SIRT3-dependent mitochondrial redox homeostasis mitigates CHK1 inhibition combined with gemcitabine treatment induced cardiotoxicity in hiPSC-CMs and mice

Administration of CHK1-targeted anticancer therapies is associated with an increased cumulative risk of cardiac complications, which is further amplified when combined with gemcitabine. However, the underlying mechanisms remain elusive. In this study, we generated hiPSC-CMs and murine models to elucidate the mechanisms underlying CHK1 inhibition combined with gemcitabine-induced cardiotoxicity and identify potential targets for cardioprotection. Mice were intraperitoneally injected with 25 mg/kg CHK1 inhibitor AZD7762 and 20 mg/kg gemcitabine for 3 weeks. hiPSC-CMs and NMCMs were incubated with 0.5 uM AZD7762 and 0.1 uM gemcitabine for 24 h. Both pharmacological inhibition or genetic deletion of CHK1 and administration of gemcitabine induced mtROS overproduction and pyroptosis in cardiomyocytes by disrupting mitochondrial respiration, ultimately causing heart atrophy and cardiac dysfunction in mice. These toxic effects were further exacerbated with combination administration. Using mitochondria-targeting sequence-directed vectors to overexpress CHK1 in cardiomyocyte (CM) mitochondria, we identified the localization of CHK1 in CM mitochondria and its crucial role in maintaining mitochondrial redox homeostasis for the first time. Mitochondrial CHK1 function loss mediated the cardiotoxicity induced by AZD7762 and CHK1-knockout. Mechanistically, mitochondrial CHK1 directly phosphorylates SIRT3 and promotes its expression within mitochondria. On the contrary, both AZD7762 or CHK1-knockout and gemcitabine decreased mitochondrial SIRT3 abundance, thus resulting in respiration dysfunction. Further hiPSC-CMs and mice experiments demonstrated that SIRT3 overexpression maintained mitochondrial function while alleviating CM pyroptosis, and thereby improving mice cardiac function. In summary, our results suggest that targeting SIRT3 could represent a novel therapeutic approach for clinical prevention and treatment of cardiotoxicity induced by CHK1 inhibition and gemcitabine.

[Comparison of three different measurement methods to determine resting energy expenditure in patients with decompensated hepatitis B cirrhosis]

Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People's Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.

[Treatment of oligoprogression to immunotherapy resistance in advanced non-small cell lung cancer]

In recent years, the incidence of lung cancer has been increasing year by year. Traditional treatments have limited clinical effects in advanced, driver-gene-negative non-small cell lung cancer. Immune checkpoint inhibitors (ICI) have dramatically changed the treatment landscape of advanced non-small cell lung cancer. However, most patients are suffered from primary and acquired resistance inevitably. Oligoprogression is one of the main progression patterns of acquired resistance. Therefore, it is essential to further understand treatment of oligoprogression to immunotherapy resistance. This article aimed to conduct a systematic review of the treatment of oligoprogression to immunotherapy resistance.

[Status and related factors on the drinking behavior among primary and secondary students in China rural middle and western regions in 2019]

Objective: To analyze the daily drinking behavior and related factors of primary and middle school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) pilot regions. Methods: Multi-stage stratified random cluster sampling method was used to select one to three national pilot counties in 22 provinces in central and western China where the NIPRCES was implemented in 2019. According to different feeding patterns, two primary schools and two middle schools were selected as key monitoring schools. One or two classes were selected from grade 3 to grade 9. The student questionnaire was used to collect the basic information and daily drinking behavior. Taking whether the drinking water ≥5 cups every day as the dependent variable, multivariate logistic regression model was used to analyze the related factors of drinking behavior among students. Results: A total of 27 374 students were included. On average, primary and middle school students in the regions where NIPRCES was implemented had 3.9 cups of water every day. Logistic regression model showed that boys (OR=1.230, P<0.001), primary school students (OR=1.379, P<0.001), father worked outside the home (OR=1.169, P<0.001), both parents worked outside the home (OR=1.228, P<0.001), non-resident students (OR=1.142, P<0.001), the school in the village (OR=1.638, P<0.001) or township (OR=1.358, P<0.001), school feeding (OR=1.252, P<0.001), the school building with flush toilets (OR=1.384, P<0.001) and the central regions (OR=1.300, P<0.001) students were more likely to drink ≥5 cups water every day. Conclusion: The water consumption of primary and middle school students in the pilot regions of NIPRCES is low, and their drinking behaviors are affected by many factors.

[Advances of tight junction damage in the corneal epithelial barrier in the pathogenesis of corneal diseases]

The cornea is a transparent tissue with significant refractive and barrier functions. Corneal epithelium constitutes the first line of defense against foreign pathogens. Corneal epithelial cells interact to form a functionally selective permeability barrier. Dysfunction of this barrier leads to corneal impairment followed by a series of ocular surface diseases and even blindness. Tight junctions (TJ), located at the top of the intercellular space of corneal epithelial superficial cells, play a critical role in establishing and maintaining the barrier function. Previous studies have shown that destruction of the TJ acts as a crucial step of the occurrence and progression of multiple ocular surface diseases. Understanding the fundamental features and functions of the TJ, noticing the risk factors of TJ disruption, and clarifying the key role of TJ in the pathogenesis of various ocular surface diseases will help to better understand and treat ocular surface diseases.

