[Correlation between the mutation spectrum of the UGT1A1 gene and clinical phenotype in patients with inherited hyperunconjugated bilirubinemia]

Objective: To analyze the distribution characteristics of UGT1A1 mutant genes (including enhancers, promoters, and exons 1-5) and further explore the correlation between UGT1A1 genotype and clinical phenotypes in patients with inherited hyperunconjugated bilirubinemia. Methods: Patients diagnosed with hereditary hyperunconjugated bilirubinemia at Nanjing Second Hospital from June 2015 to December 2022 were retrospectively analyzed. The UGT1A1 gene was examined using Sanger sequencing in all patients. Complete blood count, liver function, and abdominal imaging examinations were performed. Comparison of categorical variable data using χ(2) testor Fisher percision tests. Comparison of continaous veriable data with normal distribution using t-test. Results: 112 cases (male:female ratio 81:31, aged 9-70 years) had inherited hyperunconjugated bilirubinemia, with a total of 14 mutation sites identified, of which seven were confirmed mutations, and the frequency ranged from high to low: (TA)n accounted for 50%, c.211G>A (p.G71R) accounted for 49.10%, 1456T>G (p.Y486D) accounted for 16.96%, c.686C>A (p.R229W) accounted for 12.5%, 1091C>T (p.P364L) accounted for 8.04%, and c- 3279T>G accounted for 0.982%. Simultaneously, all patients had one to four mutations, of which only one mutation was the most common (55.36%), followed by two mutations (37.5%), and rare three and four mutations (5.36% and 1.78%). There was no statistical significance in total bilirubin (TBil) levels among the four groups (F=0.652, P=0.583). One mutation was most common in (TA)n and c.211G>A (p.G71R), among which TA6/TA7 (n=10) and TA7/TA7 (n=14) mutations were statistically significant in TBil (t=2.143, P=0.043). The c.211G>A (p.G71R) heterozygous (n=9) and isolated (n=15) mutation had no statistical significance in TBil (t=0.382, P=0.706). The GS group accounted for 75%, the intermediate group accounted for 16.9%, and the CNS-Ⅱ group accounted for 8%. TBil was statistically significant among the three groups (F=270.992, P<0.001). There was no statistically significant difference (χ(2)=3.317, P=0.19) between mutation 1 (44 cases, 14 cases, and 4 cases, respectively) and mutations ≥ 2 (40 cases, 5 cases, and 5 cases, respectively) in the GS group, intermediate group, and CNS-II group. Conclusion: The number of UGT1A1 gene mutation sites may have no synergistic effect on TBil levels in patients with inherited hyperunconjugated bilirubinemia. TA7/TA7 mutations are not uncommon, and TBil levels are relatively high.

[Long-term survival analysis of 1 367 patients treated with radical nephrectomy from a single center]

Objective: To report the long-term survival of renal cell carcinoma (RCC) patients treated with radical nephrectomy in Sun Yat-sen University Cancer Center. Methods: We retrospectively analyzed the clinical, pathological and follow-up records of 1 367 non-metastatic RCC patients treated with radical nephrectomy from 1999 to 2020 in this center. The primary endpoint of this study was overall survival rate. Survival curves were estimated using the Kaplan-Meier method, and group differences were compared through Log-rank test. Univariate and multivariate Cox analysis were fit to determine the clinical and pathological features associated with overall survival rate. Results: A total of 1 367 patients treated with radical nephrectomy with complete follow-up data were included in the study. The median follow-up time was 52.6 months, and 1 100 patients survived and 267 died, with the median time to overall survival not yet reached. The 5-year and 10-year overall survival rates were 82.8% and 74.9%, respectively. The 5-year and 10-year overall survival rates of Leibovich low-risk patients were 93.3% and 88.2%, respectively; of Leibovich intermediate-risk patients were 82.2% and 72.3%, respectively; and of Leibovich high-risk patients were 50.5% and 30.2%, respectively. There were significant differences in the long-term survival among the three groups (P<0.001). The 10-year overall survival rates for patients with pT1, pT2, pT3 and pT4 RCC were 83.2%, 73.6%, 55.0% and 31.4%, respectively. There were significant differences among pT1, pT2, pT3 and pT4 patients(P<0.001). The 5-year and 10-year overall survival rates of patients with lymph node metastasis were 48.5% and 35.6%, respectively, and those of patients without lymph node metastasis were 85.1% and 77.5%, respectively. There was significant difference in the long-term survival between patients with lymph node metastasis and without lymph node metastasis. The 10-year overall survival rate was 96.2% for nuclear Grade 1, 81.6% for nuclear Grade 2, 60.5% for nuclear Grade 3, and 43.4% for nuclear Grade 4 patients. The difference was statistically significant. There was no significant difference in the long-term survival between patients with localized renal cancer (pT1-2N0M0) who underwent open surgery and minimally invasive surgery (10-year overall survival rate 80.5% vs 85.6%, P=0.160). Multivariate Cox analysis showed that age≥55 years (HR=2.11, 95% CI: 1.50-2.96, P<0.001), T stage(T3+ T4 vs T1a: HR=2.37, 95% CI: 1.26-4.46, P=0.008), local lymph node metastasis (HR=3.04, 95%CI: 1.81-5.09, P<0.001), nuclear grade (G3-G4 vs G1: HR=4.21, 95%CI: 1.51-11.75, P=0.006), tumor necrosis (HR=1.66, 95% CI: 1.17-2.37, P=0.005), sarcomatoid differentiation (HR=2.39, 95% CI: 1.31-4.35, P=0.005) and BMI≥24kg/m(2) (HR=0.56, 95%CI: 0.39-0.80, P=0.001) were independent factors affecting long-term survival after radical nephrectomy. Conclusions: The long-term survival of radical nephrectomy in patients with renal cell carcinoma is satisfactory. Advanced age, higher pathological stage and grade, tumor necrosis and sarcomatoid differentiation were the main adverse factors affecting the prognosis of patients. Higher body mass index was a protective factor for the prognosis of patients.

Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions

We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510  GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510  GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.

[BCS1Neonatal growth retardation and lactic acidosis initiated by novel mutation sites in L gene]

This study aims to analyze the clinical characteristics and genetic variations of two cases with developmental delay and lactic acidosis in a family, and to explore the relationship between genetic variations and clinical features. A retrospective analysis was conducted on the clinical characteristics of two siblings with developmental delay and lactic acidosis who were treated at the Neonatal Department of Children's Hospital of Chongqing Medical University in May 2019 and December 2021, respectively. Whole-exome sequencing was used to detect genetic variations in the affected children. Homology modeling of the BCS1L protein was performed to analyze the structural and functional changes of the protein. The correlation between genetic variations and clinical phenotypes was analyzed. The results showed that the main clinical features of the two affected children in this family were manifestations of mitochondrial respiratory chain complex Ⅲ deficiency, including prematurity, developmental delay, respiratory failure, lactic acidosis, cholestasis, liver dysfunction, renal tubular lesions, coagulation dysfunction, anemia, hypoglycemia, hypotonia, and early death. Whole-exome sequencing revealed a novel deletion mutation c.486_488delGGA (p.E163del) and a novel missense mutation c.992C>T (p.T331I) in the BCS1L gene. Structural analysis of the homology modeling showed that the compound heterozygous mutation had a significant impact on protein function. In conclusion, the novel mutation site c.992C>T (p.T331I) in the BCS1L gene is a "likely pathogenic" mutation, and the compound heterozygous mutation is closely related to the phenotype of mitochondrial respiratory chain complex Ⅲ deficiency.

