyroid carcinoma. The human Pax-8 gene was transfected into the human thyroid carcinoma (K1 and F133) cells by the recombinant adenovirus vector. Although the NIS mRNA was not detected, the expression of mRNA and proteins of Tg and TPO in AdPax-8-infected F133 cells were activated by Pax-8. Iodide uptake in thyroid carcinoma cells was reactivated by Pax-8 (increasing 3.3-fold in K1 cells and 5.7-fold in F133 cells). Moreover, Pax-8 promoted iodide organification and the retention time of iodine in Pax-8-expressing cells apparently prolonged in vitro and in vivo (P<0.05). Pax-8-expressing thyroid carcinoma cells were selectively killed by radioiodine. The AdPax-8-infected tumors in vivo clearly visualized in scanning images at 12 h after administration of radioiodine. These results indicate that Pax-8 can promote iodide uptake, and specifically prolong the retention time of iodide in thyroid cancer in vitro and in vivo by promoting the expression of TPO and Tg proteins. Pax-8 gene transfection may lead to effective radioiodine therapy of tumor.

Comparative study of retinal nerve fibre layer measurement by RTVue OCT and GDx VCC

AIM

To evaluate the diagnostic performances and correlations of retinal nerve fibre layer (RNFL) thickness measured by RTVue OCT and GDx variable corneal compensation (VCC).

METHODS

The total and regional RNFL thickness were measured by RTVue OCT and GDx VCC in 62 normal eyes and 72 glaucomatous eyes of Chinese subjects. The RNFL thickness profiles of normal and glaucomatous eyes by RTVue OCT are plotted. Correlations of RNFL thickness measured by RTVue OCT and GDx VCC were assessed using the Pearson correlation. The discriminating abilities of the two techniques for detection of glaucoma were compared by the area under the receiver operating characteristic curves (AUC).

RESULTS

RTVue OCT demonstrated double hump patterns in the RNFL profiles. In both normal and glaucomatous subjects, the peaks were located in the superotemporal (ST) and inferotemporal (IT) regions, and the troughs were located at the nasal (NU+NL) and temporal (TU+TL) regions. Despite poor agreement, a high correlation (r=0.821) was found between the mean RNFL measurements by RTVue OCT and GDx VCC. For RTVue OCT, the highest AUCs were mean RNFL (AUC=0.914) and inferior mean RNFL (AUC=0.909). The nerve fibre indicator (AUC=0.856) and inferior RNFL (AUC=0.852) achieved the highest AUCs among all the GDx VCC measurements. The mean RNFL in RTVue OCT had the greatest AUC in the two devices. There was a significant difference in comparing the AUCs of the mean RNFL thickness obtained by RTVue OCT and GDx VCC (p=0.009).

CONCLUSIONS

Although there were absolute value differences in RNFL thickness, a high correlation was observed between RTVue OCT and GDx VCC. RTVue OCT shows a reasonable ability to distinguish normal from glaucomatous eyes.

CD14, a key candidate gene associated with a specific immune response to cockroach

BACKGROUND

Sensitization to cockroach allergen is one of the strongest predictors of asthma morbidity, especially among African Americans.

OBJECTIVE

Our aims were to determine the genomic basis of cockroach sensitization and the specific response to cockroach antigen.

METHODS

We investigated the Th1/Th2 cytokine profile of co-cultured plasmacytoid dendritic cells (pDCs) and CD4+ T cells and the 'transcript signature' of the immune response to cockroach antigen using high-throughput expression profiling of co-cultured cells.

RESULTS

We observed significantly elevated levels of IL-13, IL-10, and TNF-alpha, but undetectable levels of IL-12p70 and IFN-alpha, when cultures were exposed to crude cockroach antigen. A significant difference was observed for IL-13 between cockroach-allergic and non-allergic individuals (P=0.039). Microarray analyses demonstrated a greater response at 48 h compared with 4 h, with 50 genes being uniquely expressed in cockroach antigen-treated cells, including CD14, S100A8, CCL8, and IFI44L. The increased CD14 expression was further observed in purified pDCs, human monocytic THP-1 cells, and the supernatant of co-cultured pDCs and CD4+ T cells on exposure to cockroach extract. Furthermore, the most differential expression of CD14 between cockroach allergy and non-cockroach allergy was only observed among individuals with the CC 'high-risk' genotype of the CD14-260C/T. Ingenuity Pathways Analysis analyses suggested the IFN signalling as the most significant canonical pathway.