[Overweight and obesity status and its associated factors among primary and secondary school students in China rural middle and western regions]

Objective: To analyze the overweight and obesity status of students in the national pilot counties of the Nutrition Improvement Program for Rural Compulsory Education Students in 2019 and its associated factors. Methods: In 2019, a multi-stage cluster random sampling method was used to select about 40 students from each grade in primary and secondary schools in China's central and western regions where the Nutrition Improvement Program for Rural Compulsory Education Students was implemented. The height and weight of the children were measured using height or weight scales. The school questionnaire and county questionnaire were used to investigate the associated factors. A Chi-square test was used for comparison between groups. The logistic regression analysis was used to analyze the associated factors. Results: In 2019, the prevalence of overweight and obesity among rural primary and secondary school students aged 6-15 years in central and western China 2019 was 11.5%. It was higher for boys (13.1%) than that for girls (9.8%), higher in central (14.3%) than that in the west (9.9%) and higher for elementary school students (12.4%) than that for secondary school students (9.5%, all P<0.001). The logistic regression showed that boys (OR=1.388), primary school students (OR=1.271), students without other dietary subsidies(OR=1.037), schools in rural areas (OR=1.133), schools with enterprise-based feeding mode (OR=1.043), schools without the provision of lunch (OR=1.143), schools without the provision of dinner (OR=1.122), and schools without providing drinking water (OR=1.015) were positively associated with overweight and obesity among students (P<0.05). Schools with snack shops (OR=0.952) were negatively associated with overweight and obesity among students (P<0.001). Conclusion: A certain proportion of primary and secondary school students in rural areas of central and western China are overweight and obese. The prevalence is not only related to children's gender, school section and county area but also related to school meals, whether schools provide drinking water and other factors.

Therapeutic lumbar puncture and lumbar drainage: which is more effective for the management of intracranial hypertension in HIV patients with cryptococcal meningitis? Results of a prospective non-randomized interventional study in China

OBJECTIVE

This study aimed to evaluate the effectiveness of therapeutic lumbar drainage (LD) compared to therapeutic lumbar puncture (LP) for the management of intracranial hypertension (ICH) among HIV-positive patients with cryptococcal meningitis (CM).

METHODS

The study was a multicenter prospective non-randomized interventional clinical trial. One hundred and sixteen HIV-associated CM patients were identified who presented with ICH (≥250 mmH₂O). The LP group comprised 76 cases, while the LD group consisted of 40 cases. We compared mortality, intracranial pressure (ICP) normalization rate, and clinical symptom remission at 10 weeks, between the two groups.

RESULTS

The cumulative mortality at week 10 was 22.4% in the LP group and 20% in the LD group (p = .927), without any significant difference in mortality between the two groups. Improvement after treatment at 2-weeks, ICP normalization, and headache reversal event occurrence in the two groups showed no significant difference (p > .05). The incidence of CSF Cryptococcus clearance at two weeks in the LD group was significantly higher than in the LP group (p < .05). The frequency of invasive lumbar therapeutic procedures in the LP group during the first week was higher than that of the LD group (p < .05). Localized infection at the puncture site occurred more frequently in the LD group than in the LP group (p < .05).

CONCLUSION

For HIV-positive CM patients with an elevated ICP, LD and LP are comparably effective and safe options to normalize ICP. LP increases the frequency of invasive lumbar therapeutic procedures but does not incur more risk of infection events at the puncture site, while LD may accelerate CSF Cryptococcus clearance but may induce more frequent localized infection.

TRIAL REGISTRATION

This study was registered as one of 12 trials under a general project at the Chinese Clinical Trial Registry (ChiCTR1900021195).

[Anemia prevalence and its influencing factors among students involved in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze anemia prevalence and its influencing factors of students involved in the Nutritional Improvement Program for Rural Compulsory Education Students in 2019. Methods: From the 2019 surveillance system of the Nutrition Improvement Program for Rural Compulsory Education Students, 47 297 primary and middle school students aged 6-17 were included in the study. Hemoglobin level was tested according to the criteria of WHO 2011. Anemia prevalence of different genders, ages, and regions was analyzed. Results: The average hemoglobin level was 135.19 g/L, with the prevalence of anemia as 8.7% in the children aged 6-17. The prevalence of anemia was 10.0% in girls, higher than that in boys (7.4%). The prevalence rates in western and central areas were 9.8% and 7.1%, respectively. From northwest, southwest, central and south, east, north to northeast areas of China, the anemia rate appeared gradually decreasing (10.2%, 9.7%, 8.3%, 7.5%, 5.7% and 3.5%). The anemia prevalence rates were 8.0%, 8.3%, and 10.9% in children from the 6-, 11-, and 14-17 years age groups, respectively. Logistic regression models revealed that students from schools not using catering software (OR=1.482, 95%CI:1.296-1.694,P<0.001), schools not serving lunch (OR=1.241, 95%CI:1.103-1.395,P<0.001), and from relatively low-income families (OR=1.297, 95%CI:1.211-1.389, P<0.001) showed as risk factors for anemia. After supplementing students' dietary factors, the results showed that students who ate meat three or more times a week had a lower risk of anemia (OR=0.907, 95%CI:0.832-0.989, P=0.026). Conclusions: The Nutritional Improvement Program for Rural Compulsory Education Students had an essential impact on improving the anemia prevalence of primary and middle school students. Family income, school location, economic factors, school feeding, and students' diet programs all impacted the prevalence of anemia.