Simultaneous Detection and Distribution of Five Juvenile Hormones in 58 Insect Species and the Absolute Configuration in 32 Insect Species

Juvenile hormone (JH) plays an important role in regulating various insect physiological processes. Herein, a novel method (chiral and achiral) for the simultaneous detection of five JHs was established by processing a whole insect without complicated hemolymph extraction. The proposed method was used to determine the distribution of JHs in 58 insect species and the absolute configuration of JHs in 32 species. The results showed that JHSB₃ was uniquely synthesized in Hemiptera, JHB₃ was unique to Diptera, and JH I and JH II were unique to Lepidoptera. JH III was present in most insect species surveyed, with social insects having generally higher JH III titers. Interestingly, JHSB₃ and JHB₃, both double epoxidation JHs, were found in insects with sucking mouthparts. The absolute conformation of JH III and the 10C of the detected JHs were all R stereoisomers.

[Rapid detection and genotyping of SARS-CoV-2 Omicron BA.4/5 variants using a RT-PCR and CRISPR-Cas12a-based assay]

OBJECTIVE

To establish a rapid detection and genotyping method for SARS-CoV-2 Omicron BA.4/5 variants using CRISPPR-Cas12a gene editing technology.

METHODS

We combined reverse transcription-polymerase chain reaction (RT-PCR) and CRISPR gene editing technology and designed a specific CRISPPR RNA (crRNA) with suboptimal protospacer adjacent motifs (PAM) for rapid detection and genotyping of SARS- CoV-2 Omicron BA.4/5 variants. The performance of this RT- PCR/ CRISPPR-Cas12a assay was evaluated using 43 clinical samples of patients infected by wild-type SARS-CoV-2 and the Alpha, Beta, Delta, Omicron BA. 1 and BA. 4/5 variants and 20 SARS- CoV- 2-negative clinical samples infected with 11 respiratory pathogens. With Sanger sequencing method as the gold standard, the specificity, sensitivity, concordance (Kappa) and area under the ROC curve (AUC) of RT-PCR/CRISPPR-Cas12a assay were calculated.

RESULTS

This assay was capable of rapid and specific detection of SARS- CoV-2 Omicron BA.4/5 variant within 30 min with the lowest detection limit of 10 copies/μL, and no cross-reaction was observed in SARS-CoV-2-negative clinical samples infected with 11 common respiratory pathogens. The two Omicron BA.4/5 specific crRNAs (crRNA-1 and crRNA-2) allowed the assay to accurately distinguish Omicron BA.4/5 from BA.1 sublineage and other major SARS-CoV-2 variants of concern. For detection of SARS-CoV-2 Omicron BA.4/5 variants, the sensitivity of the established assay using crRNA-1 and crRNA-2 was 97.83% and 100% with specificity of 100% and AUC of 0.998 and 1.000, respectively, and their concordance rate with Sanger sequencing method was 92.83% and 96.41%, respectively.

CONCLUSION

By combining RT-PCR and CRISPPR-Cas12a gene editing technology, we successfully developed a new method for rapid detection and identification of SARS-CoV-2 Omicron BA.4/5 variants with a high sensitivity, specificity and reproducibility, which allows rapid detection and genotyping of SARS- CoV-2 variants and monitoring of the emerging variants and their dissemination.

[A new form of familial platelet disorder caused by germline mutations in RUNX1 in a pedigree]

Objective: To investigate the clinical and biological characteristics of familial platelet disorder (FPD) with germline Runt-related transcription factor (RUNX) 1 mutations. Methods: Patients diagnosed with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with RUNX1 mutations from February 2016 to December 2021 in Wuhan No.1 Hospital underwent pedigree analysis and were screened for gene mutations (somatic and germline). Patients diagnosed with FPD with germline RUNX1 mutations were enrolled and evaluated in terms of clinical characteristics and biological evolution. Bioinformatics analysis was used to assess the pathogenicity of mutations and to analyze the effect of mutated genes on the function of the corresponding protein. Results: Germline RUNX1 mutations were detected in three out of 34 patients suffering from MDS/AML who had RUNX1 mutations. A pedigree of FPD with RUNX1 (RUNX1-FPD) c.562A>C and RUNX1 c.1415T>C mutations was diagnosed, and the mutations were of patrilineal origin. Bioinformatics analysis indicated that the locus at positions 188 and 472 in the AML-1G type of RUNX1 was highly conserved across different species, and that variations might influence functions of the proteins. The mutations were evaluated to be highly pathogenic. Of the nine cases with germline RUNX1 mutations: two patients died due AML progression; one case with AML survived without leukemia after transplantation of hemopoietic stem cells; four patients showed mild-to-moderate thrombocytopenia; two cases had no thrombocytopenia. During the disease course of the proband and her son, mutations in RUNX1, NRAS and/or CEBPA and KIT appeared in succession, and expression of cluster of differentiation-7 on tumor cells was enhanced gradually. None of the gene mutations correlated with the tumor were detected in the four cases not suffering from MDS/AML, and they survived until the end of follow-up. Conclusions: RUNX1-FPD was rare. The mutations c.562A>C and c.1415T>C of RUNX1 could be the disease-causing genes for the family with RUNX1-FPD, and these mutations could promote malignant transformation. Biological monitoring should be carried out regularly to aid early intervention for family members with RUNX1-FPD.

Case report: Aggressive progression of acute heart failure due to juvenile tuberculosis-associated Takayasu arteritis with aortic stenosis and thrombosis

Background

Takayasu arteritis (TA) is a chronic granulomatous vasculitis with unknown pathophysiology. TA with severe aortic obstruction has a poor prognosis. However, the efficacy of biologics and appropriate timing of surgical intervention remain controversial. We report a case of tuberculosis (TB)-associated TA with aggressive acute heart failure (AHF), pulmonary hypertension (PH), thrombosis, and seizure, who failed to survive after surgery.

Case presentation

A 10-year-old boy who developed a cough with chest tightness, shortness of breath, hemoptysis with reduced left ventricular ejection fraction, PH, and increased C-reactive protein and erythrocyte sedimentation rate was hospitalized at the pediatric intensive care unit of our hospital. He had strongly positive purified protein derivative skin test and interferon-gamma release assay result. Computed tomography angiography (CTA) showed occlusion of proximal left subclavian artery and stenosis of descending aorta and upper abdominal aorta. His condition did not improve after administration of milrinone, diuretics, antihypertensive agents, and intravenous methylprednisolone pulse followed by oral prednisone. Intravenous tocilizumab was administered for five doses, followed by two doses of infliximab, but his HF worsened, and CTA on day 77 showed complete occlusion of the descending aorta with large thrombus. He had a seizure on day 99 with deterioration of renal function. Balloon angioplasty and catheter-directed thrombolysis were performed on day 127. Unfortunately, the child's heart function continued to deteriorate and died on day 133.

Conclusion

TB infection may be related to juvenile TA. The biologics, thrombolysis, and surgical intervention failed to achieve the anticipated effect in our case with aggressive AHF due to severe aortic stenosis and thrombosis. More studies are needed to determine the role of biologics and surgery in such dire cases.

Binder-Free Sodium Zinc Phosphate Protection Layer Enabled Dendrite-Free Zn Metal Anode

Aqueous Zn battery has been a promising alternative battery in large-scale energy storage systems due to its cost-effectiveness, sustainability, and intrinsic safety. However, its cycle life is impeded by the dendrite formation, severe corrosion, and side reactions on the zinc metal anode. Most ex situ coatings on the zinc surface extend the life span of zinc anodes but have drawbacks in Zn²⁺ ion conductivity. Herein, a robust sodium zinc phosphate layer was in situ built on zinc metal foil anode (Zn@NZP) via facile electrodeposition. The Zn²⁺ ion conducting protection layer alleviates corrosion, suppresses zinc dendrites, and lowers the energy barrier of Zn²⁺ plating and stripping. As a result, the Zn@NZP anode renders dendrite-free plating/stripping with a small overpotential of about 44 mV and a 12-fold enhancement long-life span compared to the bare zinc. Furthermore, a full cell using the Zn@NZP anode shows much improved capacity and cycling stability. This work provides a promising anode candidate for dendrite-free aqueous zinc ion batteries.