CONCLUSION

Our results suggest that these differentially expressed genes, particularly CD14, and genes in the IFN signalling pathway may be important candidates for further investigation of their role in the immune response to cockroach allergen.

Compare the diagnostic value of FLT and FDG PET/CT in assessment of regional lymph nodes in thoracic esophageal squamous cell carcinoma

e15620

Background: To determine whether FLT PET/CT can detect regional lymph nodes metastases in untreated thoracic esophageal squamous cell carcinoma. In view of the reported high sensitivity of FDG PET/CT for the evaluation of thoracic nodules of esophageal carcinoma, we additionally performed FDG PET/CT for direct comparison with that of FLT. Methods: From March 2008 to December 2008, 18 patients with thoracic esophageal squamous cell carcinoma underwent dual-tracer PET/CT examinations before surgery. The results of reviewing side-by-side FDG PET/CT and FLT PET/CT images for the diagnosis of locoregional lymph node metastases were compared prospectively in relation to pathologic findings. The PET images were visually inspected with the maximum standardized uptake value (SUVmax) determined from a circular region of interest (ROI) over the entire lesion. The differential threshold for malignancy was set as SUVFDG≥2.5, and SUVFLT≥1.4, respectively. Results: All patients underwent esophagectomy and lymphadenectomy, and pathologic examination confirmed nodes positive for metastasis in 14 patients and 42 of 344 excised nodes. The uptake of FDG (median SUVmax, 5.59; range, 2.5–10.6) in locoregional lymph nodes metastasis was significantly higher than that of FLT (median SUVmax, 2.93; range, 1.6–4.6). There were 14 false positive nodes in FDG PET and only 3 in FLT PET, 7 false negative nodes in FDG PET, while 11 false negative nodes in FLT PET. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FLT PET/CT were 73.81%, 99.01%, 95.93%, 91.18% and 96.45%, respectively, whereas those of FDG PET/CT were 83.33%, 95.36%, 93.90%, 71.43% and 95.36%, respectively. P values were 0.425, 0.014, 0.298, 0.055, and 0.541, respectively. Conclusions: FLT uptake in regional lymph node of esophageal carcinoma is significantly lower compared with FDG uptake.FLT PET has fewer false-positive findings compared with FDG PET. The specificity of FLT PET/CT is higher than that of FDG. We suggest that esophageal carcinoma N-staging need to combine FLT with FDG PET/CT images.

No significant financial relationships to disclose.

Prognostic significance of sentinel nodes metastases in breast cancer patients without axillary node dissection or axillary radiotherapy: CBCSG-001 trial

Abstract #1015

Background: China multicenter study of sentinel lymph node biopsy (SLNB) substituting axillary lymph node dissection (ALND) in breast cancer– CBCSG-001 trial was conducted from Jan. 2002 to Jun. 2007, with 1,970 SLNB pts recruitment. One of the second objectives of the CBCSG–001 trial was to evaluate the optimal methods and intervals for the detection of SLN macrometastases, MMs and isolated tumor cells (ITCs) and their prognostic significance in patients received SLNB without ALND or axillary radiotherapy.&#x2028; Material and Methods: Two hundred and forty-five continuous breast cancer patients with 569 SLNs identified “negative” with routine standard HE stain carried on initial 4 levels were retrospectively analyzed. All the patients received SLNB only, without ALND or axillary radiotherapy after the diagnoses of metastases in their SLNs later. All SLNs were step sectioned (SS) at 100µm interval, and for each level both HE and IHC with AE1/AE3 were performed. Forty-nine patients were identified to have metastases, with macrometastases of 12.2%, micrometastases of 61.2%, and isolated tumor cells of 26.5%. All patients had received SLNB only, with no ALND and axillary radiotherapy.&#x2028; Results: Of the 245 patients, breast conserved surgery and SLNB were performed on 106 patients (43.3%), and mastectomy and SLNB in 139 patients. With a median follow up of 50 months, there were 20 breast related events occurred. The disease free survival (DFS) of patients with routine negative SLNs was 91.6%, and 93.9% for patients with positive SLNs after SS with HE+IHC (p&gt;0.05). The overall survival (OS) were 97.4% and 98.0 for each group, respectively (p&gt;0.05). The results were the same for patients with macrometastases, micrometastases, and isolated tumor cells. Due to the relatively less events occurred, the DFS and OS had not been calculated for macrometastases, micrometastases, and isolated tumor cells, separately.&#x2028; Discussion and Conclusions: Without ALND and axillary radiotherapy, there were no significant differences of DFS and OS between patients with routine negative SLNs and patients with positive SLNs after SS with HE+IHC. It might be safe for these patients to receive SLNB only. The possible reasons might include: SLNs were the only positive lymph nodes in more than 60% patients, effective adjuvant systemic therapy for regional lymph nodes just as neoadjuvant chemotherapy, axillary coverage of radiotherapy in patients with breast conserved therapy, and the relatively less events occurred during the 50 months follow up period.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1015.