[Growth retardation of children and its influencing factors in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To understand the growth retardation among primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students and its influencing factors to provide evidence for improving the nutrition status of rural students in China. Methods: The multi-stage cluster random sampling method selected 1 550 969 primary and secondary school students aged 6-15 years from China's central and western regions. The ratio of male and female students was balanced. The height was measured, and the growth retardation of students was determined according to the Screening Criteria for School-age Children and Adolescents malnutrition (WS/T 456-2014), from the school and county questionnaire survey related factors. The number of cases and percentages described the growth retardation of students, and the χ² test was used for comparison between groups. Binary logistic regression was used to analyze students' growth retardation factors. Results: In 2019, the growth retardation rate of primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students was 5.7% (88 631/1 550 969), the growth retardation rate in the western part (7.1%, 66 167/927 954) was higher than that in the central part (3.7%,19 511/533 973) with difference statistically significant (P<0.001). The growth retardation rate of the boys (6.3%,50 665/803 851) were higher than that of girls (5.1%, 37 966/747 118), the difference was statistically significant (P<0.001). The growth retardation rate of primary school students in central China was 3.9%(14 914/380 598), higher than that of junior middle school students (3.0%,4 597/153 375, P<0.001). In contrast, the growth retardation rate of the western junior high school students (7.2%, 21 494/297 217) were higher than that of elementary school students (7.1%, 44 673/630 737), with a difference statistically significant (all P=0.009). Multi-factor logistic regression results showed that, in high income area (OR=0.829, 95%CI: 0.816-0.842, P<0.001), parents providing part of the meal cost (OR=0.948, 95%CI: 0.931-0.965, P<0.001), enterprises providing meals (OR=0.845, 95%CI: 0.805-0.887, P<0.001), schools providing milk (OR=0.780, 95%CI: 0.767-0.793, P<0.001), health education courses (OR=0.702, 95%CI: 0.682-0.723, P<0.001) and other local nutrition improvement efforts (OR=0.739, 95%CI: 0.720-0.758, P<0.001) were negatively correlated with the occurrence of growth retardation, The growth retardation rate of the students was lower. Conclusions: There appeared significant regional, gender, and age differences in the growth retardation rate of primary and middle school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students. Appropriate food supply in schools, health education courses, and parental participation in nutritional improvement was related to children's lower growth retardation rate.

[Status and influencing factors on the leftover school meals among students the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze the situation and influencing factors of school meals leftover among primary and secondary school students in the area of the Nutrition Improvement Program for Rural Compulsory Education Students, improve the quality of school meals, develop healthy dietary behavior, and reduce food waste. Methods: In 2019, among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns.This study randomly selected one or two classes from grade 3 to grade 9. Basic information and school meals of 26 778 students were collected by using a student questionnaire. Multivariate logistic regression was used to analyze the influencing factors of leftovers rate. Results: 54.93% (14 709) of students wasted school meals, in which the highest rate was the staple food, with the main reason as "not in favor". 11.87% (1 743) of the students wasted school meals 6-7 days a week, with 54.20% (7 957) of students wasted but in less amount. The leftover rate of staple food was the highest (29.78%), followed by vegetables and meat. The main reason of leftovers was that they didn't like this kind of food (33.52%). The rate of school meal waste was higher for girls (OR=1.19,95%CI:1.13-1.25), junior high school students (OR=1.17, 95%CI: 1.11-1.25), resident students (OR=1.06, 95%CI: 1.00-1.12), lower economic level (OR=1.06, 95%CI: 1.00-1.12), parents working outside their houses (OR=1.22, 95%CI: 1.13-1.30), health education classes (OR=1.70, 95%CI: 1.40-2.06), company-based meals (OR=1.89, 95%CI: 1.71-2.07) and school meals were not as good as home food(OR=1.89, 95%CI: 1.78-2.00)(P<0.05). Conclusions: It is common for poor rural primary and middle school students in central and western China to waste school meals, and the reasons were affected by many factors. Reducing food waste requires the joint efforts of individuals, families, schools and society.

[Research advances in contact lens-associated dry eye]

Dry eye is the most common disease in ophthalmic clinics besides refractive error, which seriously affects the life quality of patients and has become an important public health problem in China. Dry eye as a kind of multifactorial disease can be induced or accelerated by contact lens wear, which is considered as one of the risk factors of dry eye. Studies have shown that the incidence of dry eye is higher in contact lens wearers than in normal people. In 2017, the Tear Film and Ocular Surface Society included contact lens-associated dry eye (CLADE) in the iatrogenic dry eye for the first time, and its importance is evident. However, ophthalmologists mostly used to focus on serious complications such as keratitis caused by contact lens wear, and CLADE has not been well valued and understood. This article reviews the latest studies on the epidemiology, pathogenesis, diagnosis, prevention, and treatment of CLADE.

The Effect of Early vs. Deferred Antiretroviral Therapy Initiation in HIV-Infected Patients With Cryptococcal Meningitis: A Multicenter Prospective Randomized Controlled Analysis in China

Background: The optimal timing for initiation of antiretroviral therapy (ART) in HIV-positive patients with cryptococcal meningitis (CM) has not, as yet, been compellingly elucidated, as research data concerning mortality risk and the occurrence of immune reconstitution inflammatory syndrome (IRIS) in this population remains inconsistent and controversial. Method: The present multicenter randomized clinical trial was conducted in China in patients who presented with confirmed HIV/CM, and who were ART-naïve. Subjects were randomized and stratified into either an early-ART group (ART initiated 2-5 weeks after initiation of antifungal therapy), or a deferred-ART group (ART initiated 5 weeks after initiation of antifungal therapy). Intention-to-treat, and per-protocol analyses of data for these groups were conducted for this study. Result: The probability of survival was found to not be statistically different between patients who started ART between 2-5 weeks of CM therapy initiation (14/47, 29.8%) vs. those initiating ART until 5 weeks after CM therapy initiation (10/55, 18.2%) (p = 0.144). However, initiating ART within 4 weeks after the diagnosis and antifungal treatment of CM resulted in a higher mortality compared with deferring ART initiation until 6 weeks (p = 0.042). The incidence of IRIS did not differ significantly between the early-ART group and the deferred-ART group (6.4 and 7.3%, respectively; p = 0.872). The percentage of patients with severe (grade 3 or 4) adverse events was high in both treatment arms (55.3% in the early-ART group and 41.8% in the deferred-ART group; p=0.183), and there were significantly more grade 4 adverse events in the early-ART group (20 vs. 13; p = 0.042). Conclusion: Although ART initiation from 2 to 5 weeks after initiation of antifungal therapy was not significantly associated with high cumulative mortality or IRIS event rates in HIV/CM patients compared with ART initiation 5 weeks after initiation of antifungal therapy, we found that initiating ART within 4 weeks after CM antifungal treatment resulted in a higher mortality compared with deferring ART initiation until 6 weeks. In addition, we observed that there were significantly more grade 4 adverse events in the early-ART group. Our results support the deferred initiation of ART in HIV-associated CM. Clinical Trials Registration: www.ClinicalTrials.gov, identifier: ChiCTR1900021195.

Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

Background

Cryptococcal meningitis (CM) remains a leading cause of death in HIV-infected patients, despite advances in CM diagnostic and therapeutic strategies. This study was performed with the aim to develop and validate a novel scoring model to predict mortality risk in HIV-infected patients with CM (HIV/CM).

Methods

Data on HIV/CM inpatients were obtained from a Multicenter Cohort study in China. Independent risk factors associated with mortality were identified based on data from 2013 to 2017, and a novel scoring model for mortality risk prediction was established. The bootstrapping statistical method was used for internal validation. External validation was performed using data from 2018 to 2020.

Results

We found that six predictors, including age, stiff neck, impaired consciousness, intracranial pressure, CD4⁺ T-cell count, and urea levels, were associated with poor prognosis in HIV/CM patients. The novel scoring model could effectively identify HIV/CM patients at high risk of death on admission (area under curve 0.876; p<0.001). When the cut-off value of 5.5 points or more was applied, the sensitivity and specificity was 74.1 and 83.8%, respectively. Our scoring model showed a good discriminatory ability, with an area under the curve of 0.879 for internal validation via bootstrapping, and an area under the curve of 0.886 for external validation.

Conclusions

Our developed scoring model of six variables is simple, convenient, and accurate for screening high-risk patients with HIV/CM, which may be a useful tool for physicians to assess prognosis in HIV/CM inpatients.

[Anatomical limits of distal displacement of bony maxillary molars in patients with skeletal Class Ⅱ malocclusion]

PURPOSE

To compare the posterior space of the maxillary molar with osseous dislocation and investigate the retromolar space available for molar distalization in patients with maxillary prognathism.

METHODS

Cone-beam CT (CBCT) data of 136 posterior maxillary segments in 32 patients with skeletal Class I malocclusion and 36 patients with skeletal Class Ⅱ malocclusion were analyzed. The functional tip of the maxillary first and second molars was connected as the measuring reference line, the reference plane for measurement parallel to the reference line, which passed the furcation of the mandibular second molar root, was set as the "0 mm" plane. Four additional planes, which were parallel to the 0 mm-plane and located at 2, 4, 6 mm apical to the 0 mm-plane, cemento-enamel junction (CEJ) and root tip, were named the"2 mm, 4 mm, 6 mm, CEJ and TIP", in order to measure the distance from the maxillary second molar to maxillary tubercle bone cortex in the edge. SPSS 23.0 software package was used to analyze the data.

RESULTS

At all levels of measurement, the retromolar space of the values in male and female patients was not significantly different, ClassⅡ malocclusion were significantly greater than those in ClassⅠmalocclusion, with the minimum values at the CEJ level, (4.18±1.40) and (5.12±2.16) mm, respectively. As the measured level moved up, the measured clearance value increased and reached the maximum at the root tip, which was (8.64±2.41) and (10.02±2.27) mm, respectively.

CONCLUSIONS

Compared with ClassⅠmalocclusion, patients with ClassⅡmalocclusion have greater retromolar space for maxillary molar distalization along the posterior line of occlusion. More attention should be paid to the anatomical limit of maxillary second molar at the CEJ level along the bite line in the distal direction when maxillary molar is pushed backward.

Visual Analysis of the External Characteristics and Research Hotspots of Literatures in International Forensic Science

Abstract

Objective To analyze the forensic science-related literature included in the Web of Science database in the recent decade through bibliometric methods, to provide reference for relevant research. Methods Literatures were searched in 3 ways： Subject search, Journal search and Institution search. The annual distribution, national （regional） distribution, institution distribution, journal distribution and the research hotspots of the related literatures were analyzed through Thomson Data Analyzer （TDA）, Ucinet, VOSviewer, and so on. Results A total of 49 469 related literatures were included in the recent decade. The number of literatures continued to climb year by year. The top 15 countries （regions） accounted for 78.52% of the total number of published literatures, and China ranked 5th, but ranked 12th in terms of the proportion of high-cited papers; Netherlands, Switzerland, Australia, etc. had high comprehensive influence. The number of countries （regions） that cooperated with China were 129, including the United States, the United Kingdom and Germany. The Institute of Forensic Science of Saint Mary's University, University of Sydney and Netherlands Forensic Institute had high comprehensive influence, and the related literatures were published on 6 357 journals. According to high-frequency co-occurrence network and high-cited papers, brain injury, health policy, assessment scales and models and medical imaging were selected as research hotspots. Conclusion The total number of literatures in forensic science included in international SCI increased significantly, and the influence of China's achievements needs to be greatly enhanced; the research institutions were scattered, and China's research power needs to be continuously condensed; the research hotspots in international fields are extensive, and the international participation of China in top level research needs to be strengthened.

[Clinicopathological features of notochordal tumors: a study of 48 cases]

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of notochordal tumors. Methods: The clinical, radiologic and pathologic data of 48 notochordal tumors were collected from 2008 to 2019 at Shanghai Jiaotong University Sixth People's Hospital. Expression of cytokertin, S-100 protein, vimentin, brachyury and INI1 was detected by immunohistochemistry. The pathologic differential diagnoses and biologic behavior of various types of notochordal tumors were analyzed using the new standard in the 5th edition of WHO tumor classification. Results: Four cases of benign notochordal cell tumor were confined to vertebral body. Histopathologically, they lacked lobular architecture and extracellular myxoid matrix. The tumor cells were vacuolated and had centrally or peripherally located round to oval nuclei, with small nucleoli, without atypia, mimicking mature adipocytes. No mitotic figures were seen. Two cases of poorly differentiated chordoma, from patients aged 12 years and 21 years respectively, were located in cervical vertebra, and were composed of cohesive sheets or nests of epithelioid cells, with focal rhabdoid morphology. There was relatively abundant eosinophilic cytoplasm and scattered cytoplasmic vacuoles. The moderately pleomorphic nuclei were round to ovoid with vesicular chromatin and mitotic figures could be seen. Extracellular myxoid stroma was observed focally. Forty cases of conventional chordoma and two cases of extra-axis chordoma had similar histologic features. All 48 cases expressed cytokeretin, 45 cases expressed brachyury, and two poorly differentiated tumors showed loss of INI1/SMARCB1. Conclusions: There are four subtypes of chordomas: conventional, dedifferentiated, poorly differentiated and extra-axis. Chondroid chordoma is no longer thought to be a distinct entity. Each type has its unique clinicopathological characteristics. Brachyury is highly specific and sensitive for the diagnosis of various notochordal tumors. Poorly differentiated chordoma shows distinct clinicopathological features, including young age and loss of immunohistochemical expression of INI1/SMARCB1, and its diagnosis requires the combined detection of brachyury and INI1/SMARCB1.