The association of coffee consumption with the risk of osteoporosis and fractures: a systematic review and meta-analysis

To elucidate the association of coffee and bone health would help fracture risk reduction via dietary intervention. Although those who had higher coffee consumption were less likely to have osteoporosis, the associations between coffee consumption and fracture risk need further investigations with better study designs.

INTRODUCTION

The associations between coffee consumption and the risk of osteoporosis and fracture remain inconclusive. We aimed to better quantify these associations by conducting meta-analyses of observational studies.

METHODS

Relevant studies were systematically searched on PubMed, Web of Science, Cochrane library, and Embase Database up to November 25, 2021. The odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) was pooled and a dose-response analysis was performed.

RESULTS

Four studies with 7114 participants for osteoporosis and thirteen studies with 391,956 participants for fracture incidence were included in the meta-analyses. High versus low coffee consumption was associated with a lower risk of osteoporosis [pooled OR (95% CI): 0.79 (0.65-0.92)], while it was non-significantly associated with fracture incidence [pooled OR (95% CI): 0.86 (0.67-1.05) at hip and 0.89 (0.42-1.36) at non-hip]. A non-linear association between the level of coffee consumption and hip fracture incidence was shown (P = 0.004). The pooled RR (95% CI) of hip fracture risk in those who consumed 1, 2-3, 4, and ≥ 9 cups of coffee per day was 0.92 (0.87-0.97), 0.89 (0.83-0.95), 0.91 (0.85-0.98), and 1.10 (0.76-1.59), respectively. The significance in the association between coffee consumption and the hip fracture incidence decreased in those studies that had larger sample size, higher quality, and more adjustments.

CONCLUSIONS

A dose-dependent relationship may exist between coffee consumption and hip fracture incidence. The effect of high versus low coffee consumption was influenced by study designs. Further studies with dedicated designs are needed to confirm the independent effects of coffee consumption on bone health.

Facile and Rapid Synthesis of Porous Hydrated V2O5 Nanoflakes for High-Performance Zinc Ion Battery Applications

Hydrated V₂O₅ with unique physical and chemical characteristics has been widely used in various function devices, including solar cells, catalysts, electrochromic windows, supercapacitors, and batteries. Recently, it has attracted extensive attention because of the enormous potential for the high-performance aqueous zinc ion battery cathode. Although great progress has been made in developing applications of hydrated V₂O₅, little research focuses on improving current synthesis methods, which have disadvantages of massive energy consumption, tedious reaction time, and/or low efficiency. Herein, an improved synthesis method is developed for hydrated V₂O₅ nanoflakes according to the phenomenon that the reactions between V₂O₅ and peroxide can be dramatically accelerated with low-temperature heating. Porous hydrated V₂O₅ nanoflake gel was obtained from cheap raw materials at 40 °C in 30 min. It shows a high specific capacity, of 346.6 mAh/g, at 0.1 A/g; retains 55.2% of that at 20 A/g; and retains a specific capacity of 221.0 mAh/g after 1800 charging/discharging cycles at 1 A/g as an aqueous zinc ion battery cathode material. This work provides a highly facile and rapid synthesis method for hydrated V₂O₅, which may favor its applications in energy storage and other functional devices.

MicroRNA-29a-3p regulates chemosensitivity in hypopharyngeal carcinoma via targeting Cdc42

INTRODUCTION

Hypopharyngeal carcinoma is one kind of high malignant tumour followed by poor prognosis in head and neck carcinomas. This study aimed to detect miR-29a-3p and Cdc42 in patients with hypopharyngeal carcinoma.

MATERIALS AND METHODS

The expression of miR-29a-3p and Cdc42 mRNA were detected, and the correlation between miR-29a-3p/Cdc42 and clinical stages was investigated.

RESULTS

The relative expression of miR-29a-3p in stage II, III and IV hypopharyngeal carcinoma tissues was significantly lower than that of stage I (P< 0.05). The relative expression of Cdc42 mRNA in stage I, III and IV tissues was significantly higher than that of stage I (P< 0.05). The expression of miR-29a-3p in hypopharyngeal carcinoma with lymph node metastasis was significantly lower than that without lymph node metastasis (P = 0.045).

CONCLUSION

MiR-29a-3p and Cdc42 mRNA could be potential diagnostic biomarkers of hypopharyngeal carcinoma.

Clinical characteristics and outcomes of chronic nonbacterial osteomyelitis in children: a multicenter case series

OBJECTIVE

The aim of this study was to evaluate demographic, clinical, laboratory, imaging, histopathology characteristics, and treatment responses of children with Chronic nonbacterial osteomyelitis (CNO).

METHODS

Retrospective multi-center case series study of pediatric patients diagnosed with CNO treated at five tertiary centers in south China.

RESULTS

Totally there were 18 patients diagnosed as CNO between 2014 and 2020. The median age of onset was 9.2 years (range 3.7-13.1) and 55.6% were female. Median delay in diagnosis was 10.9 months (range 1.0-72.0). The most frequent presenting symptoms were bone pain (100%) and fever (44.4%). Most patients had more than one lesion (median of 5, range 1-7). Most frequently affected bones were tibiofibula (88.9%) and femur (77.8%). The MRI characteristics mainly presented as bone edema and hyperintensity in bone marrow. Bone biopsy was conducted in 11 patients (61.1%) with inflammatory cells infiltration manifested as chronic osteomyelitis, and none showed bacterial infection or tumor. In treatment, non-steroid anti-inflamatory drugs (NSAIDs) is used as the first-line drug followed by steriods, methotexate (MTX), salazosulfadimidine (SASP), Bisphosphonates and TNF-α inhibitor. Two refractory cases received combination therapy with Bisphosphonates and TNF-α inhibitor, and achieved good therapeutic effect.

CONCLUSIONS

The present study described a multicenter series of CNO from south China and highlighted the clinical features, laboratory tests, imaging characteristics and treatment outcomes. Increasing awareness of this disease is important to decrease time to diagnosis, improve access to treatment, and reduce complications.

Efficacy and safety of etanercept biosimilar rhTNFR-Fc in Chinese patients with juvenile idiopathic arthritis: An open-label multicenter observational study

BACKGROUND

Etanercept biosimilar recombinant human TNF-α receptor II: IgG Fc fusion protein (rhTNFR-Fc) has showed its efficacy and safety in Chinese patients with rheumatoid arthritis. However, data on rhTNFR-Fc's application in juvenile idiopathic arthritis (JIA) is limited.

METHODS

A prospective, observational, multicenter study was performed at 6 institutes in China from July 2020 to December 2021. In a 24-week follow-up, patients with JIA including polyarticular JIA and enthesitis related arthritis received rhTNFR-Fc plus methotrexate (MTX) treatment. The primary outcome parameters were improvements of cJADAS-10 (clinical Juvenile Arthritis Disease Activity Score), and the secondary outcome parameter was an inactive disease.

RESULTS

60 patients completed at least 12-week follow-up, and 57 completed 24-week follow-up. They had high C reactive protein values (11.6 mg/L) and cJADAS-10 (14.6) at baseline. Thirteen patients had morning stiffness. 33 patients showed synovial thickening, and 34 showed bone marrow edemas on MRI. Ultrasonography demonstrated significant joint effusions in 43 patients. The cJADAS-10 sharply decreased from 14.66 at the baseline to 2.4 at 24 weeks of rhTNFR-Fc therapy, respectively (P < 0.01). About half of patients achieved inactive disease at 24 weeks of therapy. Compared with the baseline, the number of patients with morning stiffness, joint effusions, bone marrow edema and synovial thickening on MRI significantly decreased at 24 weeks. Adverse events were consistent with known side effects of biologic agents.

CONCLUSIONS

The present study indicated that the combination of rhTNFR-Fc and MTX significantly improve symptoms and disease activity of children with JIA. This study suggests etanercept biosimilar rhTNFR-Fc as an effective and safe therapy for children with JIA.