Optimal detection of micrometastases in sentinel lymph node of breast cancer: CBCSG-001 trial

Abstract #1011

Background: Although sentinel lymph node biopsy (SLNB) has become the method of choice for axillary staging, the extent of the pathological examination (HE or IHC, the number or intervals of sections) described in the literature differed considerably between studies, particularly for the detection of micrometastases (MMs). As one of the second objectives of the CBCSG–001 trial (China multicenter study of sentinel node biopsy substituting axillary node dissection), our aim was to evaluate the optimal methods and intervals for the detection of SLN macrometastases, MMs and isolated tumor cells (ITCs).&#x2028; Material and Methods: Two hundred and forty-five continuous breast cancer patients with 569 SLNs identified “negative” with standard HE stain carried on initial 4 levels were retrospectively analyzed. All SLNs were step sectioned (SS) at 100µm interval, and for each level both HE and IHC with AE1/AE3 were performed. Then HE and IHC detection rates were analyzed at 100-, 200-, 300-, 400-, and 500µm intervals for the detection of macrometastases, MMs and ITCs.&#x2028; Results: In 245 cases with original SLN negative cases, 36 (14.7%), 49 (20.0%) and 49 (20.0%) cases were found to had metastases with SS HE, SS IHC, and SS HE+IHC, respectively (SS IHC/ SS HE+IHC vs. SS HE, p&gt;0.05). In all the 5741 sections, metastases were found in 180 sections (3.1%) by SS HE, 307 (5.4%) by SS IHC, and 322 (5.6%) by SS HE+IHC (p=0.000). The metastases included macrometastases 12.2%, MMs 61.2%, and ITC 26.5%. The detection rates of MMs were 7.8%, 12.2%, and 12.2%, respectively (SS IHC/ SSHE+IHC vs. SS HE, p&gt;0.05). The detection rates of ITCs were 4.5%, 5.3%, and 5.3%, respectively (p&gt;0.05). The detection rates of metastases were significantly higher in patients with invasive lobular carcinoma (57.1%) than with invasive ductal carcinoma (16.7%, p=0.001), but no significant differences were found among different ages, tumor sizes, locations, grades, ER, PR, and HER-2 status (all p&gt;0.05). The detection rates of metastases at 100-, 200-, 300-, 400-, and 500-µm intervals by SS HE were 14.7%, 13.5%, 11.4%, 8.6%, and 7.8%, respectively. No significant differences were found between 100- and 200-µm intervals (p=0.697), and between 100- and 300-µm (p=0.284), while p&lt;0.05 between 100-µm and other intervals. The detection rates of metastases at 100-, 200-, 300-, 400-, and 500-µm intervals by SS HE+IHC were 20.0%, 18.8%, 18.0%, 16.3%, and 13.1%, respectively. No significant difference was found between 100- and 200-µm intervals (p=0.732), 100- and 300-µm (p=0.565), and between 100- and 400-µm (p=0.292), while p=0.041 between 100-µm and 500-µm.&#x2028; Conclusion: SS HE could significantly increase the detection rate of SLN metastasis compared to our routine 4 levels HE pathological examination. SS HE+IHC could further improve the detection of SLN metastases. The detection rates of metastases were significantly higher in patients with invasive lobular carcinoma than those with invasive ductal carcinoma. The optimal interval for the detection of micrometastases in SLN was 300-µm with SS HE, and 400-µm with SS HE+IHC.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1011.