Virtual Histology of Cortical Thickness and Shared Neurobiology in 6 Psychiatric Disorders

IMPORTANCE

Large-scale neuroimaging studies have revealed group differences in cortical thickness across many psychiatric disorders. The underlying neurobiology behind these differences is not well understood.

OBJECTIVE

To determine neurobiologic correlates of group differences in cortical thickness between cases and controls in 6 disorders: attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and schizophrenia.

DESIGN, SETTING, AND PARTICIPANTS

Profiles of group differences in cortical thickness between cases and controls were generated using T1-weighted magnetic resonance images. Similarity between interregional profiles of cell-specific gene expression and those in the group differences in cortical thickness were investigated in each disorder. Next, principal component analysis was used to reveal a shared profile of group difference in thickness across the disorders. Analysis for gene coexpression, clustering, and enrichment for genes associated with these disorders were conducted. Data analysis was conducted between June and December 2019. The analysis included 145 cohorts across 6 psychiatric disorders drawn from the ENIGMA consortium. The numbers of cases and controls in each of the 6 disorders were as follows: ADHD: 1814 and 1602; ASD: 1748 and 1770; BD: 1547 and 3405; MDD: 2658 and 3572; OCD: 2266 and 2007; and schizophrenia: 2688 and 3244.

MAIN OUTCOMES AND MEASURES

Interregional profiles of group difference in cortical thickness between cases and controls.

RESULTS

A total of 12 721 cases and 15 600 controls, ranging from ages 2 to 89 years, were included in this study. Interregional profiles of group differences in cortical thickness for each of the 6 psychiatric disorders were associated with profiles of gene expression specific to pyramidal (CA1) cells, astrocytes (except for BD), and microglia (except for OCD); collectively, gene-expression profiles of the 3 cell types explain between 25% and 54% of variance in interregional profiles of group differences in cortical thickness. Principal component analysis revealed a shared profile of difference in cortical thickness across the 6 disorders (48% variance explained); interregional profile of this principal component 1 was associated with that of the pyramidal-cell gene expression (explaining 56% of interregional variation). Coexpression analyses of these genes revealed 2 clusters: (1) a prenatal cluster enriched with genes involved in neurodevelopmental (axon guidance) processes and (2) a postnatal cluster enriched with genes involved in synaptic activity and plasticity-related processes. These clusters were enriched with genes associated with all 6 psychiatric disorders.

CONCLUSIONS AND RELEVANCE

In this study, shared neurobiologic processes were associated with differences in cortical thickness across multiple psychiatric disorders. These processes implicate a common role of prenatal development and postnatal functioning of the cerebral cortex in these disorders.

Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis

BACKGROUND

This study aims to evaluate specific risk factors influencing prognosis of HIV-infected patients with toxoplasma encephalitis (TE) in order to develop a prognostic risk scoring system for them.

METHODS

This is a six-center retrospective study of hospitalized HIV/TE patients. Data including six-week mortality after diagnosis, baseline characteristics, clinical features, laboratory tests and radiological characteristics of eligible patients were assimilated for risk model establishing.

RESULTS

In this study, the six-week mortality among 94 retrospective cases was 11.7% (11/94). Seven specific risk factors, viz. time from symptom onset to presentation, fever, dizziness, CD4+ T-cell counts, memory deficits, patchy brain lesions, and disorders of consciousness were calculated to be statistically associated with mortality. A criterion value of '9' was selected as the optimal cut-off value of the established model. The AUC of the ROC curve of this scoring model was 0.976 (p < 0.001). The sensitivity and specificity of the risk scoring model was 100.0 and 86.9%, respectively, which were 81.8 and 94.1% of this scoring model in the verification cohort, respectively.

CONCLUSIONS

The developed scoring system was established with simple risk factors, which also allows expeditious implementation of accurate prognostication, and appropriate therapeutic interventions in HIV-infected patients with TE.

Progress in Research on Biomarkers of Post-Traumatic Epilepsy

Abstract

Post traumatic epilepsy （PTE） is a serious complication of traumatic brain injury and a difficult problem in forensic justice practice. In recent years, many biomarkers have been applied to the diagnosis, treatment and prognosis of injuries and diseases. There have been many studies on the biomarkers of PTE in the field of epilepsy. This paper reviews the progress in research on biomarkers of PTE in recent years in order to provide reference for the forensic identification of PTE.