Short-term effectiveness of baricitinib in children with refractory and/or severe juvenile dermatomyositis

OBJECTIVE

To determine the short-term effectiveness safety of baricitinib in children with refractory and/or severe juvenile dermatomyositis (rsJDM) in a real-world setting.

METHODS

This was a single-center retrospective study, including 20 children with rsJDM. They were all treated using baricitinib combined with steroids and other immunosuppressive agents. The childhood myositis assessment scale (CMAS) and PRINTO remission criteria were used to evaluate the disease severity and treatment outcome at 0, 4, 12, and 24 weeks after initiation of baricitinib.

RESULTS

The skin rash improved in 95% of patients (19/20) at week 24, with a significant decrease of skin-DAS at weeks 12 (6.0 vs. 2.0, p < 0.05] and week 24 [6.0 vs. 1.0, p < 0.05) by median statistics. The CMAS score increased significantly at week 12 (41.0 [29.0, 44.0] vs. 46.0 [42.0, 52.0], p < 0.05) and week 24 (41.0 [29.0, 44.0] vs. 50.0 [45.0, 52.0], p < 0.05), as did the manual muscle testing (MMT)-8 score at week 24 (73.0 [610, 76.0] vs. 79.0 [77.0, 80.0], p < 0.05). At 24 weeks, the complete response (CR) and partial response (PR) were achieved in 75% (15/20) and 15% (3/20), respectively. The dose of corticosteroids (CS) decreased by 37% from the baseline (0.53 [0.42, 1.00] mg/kg) to week 12 (0.33 [0.18, 0.40] mg/kg) (p < 0.05), and by 49% at week 24 (p < 0.05). No serious side effects were observed.

CONCLUSION

Baricitinib combined with traditional immunosuppressants treatment was efficacious in rsJDM. Add-on therapy of baricitinib was helpful for tapering CS dose. No serious side effects were observed in this study.

Reliability and validity of a brief version of the Questionnaire of Olfactory Disorders (brief QOD) in patients with olfactory dysfunction

BACKGROUND

The aim of this study was to determine the reliability and validity of the brief version of Questionnaire of Olfactory Disorders (brief QOD).

METHODS

A total of 372 patients participated in this study. Olfactory function was examined using the Sniffin' Sticks test. The brief version of QOD, including 4 items concerning parosmia (QOD-P), 7 items concerning quality of life (QOD-QOL), and 3 visual analog scales to rate disease burden, awareness of the disorder and issues related to professional life (QOD-VAS), was used to assess subjective information on olfactory dysfunction. We evaluated the split-half reliability, internal consistency and validity of the brief QOD.

RESULTS

The split-half reliability was 0.60 (QOD-P), 0.87 (QOD-QOL), and 0.66 (QOD-VAS), respectively. The Cronbach's α coefficient was 0.63 (QOD-P), 0.87 (QOD-QOL), and 0.71 (QOD-VAS), respectively. Olfactory function was found to be associated with QOD-P, QOD-QOL and QOD-VAS.

CONCLUSIONS

The brief QOD is a suitable scale for the assessment of subjective severity of olfactory dysfunction for purposes such as treatment counseling, disability assessment, treatment control, and research in patients with olfactory disorder.

Probing Gluon Spin-Momentum Correlations in Transversely Polarized Protons through Midrapidity Isolated Direct Photons in p^{↑}+p Collisions at sqrt[s]=200 GeV

Studying spin-momentum correlations in hadronic collisions offers a glimpse into a three-dimensional picture of proton structure. The transverse single-spin asymmetry for midrapidity isolated direct photons in p^{↑}+p collisions at sqrt[s]=200  GeV is measured with the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). Because direct photons in particular are produced from the hard scattering and do not interact via the strong force, this measurement is a clean probe of initial-state spin-momentum correlations inside the proton and is in particular sensitive to gluon interference effects within the proton. This is the first time direct photons have been used as a probe of spin-momentum correlations at RHIC. The uncertainties on the results are a 50-fold improvement with respect to those of the one prior measurement for the same observable, from the Fermilab E704 experiment. These results constrain gluon spin-momentum correlations in transversely polarized protons.

Health-related quality of life in patients with recurrent pericarditis: results from RHAPSODY, a phase 3 study of rilonacept

Background

Recurrent pericarditis (RP) patients report that painful, debilitating flares negatively impact their health-related quality of life (HRQoL). RHAPSODY, the Phase 3 trial of rilonacept (IL-1α/IL-1β cytokine trap), included a daily pain diary and patient-reported outcome SF-36v2 to measure HRQoL throughout the trial.

Purpose

The purpose of this research is to evaluate the effect of rilonacept on HRQoL in relation to changes in pain for RP patients who have a recurrence.

Methods

RHAPSODY enrolled 86 patients with acute symptomatic RP to receive weekly rilonacept for a 12-week run-in (RI) period and randomized 61 patients (1:1) to receive placebo (n=31) or continue rilonacept (n=30) for the event-driven randomized-withdrawal (RW) period. Patients on placebo who experienced a qualifying recurrence during RW (return of pericarditis pain and increase in C-reactive protein) were rescued with bailout rilonacept. Patients reported daily pericarditis pain electronically, using a 0–10 numeric rating scale (NRS), and completed the SF-36v2 at study visits prior to clinician interaction. Scores from RI Baseline (BL), RI Week 12 (RW BL), Recurrence visit, and RW up to Week 24 (or end of study; EOS) were evaluated for patients who experienced recurrence in RW. Analyses exclude one patient randomized to placebo who had a recurrence after Week 24 of the RW period.

Results

Analyses focused on the 22 of 30 patients (73%) in the placebo group who experienced a recurrence before Week 24 of RW (median time from RW BL to recurrence: 8.6 weeks). During RI, daily pain scores decreased while on rilonacept (Cohen's effect size [ES] d=−2.0), and SF-36v2 scores improved, with scores at RI BL (Fig. 1 red line) below the general population average of 50 and near or above average at RI Week 12 (Fig. 1 blue line); ES were all large (d&gt;0.8), ranging from 0.917 (Mental Component Summary) to 2.021 (Bodily Pain). At recurrence, pain scores increased (d=6.5; Fig. 2) and SF-36v2 scores were below the population average (Fig. 1 orange line), with largest reductions between RI Week 12 (RW BL) and recurrence for Bodily Pain (−13.4) and Physical Component Summary (−10.6). Following rilonacept bailout, average pain decreased (d=−2.1; Fig. 2), and by RW Week 24/EOS, SF-36v2 scores returned to similar levels as at the end of the RI period (Fig. 1 green line).

Conclusion

Impaired RI BL SF-36v2 scores indicate negative impact of RP on HRQOL in RP patients. While receiving rilonacept, HRQoL scores improved to near or above population averages, in conjunction with patient-reported pain. After discontinuing rilonacept during RW, HRQoL scores worsened at recurrence and improved upon receipt of bail-out rilonacept, similar to pain. These results provide support for the broader benefit of rilonacept treatment beyond pain, when administered on top of conventional therapies and as mono-therapy, providing evidence of its potential to improve HRQoL in this patient population.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Kiniksa Pharmaceuticals, Ltd.

Development of a Self-reported Olfactory Dysfunction Questionnaire (SODQ) to screen olfactory disorders in China

BACKGROUND

The diagnosis of olfactory dysfunction is challenging given the negligence during routine physical examination, inconvenience of diagnosis in clinical practice, and the inattention to cross-cultural adaptability. The study aimed to develop and validate a simple and effective self-reported olfactory dysfunction questionnaire (SODQ) for the initial screening of clinical olfactory disorders in China.