Effects of DNAzymes targeting Aurora kinase A on the growth of human prostate cancer

Aurora kinase A has been demonstrated to be involved in the malignant progression of many types of cancer including prostate cancer, we therefore hypothesized that Aurora kinase A might work as a valuable target for prostate cancer treatment. To test this hypothesis, we used DNAzyme technology to inhibit Aurora kinase A expression and evaluated the effects of DNAzymes as therapeutic agents to treat prostate cancer. In an in vitro cleavage assay, we found that a DNAzyme (DZ2) targeting Aurora kinase A could effectively cleave Aurora kinase A mRNA. When transfected into the prostate cancer cell line PC3, DZ2 was found to strongly inhibit the expression of Aurora kinase A examined by western blot analysis, and thus suppressed cell growth, arrested the progression of cell cycle, induced cell apoptosis and attenuated cell migration, as measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium assay, flow cytometry and Boyden chamber assay. Through in vivo study, we also found that DZ2 could significantly inhibit the growth of human prostate cancer xenografts in nude mice. In conclusion, DZ2 could effectively attenuate malignant progression of prostate cancer both in vitro and in vivo, suggesting that DNAzyme targeting Aurora kinase A may be used as a valuable therapy to treat prostate cancer.

Calcium and survivin are involved in the induction of apoptosis by dihydroartemisinin in human lung cancer SPC-A-1 cells

Dihydroartemisinin (DHA), a semisynthetic derivative of artemisinin isolated from the traditional Chinese herb Artemisia annua, is an effective novel antimalarial drug. Recent studies suggest that it also has anticancer effects. The present study investigated the apoptosis activity of DHA in cultured human lung cancer cells by terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) assay and flow cytometry. Intracellular free calcium concentrations in the lung cancer cells were evaluated by laser scanning confocal microscopy using Fura-3/AM as probe. The observations also indicated that DHA downregulated the mRNA and protein expression level of survivin in the lung cancer cell line SPC-A-1 cells, whereas it did not affect those of caspase-4. These results demonstrated that DHA can induce apoptosis of lung cancer cell line SPC-A-1 cells and that calcium and survivin participated in the apoptotic signalling pathways.

Translocation t(14;18) and gain of chromosome 18/BCL2: effects on BCL2 expression and apoptosis in B-cell non-Hodgkin's lymphomas

Gain of chromosome 18q and translocation t(14;18) are] frequently found in B-cell non-Hodgkin's lymphomas (B-NHL). Increased BCL2 transcription and BCL2 protein expression have been suggested to be the result of the gain. We utilized FISH, PCR and array CGH to study BCL2 and chromosome 18 copy number changes and rearrangements in 93 cases of B-NHL. BCL2 protein was expressed in >75% of the tumor cells in 92% of the cases by immunohistochemistry. Gain of BCL2 was associated with a 25% increase in BCL2 expression levels (immunoblotting), whereas t(14;18) resulted in a 55% increase in BCL2 levels compared to cases without BCL2 alterations. The tumor cell (spontaneous) apoptotic fractions were similar for the cases with different BCL2 genotypes. However, the normal cell apoptotic fractions were higher for the tumors with t(14;18) compared to the tumors without BCL2 alterations, while the tumors with gain of BCL2 only showed intermediate levels. Low-level gains of parts of chromosome 18 were found in 14 of the 38 B-NHL cases with t(14;18), with a consensus region 18pter-q21.33 that did not include the BCL2 gene. The 11 cases with 18q gain only showed a consensus region encompassing 18q21.2-18q21.32 and 18q21.33, which contain PMAIP1/MALT1 and BCL2, respectively.

DNA interstrand cross-links induce futile repair synthesis in mammalian cell extracts

DNA interstrand cross-links are induced by many carcinogens and anticancer drugs. It was previously shown that mammalian DNA excision repair nuclease makes dual incisions 5' to the cross-linked base of a psoralen cross-link, generating a gap of 22 to 28 nucleotides adjacent to the cross-link. We wished to find the fates of the gap and the cross-link in this complex structure under conditions conducive to repair synthesis, using cell extracts from wild-type and cross-linker-sensitive mutant cell lines. We found that the extracts from both types of strains filled in the gap but were severely defective in ligating the resulting nick and incapable of removing the cross-link. The net result was a futile damage-induced DNA synthesis which converted a gap into a nick without removing the damage. In addition, in this study, we showed that the structure-specific endonuclease, the XPF-ERCC1 heterodimer, acted as a 3'-to-5' exonuclease on cross-linked DNA in the presence of RPA. Collectively, these observations shed some light on the cellular processing of DNA cross-links and reveal that cross-links induce a futile DNA synthesis cycle that may constitute a signal for specific cellular responses to cross-linked DNA.