[Analysis on drug resistance-associated mutations of multi-drug resistant Mycobacterium tuberculosis based on whole-genome sequencing in China]

Objective: To analyze the resistance mutational profiles of multi-drug resistant Mycobacterium tuberculosis in China and the correlation between major mutation types and genotypes based on the whole-genome sequencing data. Methods: Search and download of the genome-wide sequencing data of M. tuberculosis published in China by August 2019 on NCBI database were conducted. Mutation frequency of drug resistance-related gene loci based on whole-genome sequencing was used to predict the molecular susceptibility of strains, and the correlation between mutation types and genotypes was analyzed. Results: According to the results of molecular resistance and susceptibility profiles, 1 024 MDR strains were identified from 2 019 M. tuberculosis strains. The major mutation types of resistance-related genes to common drugs were katG S315T (73.2%, isoniazid), rpoB S450L (63.1%, rifampicin), rpsL K43R (70.0%, streptomycin), embB M306V (37.4%, ethambutol), pncA_promoter T (-11)C (7.9%, pyrazinamide), gyrA A90V (32.3%, fluoroquinolones), rrs A1401G (67.7%, second-line injection drugs), fabG1_promoter C (-15) T (87.0%, Ethionamide), folC I43T (30.4%, P-aminosalicylic acid). Among them, the frequencies of katG S315T, embB M306V, rpsL K43R, gyrA A90V in lineage 2 were significantly higher than those in lineage 4, and folC I43T was only found in lineage 2. The proportion of katG S315T was significantly higher in the ancient Beijing genotype compared to the modern genotype, in contrast, the proportion of rpsL K43R was significantly higher in modern Beijing genotype, the differences were significant (all P<0.05). Conclusions: The results showed the main mutation types of resistance-related genes of MDR strains to many commonly used anti-tuberculosis drugs in China based on whole-genome sequencing, providing a basis for the development of sensitive and specific rapid molecular detection methods. At the same time, it was also found that the major mutation types of MDR-related genes were related to the genotype of the strains.

P5396CRISPR/Cas9 mediated miR-29b editing restores muscle atrophy and exercise capacity in mice

Background

Muscle atrophy is the loss of skeletal muscle mass and strength in response to diversity catabolic stimuli, such as heart failure. At present, no effective treatment except exercise is validated on reducing multiple muscle atrophy clinically. We have recently reported that microRNA-29b (miR-29b) promotes multiple types of muscle atrophy.

Purpose

The goal of this study was to assess whether genome editing using a clustered regularly interspaced short palindromic repeat/Cas9 (CRISPR/Cas9) system can efficiently introduce loss-of-function mutations into the endogenous miR-29b in vivo and as a potential therapy by treating muscle atrophy.

Methods

We used lentivirus to express CRISPR-associated 9 and a CRISPR guide RNA targeting miR-29b. Mutagenesis rate of miR-29b and off-target mutagenesis were detected by T7 Endonuclease I (T7EI) Assay. The expression level of miR-29b were measured in vitro and vivo after administration of the virus by using qRT-PCR. After intramuscular administration of the virus, the angiotensin II (AngII), immobilization and denervation-induced muscle atrophy were performed. Then muscle function was assessed in exercise capacity, the appearance and weight of muscle, the size of the muscle fibers, molecular and cellular detection.

Results

Here, we report that CRISPR/Cas9 mediated genome editing through intramuscular administration efficiently targeting the biogenesis processing sites in pre-miR-29b. No off-target mutagenesis was detected in 10 selected sites. This CRISPR-based treatment resulted in decreased miR-29b levels specifically. In vivo, this CRISPR-based treatment could ameliorate the muscle atrophy induced by angiotensin II (AngII), immobilization and denervation via activation of PI3K-AKT-mTOR signaling pathway and protect against AngII-induced apoptosis in mice. Moreover, the exercise capacity is also significantly enhanced.

Conclusion

Our work establishes CRISPR/Cas9 based gene targeting on miRNA as a potential durable therapy for treatment of muscle atrophy and expands the strategies available interrogating miRNA function in vivo.

Acknowledgement/Funding

The grants from National Natural Science Foundation of China (81722008, 91639101 and 81570362 to JJ Xiao)

Effects of long-term exposure to tenofovir disoproxil fumarate-containing antiretroviral therapy on renal function in HIV-positive Chinese patients

BACKGROUND

The regimen containing tenofovir disoproxil fumarate (TDF)+lamivudine or emtricitabine + efavirenz remains the recommended first-line antiretroviral therapy (ART) by the WHO. Limited studies, however, have been conducted on the incidence of renal impairment among Chinese patients with long-term exposure to TDF-containing ART regimens.

METHODS

We retrospectively analyzed 269 eligible patients who had no comorbidities and received TDF-containing ART from July 2014 to April 2015. TDF-related renal impairment was defined as a decrease of eGFR by >25% from baseline or eGFR <90 ml/min/1.73 m². Decreased renal function was defined as a decrease of eGFR by > 10 mL/min/1.73 m² from baseline.

RESULTS

97.0% of study patients were male (median age 29, eGFR 124.0 ml/min/1.73 m²). After 168-week of ART, renal impairment occurred in 7 patients (2.7%). The incidence of decreased renal function was significantly higher at Week 168 compared with that observed at Week 12 (24.8% vs 3.7%, p < 0.001). In generalized estimating equation analysis, patients receiving ART for 144-week (aOR4.1, 95%CI 2.0-8.4) and 168-week (aOR8.4, 95%CI 4.2-16.4) were more likely to develop decreased renal function compared with those receiving ART for 12-week, so were the patients with a weight <58 kg (aOR2.3, 95%CI 1.2-4.3) and 58-66 kg (aOR2.0, 95%CI 1.0-3.8) compared to those with a weight ≥67 kg. At 168-week, 41.0% of 100 patients examined had elevated urine β2-microglobulin levels, which were negatively correlated with eGFR (r = -0.22, p = 0.02).

CONCLUSIONS

TDF-related renal impairment remained rare in HIV-positive Chinese patients with a median age of 29 years who had no comorbidities. A lower weight and duration of ART were associated with decreased renal function.