METHODS

A total of 121 subjects participated in the study; of these, 96 subjects completed the T&T olfactometer test and 12-item questionnaire, and 25 participants were retested using the SODQ after one week. The T&T olfactometer test examined the olfactory function and the questionnaire measured the ability to perceive common odors in daily life. We evaluated the factor structure, reliability, validity, and discriminative ability of the SODQ.

RESULTS

The final version of the SODQ consisted of 10 items with one factor. Test-retest and internal consistency were excellent. Convergent validity of the questionnaire with the T&T olfactory test was high. Furthermore, the discrimination ability was high for the questionnaire with an area under the curve of 0.95 and a cut-off point of 22.

CONCLUSIONS

The SODQ is a brief, valid, and repeatable tool that has the potential to effectively screen for clinical olfactory disorders from a subjective perspective.

P–757 The risk of aspirin and prednisone using in women with antithyroid antibodies undergoing assisted reproductive technology

Study question

Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology?

Summary answer

Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate.

What is known already

Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood.

Study design, size, duration

A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer.

Participants/materials, setting, methods

Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables.

Main results and the role of chance

A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P &lt; 0.001) and implantation rate (F = 4.388, P = 0.036). The fertilization rate (P = 0.407), high-quality embryo rate (P = 0.208) and blastulation rate (P = 0.157) were not influenced by the use of medication. In this study, likelihood of clinical pregnancy (P = 0.066) did not change significantly after therapy, and miscarriage rate (P = 0.042) increased after medical treatment.

Limitations, reasons for caution

Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed.

Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious.

Trial registration number

n/a

Characterization of serum adiponectin and leptin in healthy perinatal dairy cows or cows with ketosis, and their effectson ketosis involved indices

We investigated changes in concentrations of ADP (adiponectin), LEP (leptin), BHBA (beta-hydroxybutyric acid), NEFA (non-esterified fatty acid), Glucose (Glu) and INS (insulin) in serum of healthy perinatal dairy cows and cows with ketosis. Twenty-one healthy cows and seventeen cows with ketosis from a herd of a total 60 Holstein cows (near dry period i.e. 56 days antepartum) were selected. Blood was collected through the tail vein every 7 days, from 56 day antepartum to 56 day postpartum. Serum ADP, LEP, BHBA, NEFA, Glu, and INS concentrations were determined, and ketosis was diagnosed through serum BHBA (≥1.2 mmol/L). We showed the concentration of serum adipokines and energy balancing indices were stable during antepar- tum period. However, ADP concentration increased while LEP decreased, and there were a significant increase in cows with ketosis compared to that of in healthy cows. Serum BHBA and NEFA concentrations increased significantly at first, and then gradually decreased in both healthy cows and cows with ketosis. However, cows with ketosis showed higher concentrations of BHBA and NEFA which restored later. The serum concentration of Glu in both healthy dairy cows and cows with ketosis showed a decreasing trend. INS concentration in healthy cows was decreased while it was increased in cows with ketosis. The results reflect the extent of hypo- glycemia and lipid mobilization postpartum, suggest IR exists in cows with ketosis while serum ADP and LEP might play roles in the development of ketosis.

Severe diarrhea in a 10-year-old girl with Aicardi-Goutières syndrome due to IFIH1 gene mutation

Interferon-induced with helicase C domain 1 (IFIH1) is a cytosolic sensor of dsRNA that induces an anti-viral Type I interferon (IFN) state. A gain-of-function mutation in IFIH1 can cause increased Type I IFN activity and is clinically associated with Aicardi-Goutières syndrome (AGS). AGS is a multisystem disease, characterized as an early-onset progressive encephalopathy with basal ganglia calcification and systemic lupus erythematosus-like features. Gastrointestinal manifestation is rare in AGS patients. We described a 10-year-old female patient with a heterozygous IFIH1 gene mutation who presented with gastrointestinal colitis, cystitis and very severe diarrhea as initial major manifestations of AGS. Proteinuria with high titer of antinuclear antibody and anti-double-stranded DNA was found in this patient. She also had growth retardation and a history of seizures (about two episodes each year) but without attacks until 7 years old. Serum cytokines detected by flow cytometry indicated extremely high level of interleukin 6 (1970.1 pg/ml) and IFN-α (204.1 pg/ml). A contrast-enhanced CT scan of the whole abdomen and an intestinal hydro-MRI indicated that the walls of her stomach, small bowel, colon, and bladder were in various degrees of edema and thickened states. Whole exome sequencing analysis indicated that she harbors an IFIH1 heterozygous mutation (c.2336G > A (p.R779H)) in both blood and intestinal samples. Abundant inflammatory cells infiltration into the intestinal epithelium was observed by immunohistochemical staining. Positive staining of caspase 4 and caspase 5 suggested that the signaling pathway of pyroptosis was involved in the mechanism of intestinal inflammation in AGS. Diarrhea was significantly improved after steroids and intravenous immunoglobulin treatments. Gastrointestinal colitis and cystitis can be rare manifestations of AGS with IFIH1 mutation. Caspase and its related inflammasome pathway may involve in the pathogenesis of AGS.

Long non-coding RNA LINC00665 promotes metastasis of breast cancer cells by triggering EMT

OBJECTIVE

In recent years, studies have found that abnormally expressed long non-coding RNA (lncRNA) is closely associated with the progression of breast cancer (BCa). Some lncRNAs have been identified to be involved in the regulation of BCa cell invasion and metastasis. In this research, LINC00665 was found to be abnormally expressed in BCa tissues and cells, and its regulatory effects on invasion and metastasis of BCa were explored. The aim of this study was to investigate the expression characteristics of LINC00665 in BCa, and its regulatory role in BCa progression.

PATIENTS AND METHODS

LINC00665 expressions in BCa tissue samples and normal ones were collected from GEPIA database. The expression of LINC00665 in BCa tissues and cell lines was further confirmed by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). After knockdown of LINC00665 expression in BCa cells by transfection of small interfering RNA, cell migration and invasion abilities were examined by cell wound healing and transwell assay. Expressions of epithelial-mesenchymal transition (EMT)-related markers in BCa cells were examined using qRT-PCR and Western blot.

RESULTS

LINC00665 was highly expressed in BCa tissues and cell lines, and the high expression of LINC00665 could be used to predict a poor prognosis of BCa patients. In addition, the results of in vitro cell experiments showed that the migration and invasion ability of BCa cells were remarkably attenuated after downregulation of LINC00665. At the same time, qRT-PCR and Western blot results revealed that downregulation of LINC00665 was able to inhibit the expressions of EMT-related genes in BCa cells.

CONCLUSIONS

LINC00665 is highly expressed in BCa tissues and cell lines, which could predict poor prognosis of BCa patients. In addition, LINC00665 may promote the malignant metastasis of BCa cells by affecting the EMT process.

Discovery of the acetyl cation, CH3CO+, in space and in the laboratory

Using the Yebes 40m and IRAM 30m radiotelescopes, we detected two series of harmonically related lines in space that can be fitted to a symmetric rotor. The lines have been seen towards the cold dense cores TMC-1, L483, L1527, and L1544. High level of theory ab initio calculations indicate that the best possible candidate is the acetyl cation, CH3CO+, which is the most stable product resulting from the protonation of ketene. We have produced this species in the laboratory and observed its rotational transitions Ju = 10 up to Ju = 27. Hence, we report the discovery of CH3CO+ in space based on our observations, theoretical calculations, and laboratory experiments. The derived rotational and distortion constants allow us to predict the spectrum of CH3CO+ with high accuracy up to 500 GHz. We derive an abundance ratio N(H2CCO)/N(CH3CO+)~44. The high abundance of the protonated form of H2CCO is due to the high proton affinity of the neutral species. The other isomer, H2CCOH+, is found to be 178.9 kJ mol-1 above CH3CO+. The observed intensity ratio between the K=0 and K=1 lines, ~2.2, strongly suggests that the A and E symmetry states have suffered interconversion processes due to collisions with H and/or H2, or during their formation through the reaction of H 3 + with H2CCO.