The relationship between the c-jun mRNA expression and apoptosis of neurons in rat brain following perinatal ischemic-hypoxia

OBJECTIVE

To investigate the relationship between c-jun mRNA and apoptosis of neurons following perinatal ischemic-hypoxia.

METHODS

We set up a fetal rat model of perinatal ischemic-hypoxia by ligating unilateral uterine horn vessel of pregnant Wistar rats (21-day gestation). The contralateral horn vessel was not ligated and the fetuses in these uteri served as controls. Rat pups were delivered by cesarean section at the end of ischemic hypoxic insult and then the rats' brain tissues were collected in different points of time. In situ hybridization and TUNEL methods were used to detect the c-jun mRNA expression and neural cells apoptosis separately.

RESULTS

The expression of c-jun mRNA in brain tissues began at 15 minutes, reached the first peak at 1-2 hours after ischemic-hypoxic insult and reduced gradually after 4 hours and the second peak at 24th hour after insult, gradually disappeared till 72nd hour. There were very low c-jun mRNA expression of hippocampus in the control group 24 h after birth. Meanwhile, we observed that the apoptosis of neuronal cells in cerebral cortex was much more than that in the control group.

CONCLUSION

The increases of immediate early gene c-jun expression and the cell apoptosis could be induced by perinatal ischemic-hypoxia. The higher expression of c-jun mRNA might induce the transcription of its target gene, especially, so called "death related genes", which would be a promoter for cell apoptosis.

[Determination of germanium and selenium in malt powder by GFAAS]

A method for determination of germanium and selenium in malt powder has been developed by graphite furnace atomic absorption spectrometry with L'vov platform. While (Pd+Ni) and Pd were used as matrix modifiers,the ashing temperatures of Ge and Se were increased to 1400 and 1200 degrees C respectively,and the matrix inferences were removed. The characteristic masses are 31 pg Ge and 23pg Se(0.0044 A), the detection limits are 28pg Ge and 62pg Se (3 sigma), the precisions (n = 9) are 3. 7-5.6%(Ge) and 4.3-6.5% (Se) and the recoveries are among 90-105%.

(6-4) photolyase: light-dependent repair of DNA damage

DNA photolyase represents a phenomenal class of DNA repair enzymes in that it harvests the light energy to repair DNA lesions caused by ultraviolet light. Mother Nature evolves two types of photolyases, one specific for repairing cyclobutane pyrimidine dimers and the other for pyrimidine-(6-4)-pyrimidone photoproducts. Together, these two kinds of DNA photolesions account for the majority of ultraviolet light-induced DNA lesions. So far, the basic chemical steps of the enzyme mechanism of the two classes of photolyases appear to be very similar. Therefore, it will be very interesting to uncover the determinants of the different substrate specificity between the two photolyases. In this review, we focus on the discussion of the photolyase specific for repairing pyrimidine-(6-4)-pyrimidone photoproducts mainly because the research of the cyclobutane pyrimidine dimer photolyase has recently been reviewed quite extensively.

[The changes of glutamate receptor and free Ca2+i in hypoxic-ischemic cerebral injury: experimental study]

This experiment was designed to explore the pathogenesis in hypoxic-ischemic encephalopathy (HIE). Sixteen newborn pigs were divided into two groups: (Group A) normal control and (Group B) HIE 24 hours. The glutamate receptor (Glu R) in forebrain crude synaptic membrane (SPM) and free Ca2+i in RBC were tested respectively. The results revealed that the binding sites (Bmax) of Glu R in Group B was much lower than that in Group A, but the affinity (Kd) showed no statistic difference between Group A and Group B. In addition, free Ca2+i of RBC in Group B was much higher than that in Group A. This study demonstrates that the changes of Glu R and Ca2+i are involved in the pathogenesis of hypoxic-ischemic cerebral injury in newborn animals.