[The study of the value of H3F3A G34W immunohistochemical staining in the diagnosis of giant cell tumor of bone]

Objective: To investigate the diagnostic role of H3F3A G34W immunohistochemistry in giant cell tumor of bone. Methods: A total of 275 tumors were collected from 2016 to 2018 at Shanghai Jiaotong University Affiliated Sixth People's Hospital, including 136 giant cell tumors of bone, 31 general osteosarcomas, 3 osteoclast-rich osteosarcomas, 3 brown tumors, 34 chondroblastomas, 29 giant cell tumors of tendon sheath, 20 primary arteromatoid bone cysts and 19 non-ossifying fibromas. Results: Among the 136 cases of giant cell tumor of bone,82 patients were male and 54 were female. The age ranged from 15 to 72 years (median age 38 years). Nuclear positivity for H3F3A G34W was seen in 119/136(87.5%) giant cell tumors of bone and 1/31(3.2%) general osteosarcoma,while all osteoclast-rich osteosarcomas, brown tumors, chondroblastomas, giant cell tumors of tendon sheath, primary arteromatoid bone cysts and non-ossifying fibroma were negative. Conclusions: The monoclonal antibody against the G34W mutated site of H3F3A is a specific biomarker for giant cell tumor of bone and useful for the diagnosis and differential diagnosis of giant cell tumor of bone. Meanwhile,for those cases in which giant cell tumor of bone are diagnosed basing on clinical,pathologic and radiographic features but are negative for H3F3A G34W,should be tested for rare mutations or H3F3A wild type.

[Research Progress on Postmortem Interval Estimation by Vitreous Humor]

Postmortem interval （PMI） estimation is one of the most challenging problems in the field of forensic science. Vitreous humor is a hotspot which has been used for PMI estimation and postmortem chemical analysis in forensic pathology. In order to provide novel perspectives for the future research of PMI estimation using vitreous humor, the comparison between vitreous humor with other common body fluids, the effect of temperature on vitreous humor, vitreous humor detection method and data fitting method have been reviewed in this paper.

[Role of sleep apnea monitoring management platform in the treatment of patients with obstructive sleep apnea hypopnea syndrome]

Objective:To investigate the clinical significance and value of the sleep apnea monitoring management platform in the treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by comparing with the traditional continuous positive airway pressure (CPAP) card reader mode.Method:A total of 48 severe adult OSAHS patients from Department of Otorhinolaryngology Head and Neck Surgery-Sleep Medical Center of the Third People's Hospital of Honghe during the period of Nov. 2015 to Aug. 2016 were collected in this prospective study. All of them were diagnosed by PSG and treated with nasal continuous positive airway pressure. They were randomly divided into group A (n=24) and group B (n=24). Group A and B were treated with the traditional CPAP card reader mode and the sleep apnea monitoring management platform respectively. During the follow-up, the compliance, mean blood oxygen saturation, titration pressure, Epworth sleepiness scale after 1, 3, 6 and 12 month treatment were compared between two groups. Ttest was used to analyze the difference. Statistical significance was set at P <0.05.Result:Statistical analysis showed that there were significant difference in the compliance of using CPAP, mean blood oxygen saturation and Epworth sleepiness scale score between the two groups (P < 0.05), but the titration pressure had no difference between the two groups (P>0.05).Conclusion:Compared the sleep apnea monitoring management platform with traditional CPAP card reader mode in the treatment of OSAHS patients, the former could solve the problems during the CPAP use in time, improve the compliance of using CPAP, and which could increase the efficacy of CPAP. Thus, the sleep apnea monitoring management platform is of more clinical value and deserve promotion.

[Study on breakfast consumption of children aged from 6-17 in China in 2010-2012]

Objective: To investigate breakfast status and influencing factors among children aged 6-17 in China in 2010-2012. Methods: Data were collected from China National Nutrition and Health Surveillance in 2010-2012. By using multi-stage stratified sampling and population proportional stratified random sampling method, the research objects were 29 393 children, who aged 6 to 17 y from 150 sites in 31 provinces in mainland China. The information of breakfast frequency and the numbers of breakfast dinning out (in restaurant and at schools) in the past week with seven days were collected by questionnaire; and compared by different ages, genders and areas. Results: During the past week, 91.1% (26 776/29 393) of the children aged 6 to 17 y had their breakfast daily, and 94.6% (13 457/14 221) of children aged 6 to 11 y was higher than 87.8% (13 319/15 172) of children aged 12 to 17 y, the highest proportion of the children never eat breakfast (0 time in the past week) found in poor rural areas was 3.6% (189/5 261), the ratio of big cities, small-medium cities and normal rural areas was 1.1% (77/7 104), 0.6% (51/8 361), and 0.6% (54/8 667), respectively (P<0.001). The rate of boys and girls ate their breakfast daily in the past week were 91.3% (13 481/14 761), and 90.9% (13 295/14 632), respectively (P>0.05). Totally 42.2% (12 398/29 393) of children ate breakfast outside-home (the restaurant and the school) in the past week, the percentage of children aged 12 to 17 y and poor rural areas was higher, 50.9% (7 722/15 172), and 52.4% (2 756/5 261), respectively (P<0.001). 42.1% (6 208/14 761) boys and 42.3% (6 190/14 632) girls ate their breakfast outside-home (P>0.05). The place of most school-age children eat outside-home was school, the ratio was 32.2% (9 477/29 393). Conclusion: It was common for school-aged children in China to skip breakfast during their daily lives, especially in poor rural areas and older children, lots of school-aged children ate breakfast outside-home, and most of them ate breakfast in school.

[Repairmen of the rabbit's oral mucosa by tissue engineering technology]

Objective:This experiment proposed to complicate BMMSCs and PLLA/SF scaffolds, to study its repairing ability for rabbit oral mucosa wound, and try to evaluate the most potential mixed proportion of PLLA and SF for tissue engineering. Method:Separating,cultivating and identifying BMMSCs. Observing cell phenotype of BMMSCs after cultivating BMMSCs in P70S30 PLLA/SF scaffold for one week.Observing the structure change of BMMSCs and P70S30PLLA/SF scaffold complexes after oral mucosa transplantation experiment for a week；Comparing the wound healing rate of composite of BMMSCs and PLLA/SF scafold，PLLA/SF scaffold and nature repair. Result:①There wasn't a significant effect of PLLA/SF scaffold on cell phenotype of BMMSCs.②The wounds fused well with the oral mucosa transplanted composite of BMMSCs and P70S30 PLLA/SF scaffold after a week.③The healing rate of composite of BMMSCs and P70S30 scaffold was the highest.The average healing rate of composite of BMMSCs and P70S30 scaffold was 94.8%,whose difference was statistically significant compared with natural healing and pure scaffold(P<0.01). Conclusion:①The complex composed of BMMSCs and PLLA/SF scaffolds has the potential as an ideal scaffold for tissue engineering oral mucosa.②The complex composed of BMMSCs and P70S30 PLLA/SF scaffolds is the most beneficial to wound healing of oral mucosa,and has the greatest potential for constructing tissue engineering oral mucosa.