Case Report: Macrophage Activation Syndrome and Widespread Neuroimaging Abnormality in Childhood-Onset Systemic Lupus Erythematosus

Macrophage activation syndrome (MAS) and widespread brain lesions are rare and severe complications of childhood-onset systemic lupus erythematosus (SLE). We report an 11-year-old girl who presented with recurrent rashes for half a year and fever for 2 weeks. Clinical and laboratory features at admission pointed to the diagnosis of SLE and SLE-associated MAS. Cerebral magnetic resonance imaging taken on day 4 after admission showed abnormal signals. Glucocorticoid therapy was started on day 5. Two days later, the patient appeared weak and ill, then the next day she exhibited dizziness, drowsiness, apathia, and dysarthria. High-dose methylprednisolone, cyclophosphamide, and intravenous immunoglobulin were used to treat the patient, and intrathecal dexamethasone was given. The patient was discharged on day 30 after admission and showed complete clinical resolution and improved magnetic resonance imaging resolution.

LncRNA SAMD12-AS1 down-regulates P53 to promote malignant progression of glioma

OBJECTIVE

To study the expression level of long non-coding RNA (LncRNA) SAMD12-AS1 in glioma and its influence on the invasive ability of glioma cells; meanwhile, the regulation mechanism of LncRNA SAMD12-AS1 promoting the development of glioma was further explored.

PATIENTS AND METHODS

The expression level of SAMD12-AS1 in 40 pairs of tumor tissue specimens and paracancerous ones collected from glioma patients were examined through Real Time quantitative-Polymerase Chain Reaction (qRT-PCR) method, and the interplay between SAMD12-AS1 expression and clinical indicators of glioma patients was also analyzed. Meanwhile, the expression of SAMD12-AS1 in glioma cell lines was further verified by qRT-PCR. In addition, SAMD12-AS1 knockdown model was constructed using glioma cell lines (T98-G and U87). Cell Counting Kit-8 (CCK-8), cell wound healing test, and transwell assays were conducted to examine the impact of SAMD12-AS on glioma cell functions. Additionally, whether it exerted its biological characteristics through P53 was finally explored.

RESULTS

qPCR results in the study revealed that SAMD12-AS1 expression in tumor tissue specimens of glioma patients was remarkably higher than that in the adjacent ones, and the difference was statistically significant. Compared with patients with low expression of SAMD12-AS1, patients with high expression of SAMD1-AS1 had a higher incidence of lymph node or distant metastasis. In addition, compared to the NC group, knocking down SAMD12-AS1 markedly attenuated the proliferation rate, as well as the invasiveness and migration ability of glioma cells. Subsequently, in glioma tissues, it was verified that P53 expression was remarkably decreased and negatively correlated with SAMD12-AS1. Finally, cell recovery experiment also demonstrated that there may exist a mutual regulation between SAMD12-AS1 and P53, which then together affected the malignant progression of glioma.

CONCLUSIONS

LncRNA SAMD12-AS1 may accelerate the invasion and migratory capacities of glioma cells by modulating P53, and its expression was confirmed to be significantly relevant to the incidence of lymph node or distant metastasis.

[Survey of related factors of maternal venous thromboembolism in nine hospitals of China]

Objective: To investigate and analyze disease status and risk factors of venous thromboembolism (VTE) during pregnancy and puerperium in our country. Methods: Clinical datas were collected from 575 patients diagnosed with VTE during pregnancy and puerperium and hospitalized in nine medical institutions in our country from January 1, 2015 to November 30, 2019, and retrospectively analyzed it's disease status and risk factors. Results: (1) The proportion of VTE in pregnancy and puerperium was 50.6% (291/575) and 49.4% (284/575), respectively. Four patients died, the mortality rate was 0.7% (4/575). The cause of death was pulmonary embolism. (2) The location of VTE during pregnancy and puerperium was mainly in the lower limb vascular (76.2%, 438/575), followed by pulmonary vessels (7.1%, 41/575). (3) In the risk factors of VTE, cesarean section accounted for 32.3% (186/575), maternal advance age accounted for 27.7% (159/575), braking or hospitalization during pregnancy accounted for 13.6% (78/575), other risk factors accounted for more than 5% were previous VTE, obesity, preterm birth, assistant reproductive technology conception and so on, pre-eclampsia and multiple pregnancy accounted for 4.9% (28/575) respectively. In addition, some patients with VTE did not have any of the above risk factors, and the incidence rate was as high as 23.1% (133/575). Conclusions: The occurrence of VTE during pregnancy and puerperium is related to multiple risk factors, and could lead to matemal death, It is very necessary to screen VTE risk factors for all pregnant women, to make corresponding prevention and control measures.

Influences of hucMSC-exosomes on VEGF and BMP-2 expression in SNFH rats

OBJECTIVE

To investigate the influences of human umbilical cord mesenchymal stem cell-derived exosomes (hucMSC-exosome) on steroid-induced necrosis of the femoral head (SNFH) and the expressions of vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) in rats.

PATIENTS AND METHODS

A total of 20 male Sprague-Dawley rats were randomly divided into SNFH group and SNFH + hucMSC-exosome group using a random number table. Prednisolone acetate (24.5 mg/kg) was injected twice a week to establish the rat model of SNFH, and hucMSC-exosome in a certain dose was additionally injected into the marrow cavity in SNFH + hucMSC-exosome group. After 3 weeks, the influences of hucMSC-exosome on the pathological changes and apoptosis of the femoral head in SNFH rats were detected via hematoxylin-eosin (H&E) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. In addition, the expressions of cluster of differentiation 31 (CD31), VEGF, and BMP-2 in bone tissues in both groups were detected via immunohistochemical staining, and the messenger ribonucleic acid (mRNA) and protein expression levels of VEGF and BMP-2 in necrotic bone tissues in both groups were detected via Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and Western blotting.

RESULTS

The results of H&E staining revealed that the fibrous callus formation was good, the new trabecular structure was more obvious, the number of vacuum cleft declined, and there were fewer enlarged adipocytes in SNFH + hucMSC-exosome group compared with SNFH group. The results of TUNEL staining showed that the number of apoptotic cells in femoral head tissues was smaller in SNFH + hucMSC-exosome group (p<0.05). According to the results of immunohistochemistry, hucMSC-exosome could increase the expression of vascular endothelial marker CD31 in SNFH rats (p<0.05). Besides, the results of RT-PCR, immunostaining and Western blotting manifested that both the mRNA and protein levels of BMP-2 and VEGF in femoral head tissues were significantly increased in SNFH + hucMSC-exosome group (p<0.05).

CONCLUSIONS

HucMSC-exosome can improve SNFH in rats, whose mechanism may be related to the up-regulation of VEGF and BMP-2 by exosomes.

FRI0463 IDENTIFICATION OF EARLY CLINICAL AND LABORATORY CHARACTERISTICS OF MACROPHAGE ACTIVATION SYNDROME ASSOCIATED WITH SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

Background:

Macrophage activation syndrome (MAS) is a severe, potentially life-threatening complication of systemic juvenile idiopathic arthritis (SJIA). However, early recognition of MAS remains challenging. Because it is clinically heterogeneous, hemophagocytosis is often not detected, and histopathological features lack the specificity associated with hemophagocytic syndromes. In addition, it is often difficult to distinguish early MAS from SJIA or sepsis-like syndromes.

Objectives:

To identify early clinical and laboratory characteristics of MAS associated with SJIA.

Methods:

This is a retrospective cohort study of 149 SJIA patients treated at the Children’s Hospital of Zhejiang University School of Medicine between January 2010 to December 2017. All patients fulfilled 2001 ILAR criteria for SJIA, and 27 fulfilled 2016 Classification Criteria for MAS. We evaluated the clinical and laboratory features of SJIA patients with MAS and compared them to those without MAS. We focused our analysis on early MAS, which was defined as the time when the initial clinical and/or laboratory abnormalities suggestive of MAS were first detected.

Results:

The clinical features associated with early MAS were hypotension, absence of arthritis and lymphadenopathy, bone marrow hemophagocytosis, central nervous system dysfunction, and gastrointestinal involvement. The best laboratory parameters for early MAS detection were platelet counts ≤275.0 × 109/L, lactate dehydrogenase >596.0 U/L, aspartate aminotransferase >47.0 U/L, erythrocyte sedimentation rates ≤41.0 mm/h, ferritin >1400.0 ng/mL, D-dimer >1.40 mg/L, triglyceride >1.30 mmol/L, alanine aminotransferase >33.0 U/L, C-reactive protein ≤68.0 mg/L, fibrinogen ≤4.1 g/L, absolute neutrophil counts ≤5.2 × 109/L, serum total protein ≤66.0 g/L, and white blood cell ≤9.8 × 109/L. The combination of cytokines of IFN-γ >17.1 pg/mL and IL-10 >7.8 pg/mL were found to be a specific and good prognostic cytokine pattern for early recognition of MAS, the sensitivity and specificity as 71.4% and 98.2%.(Table 1, Fig 1, 2)

Table 1.

Identification of clinical and Cytokine characteristics differentiating patients with MAS onset from SJIA patients without MAS

CharacteristicsSensitivity (%)Specificity (%)OR (95% CI)p valueClinical characteristicsHypotension35.598.433.0 (6.8–160.1)0.000Absence of Arthritis77.485.219.8 (7.4–52.7)0.000Hemophagocytosis in the bone marrow28.697.314.5 (2.0–107.5)0.009Central nervous system involvement25.891.03.5 (1.3–9.7)0.015Gastrointestinal involvement22.691.83.3 (1.1–9.4)0.029Absence of lymphadenopathy77.451.62.6 (1.1–6.1)0.027Cytokine levelsIFN-γ >17.1 pg/mL82.183.649.5 (15.6–156.9)0.000IL-10 >7.8 pg/mL78.693.123.5 (7.9–69.5)0.000IFN-γ >17.1 pg/mL and IL-10 >7.8 pg/mL71.498.2142.5 (28.2–720.6)0.000

OR, odds ratio. CI, confidence interval. PLT, platelet. LDH, lactate dehydrogenase. AST, aspartate aminotransferase. ESR, erythrocyte sedimentation rate. FER, ferritin. D-D, D-dimer. TG, triglycerides. ALT, alanine aminotransferase. CRP, C-reactive protein. FIB, fibrinogen. ANC, absolute neutrophil count; TP, total protein. WBC, white blood cells. ALB, albumin. IL, interleukin. IFN, interferon.

Fig 1.

Comparison of clinical characteristics in the MAS process. * P < 0.05. ** P < 0.01. CNS involvement: Central nervous system involvement.

Fig 2.

Comparison of serum cytokine levels in the MAS process. * P < 0.05. ** P < 0.01.

Conclusion:

Sudden hypotension, absence of arthritis, and significantly increased IFN-γ and IL-10 levels are important clinical and laboratory markers for early MAS identification in addition to the traditional features of SJIA-associated MAS.

References:

(not show references here)

Disclosure of Interests:

None declared

Staged horizontal bone augmentation for dental implants in aesthetic zones: A prospective randomized controlled clinical trial comparing a half-columnar bone block harvested from the ramus versus a rectangular bone block from the symphysis

In this study, the clinical outcomes of horizontal ridge augmentation using half-columnar bone grafts from the ramus (group I: 27 patients, 32 implants) versus rectangular bone grafts from the symphysis (group II: 19 patients, 27 implants) were compared; grafts were combined with organic bovine bone and collagen membrane. Cone beam computed tomography images were obtained preoperatively, immediately after restoration (baseline), and 1 year after loading. Four months after grafting, horizontal bone resorption at the alveolar crest did not differ significantly between the two groups (P=0.291). At 4mm apical to the alveolar crest, horizontal bone resorption in group I was significantly less than that in group II (P=0.041). One year after loading, horizontal bone resorption in group I was lower than that in group II, with no significant difference. The residual thickness of the labial bone at the implant site in group I was significantly higher than that in group II. Horizontal ridge augmentation with either a half-columnar autogenous graft from the ramus or a rectangular autogenous graft from the symphysis can provide acceptable results in aesthetic regions. The half-columnar group demonstrated better graft stability both at 4 months after augmentation and 1 year after loading.

Brassinosteroids are involved in ethylene-induced Pst DC3000 resistance in Nicotiana benthamiana

Plant immunity is regulated by a huge phytohormone regulation network. Ethylene(ET) and brassinosteroids (BRs) play critical roles in plant response to biotic stress; however, the relationship between BR and ET in plant immunity is unclear. We used chemical treatments, genetic approaches and inoculation experiments to investigate the relationship between ET and BR in plant defense against Pst DC3000 in Nicotiana benthamiana. Foliar applications of ET and BR enhanced plant resistance to Pst DC3000 inoculation, while treatment with brassinazole (BRZ, a specific BR biosynthesis inhibitor) eliminated the ET induced plant resistance to Pst DC3000. Silencing of DWARF 4(DWF4, a key BR biosynthetic gene), BRASSINOSTEROID INSENSITIVE 1 (BRI1, aBR receptor) and BRASSINOSTEROID-SIGNALING KINASE 1 (BSK1, downstream of BRI1) also neutralised the ET-induced plant resistance to Pst DC3000. ET can induce callose deposition and reactive oxygen species (ROS) accumulation to resistPst DC3000, BRZ-treated and gene-silenced were completely eliminate this response. Our results suggest BR is involved in ET-induced plant resistance, the involvement of ET in plant resistance is possibly by the induction of callose deposition and ROS accumulation, in a BR-dependent manner.

LncRNA SNHG8 promotes the development and chemo-resistance of pancreatic adenocarcinoma

OBJECTIVE

The aim of this study was to investigate the role of small nucleolar RNA host gene 8 (SNHG8) in the pathogenesis of pancreatic adenocarcinoma and to explore the possible underlying mechanism.

PATIENTS AND METHODS

SNHG8 expression in 40 pairs of pancreatic adenocarcinoma tissues and para-cancerous tissues, as well as 10 normal pancreas tissues was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Survival analysis was conducted to explore the correlation between SNHG8 expression and the prognosis of pancreatic adenocarcinoma patients. After the transfection of SNHG8 siRNA into pancreatic adenocarcinoma cells, the proliferation and cell cycle were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Meanwhile, cell apoptosis was detected by flow cytometry and Western blot. The regulatory effect of SNHG8 on the chemo-sensitivity of pancreatic adenocarcinoma cells was assessed by CCK-8 assay.

RESULTS

The expression of SNHG8 in pancreatic adenocarcinoma tissues was significantly higher than that of para-cancerous tissues and normal pancreatic tissues. Pancreatic adenocarcinoma patients with higher expression of SHNG8 presented shorter overall survival than those with lower expression. Meanwhile, SNHG8 expression was correlated with tumor stage and differentiation level, whereas not correlated with age, sex, tumor location and lymph node metastasis of pancreatic adenocarcinoma patients. In vitro results showed that SNHG8 knockdown significantly decreased the proliferative ability, prolonged G0/G1 phase and increased the apoptosis of Hs766T and PANC-1 cells. Western blot results elucidated that SNHG8 knockdown remarkably downregulated the protein expression levels of cleaved caspase-3 and cleaved PARP in Hs766T and PANC-1 cells. In addition, SNHG8 significantly decreased the chemo-sensitivity of pancreatic adenocarcinoma cells.

CONCLUSIONS

SNHG8 is highly expressed in pancreatic adenocarcinoma tissues and is negatively correlated with its prognosis. Moreover, SNHG8 promotes cell proliferation and cell cycle, whereas inhibits cell apoptosis and reduces the chemo-sensitivity of pancreatic adenocarcinoma cells.

MicroRNAs in the Intestine: Role in Renewal, Homeostasis, and Inflammation

The mammalian intestine is not only an organ for food digestion and nutrient absorption but also an integral part of the immune and endocrine systems. The intestinal epithelium under stressful environments requires epithelial cells to rapidly elicit changes in gene expression patterns to regulate their survival, adapt to stress, and maintain epithelial homeostasis. Recently, miRNAs have emerged as a novel class of posttranscriptional gene regulators that are fundamentally involved in many aspects of intestinal epithelial differentiation, architecture, and barrier function. In this review, we highlight the critical roles of miRNAs in both the crypt-villus axis of cellular self-renewal and inflammation in the mammalian intestinal mucosa and their impact on the microbiota. We also discuss the functions of specific miRNAs within the intestine to better understand the cellular mechanisms that promote intestinal homeostasis, and the influence of dietary components in the regulation of endogenous miRNA in the study of nutrition and gene regulation in intestinal health.

Nuclear Dependence of the Transverse Single-Spin Asymmetry in the Production of Charged Hadrons at Forward Rapidity in Polarized p+p, p+Al, and p+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the nuclear dependence of transverse single-spin asymmetries (TSSAs) in the production of positively charged hadrons in polarized p^{↑}+p, p^{↑}+Al, and p^{↑}+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements have been performed at forward rapidity (1.4<η<2.4) over the range of transverse momentum (1.8<p_{T}<7.0  GeV/c) and Feynman x (0.1<x_{F}<0.2). We observed positive asymmetries for positively charged hadrons in p^{↑}+p collisions, and significantly reduced asymmetries in p^{↑}+A collisions. These results reveal a nuclear dependence of TSSAs for charged-hadron production in a regime where perturbative techniques are applicable. These results provide new opportunities to use p^{↑}+A collisions as a tool to investigate the rich phenomena behind TSSAs in hadronic collisions and to use TSSAs as a new handle in studying small-system collisions.

LncRNA KCNQ1OT1 controls cell proliferation, differentiation and apoptosis by sponging miR-326 to regulate c-Myc expression in acute myeloid leukemia

Long noncoding RNAs (lncRNAs) have been reported to play essential roles in development and treatment of acute myeloid leukemia (AML). However, the role of lncRNA potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1 (KCNQ1OT1) in AML progression and its mechanism remain largely unknown. The expressions of KCNQ1OT1, microRNA-326 (miR-326) and c-Myc were measured by quantitative real-time polymerase chain reaction and western blot, respectively. Phorbol myristate acetate (PMA) was used for cell differentiation. Cell proliferation, apoptosis and differentiation were measured by MTT assay, flow cytometry and qRT-PCR, respectively. The interaction between miR-326 and KCNQ1OT1 or c-Myc was explored by luciferase activity, RNA immunoprecipitation or RNA pull-down assay. We found that the expression of KCNQ1OT1 was enhanced in AML samples compared with control. KCNQ1OT1 knockdown inhibited cell proliferation but promoted apoptosis and cell differentiation. KCNQ1OT1 was a decoy of miR-326 and c-Myc was a target of miR-326. KCNQ1OT1 regulated AML cell proliferation, apoptosis and differentiation by sponging miR-326. Moreover, overexpression of miR-326 suppressed proliferation but promoted apoptosis and PMA-induced differentiation by targeting c-Myc in AML cells. Besides, c-Myc protein level was suppressed by KCNQ1OT1 interference and rescued by miR-326 abrogation. Our data showed that KCNQ1OT1 regulates proliferation, differentiation and apoptosis in AML cells by acting as a competing endogenous RNA (ceRNA) for miR-326 to regulate c-Myc, providing a novel avenue for AML treatment.

Minimally invasive non-surgical vs. surgical approach for periodontal intrabony defects: a randomised controlled trial

Background

Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects.

Methods

This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25–70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 ‘intrabony defect’ with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes.

Discussion

This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures.

Trial registration

ClinicalTrials.gov, NCT03797807. Registered on 9 January 2019.

Beam Energy and Centrality Dependence of Direct-Photon Emission from Ultrarelativistic Heavy-Ion Collisions

The PHENIX collaboration presents first measurements of low-momentum (0.4<p_{T}<3  GeV/c) direct-photon yields from Au+Au collisions at sqrt[s_{NN}]=39 and 62.4 GeV. For both beam energies the direct-photon yields are substantially enhanced with respect to expectations from prompt processes, similar to the yields observed in Au+Au collisions at sqrt[s_{NN}]=200. Analyzing the photon yield as a function of the experimental observable dN_{ch}/dη reveals that the low-momentum (>1  GeV/c) direct-photon yield dN_{γ}^{dir}/dη is a smooth function of dN_{ch}/dη and can be well described as proportional to (dN_{ch}/dη)^{α} with α≈1.25. This scaling behavior holds for a wide range of beam energies at the Relativistic Heavy Ion Collider and the Large Hadron Collider, for centrality selected samples, as well as for different A+A collision systems. At a given beam energy, the scaling also holds for high p_{T} (>5  GeV/c), but when results from different collision energies are compared, an additional sqrt[s_{NN}]-dependent multiplicative factor is needed to describe the integrated-direct-photon yield.

Elastocapillary self-assembled neurotassels for stable neural activity recordings

Implantable neural probes that are mechanically compliant with brain tissue offer important opportunities for stable neural interfaces in both basic neuroscience and clinical applications. Here, we developed a Neurotassel consisting of an array of flexible and high-aspect ratio microelectrode filaments. A Neurotassel can spontaneously assemble into a thin and implantable fiber through elastocapillary interactions when withdrawn from a molten, tissue-dissolvable polymer. Chronically implanted Neurotassels elicited minimal neuronal cell loss in the brain and enabled stable activity recordings of the same population of neurons in mice learning to perform a task. Moreover, Neurotassels can be readily scaled up to 1024 microelectrode filaments, each with a neurite-scale cross-sectional footprint of 3 × 1.5 μm², to form implantable fibers with a total diameter of ~100 μm. With their ultrasmall sizes, high flexibility, and scalability, Neurotassels offer a new approach for stable neural activity recording and neuroprosthetics.

The potential of cadmium ion-immobilized Rhizobium pusense KG2 to prevent soybean root from absorbing cadmium in cadmium-contaminated soil

AIMS

Because the effect of Cd2+ -immobilized microbe on Cd uptake of plants in Cd-contaminated soil remains underexplored, this study focuses on the effect of Cd2+ -immobilized rhizobia on Cd uptake of soybean.

METHODS AND RESULTS

Strain KG2 from soybean nodule was identified as Rhizobium pusense KG2 by phylogenetic analysis. Rhizobium pusense KG2 showed the 120 mg l-1 of minimal lethal concentration for Cd2+ . In 50 and 100 mg l-1 of Cd2+ liquid, approximately 2 × 1010 cells removed 56·71 and 22·11% of Cd2+ , respectively. In pot soil containing 50 and 100 mg kg-1 of Cd2+ , strain KG2 caused a 45·9 and 35·3% decrease in soybean root Cd content, respectively. Meanwhile, KG2 improved the root and shoot length, nitrogen content and biomass of soybean plants and superoxide dismutase activity.

CONCLUSIONS

The Cd2+ -immobilized rhizobia could inhibit soybean plants to absorb Cd2+ from soil, promote plant growth and improve plant's tolerance against Cd. This study is the first time to report that R. pusense is an effective nodulating rhizobium of legume.

SIGNIFICANCE AND IMPACT OF THE STUDY

Some Cd2+ -immobilized microbe lowering Cd uptake of plant and promoting plant growth should be considered as an effective strategy for producing safety crops in the Cd-contaminated agricultural soil.