Peripheral telomere length and hippocampal volume in adolescents with major depressive disorder

Several studies have reported that adults with major depressive disorder have shorter telomere length and reduced hippocampal volumes. Moreover, studies of adult populations without major depressive disorder suggest a relationship between peripheral telomere length and hippocampal volume. However, the relationship of these findings in adolescents with major depressive disorder has yet to be explored. We examined whether adolescent major depressive disorder is associated with altered peripheral telomere length and hippocampal volume, and whether these measures relate to one another. In 54 unmedicated adolescents (13-18 years) with major depressive disorder and 63 well-matched healthy controls, telomere length was assessed from saliva using quantitative polymerase chain reaction methods, and bilateral hippocampal volumes were measured with magnetic resonance imaging. After adjusting for age and sex (and total brain volume in the hippocampal analysis), adolescents with major depressive disorder exhibited significantly shorter telomere length and significantly smaller right, but not left hippocampal volume. When corrected for age, sex, diagnostic group and total brain volume, telomere length was not significantly associated with left or right hippocampal volume, suggesting that these cellular and neural processes may be mechanistically distinct during adolescence. Our findings suggest that shortening of telomere length and reduction of hippocampal volume are already present in early-onset major depressive disorder and thus unlikely to be only a result of accumulated years of exposure to major depressive disorder.

Outbreak of extended-spectrum β-lactamase-producing Escherichia coli transmitted through breast milk sharing in a neonatal intensive care unit

BACKGROUND

Routine surveillance in a neonatal intensive care unit (NICU) showed an increased detection of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-E. coli) in August 2012, following nearly a year without detection.

AIM

To describe the investigation and interventions by a hospital infection control team of an outbreak of ESBL-E. coli in a NICU.

METHODS

Six neonates with positive cultures of ESBL-E. coli (five with respiratory colonization, one with a urinary tract infection), control infants who were negative for ESBL-E. coli during the study period, and mothers who donated their breast milk were included. A case-control study was performed to identify possible risk factors for positive ESBL-E. coli cultures and molecular typing of isolated strains by pulsed-field gel electrophoresis.

FINDINGS

The odds ratio for ESBL-E. coli infection after receiving shared unpasteurized breast milk during the study period was 49.17 (95% confidence interval: 6.02-354.68; P < 0.05). The pulsed-field gel electrophoresis pattern showed that all strains were identical, and the same pathogen was detected in freshly expressed milk of a particular donor. After ceasing the breast milk sharing, the outbreak was successfully terminated.

CONCLUSION

This outbreak indicates that contamination of milk packs can result in transmission of a drug-resistant pathogen to newborn infants. Providers of human breast milk need to be aware of the necessity for low-temperature pasteurization and bacterial cultures, which should be conducted before and after freezing, before prescribing to infants.

Abstract P6-10-05: First-line chemotherapy versus first-line endocrine therapy in hormone receptor positive HER2 negative patients with metastatic breast cancer in China: Results of the study of breast cancer group of the Chinese Society of Clinical Oncology (CSCO)

Background: The primary objective for metastatic breast cancer is to prolong the patients survival. So the appropriate choice of the first-line therapy strategy is very important. For the HR-positive metastatic breast cancer, we haven't strong data to head-to-head compare the chemotherapy with endocrine therapy as the first-line treatment.

Methods: Two hundreds patients with HR-positive metastatic breast cancer were enrolled at 47 cancer centers in China from 2009 to 2012. Investigators decided to give chemotherapy or endocrine therapy according to their clinical judgements. Chemotherapy and endocrine therapy regimens followed the NCCN guildline. All the patiens haven't take any treatment after relapse or metastasis. All the patients were estrogen- receptor positive and/or progesterone-receptor positive,HER2 negative. Chemotherapy or endocrine therapy was continued in the progressive disease(PD) or unacceptable toxicity. Primary endpoint was progression-free survival(PFS), second endpoints were time to failure(TTF), response rate.

Results: According to the investigator judgements, one hundred patient took chemotherapy(CT arm), another one hundreds patients took endocrine therapy(ET arm). Pt characteristics were balanced between the two arms: median age 49y/50y, median disease-free survival(DFS) 40m/30m, visceral/non-visceral metastatic 52%/40%. There was more patients with ≥2 metastatic sites in CT arm than ET arm (50% vs 32%). Following up to Dec 2012, reasons for early treatment discontinuation were : PD 25 pts, toxicity 38 pts in CT arm, PD 82 pts, toxicity 2 pts in ET ram. The median PFS was 52 weeks(95% CI 23.2-80.8 weeks) and 48 weeks(95% CI 38.9-57.0 weeks) for CT arm and ET arm(P = 0.589),respectively. The median TTF was 20 weeks and 48 weeks for CT arm and ET arm,respectively(P = 0.025). Response rate was 63% and 22% for CT arm and ET arm,respectively(P&lt;0.001). But clinical benefit rate(CR+PR+SD≥6months) was 67% and 69% for CT arm and ET arm,respectively(P = 0.333). Subgroup analysis showed TTF were 48 weeks in ET arm and 15 weeks in CT arm(p = 0.038) for patients who had more than 2 years DFS. TTF results also indicated significant difference in single metastatic site pts and non-visceral metastatic pts between two arms. ET arm was superior to CT arm.

Conclusions: Our results indicate first-line chemotherapy has higher response rate than first-line endocrine therapy for HR-positive meatstatic breast cancer, but chemotherapy has shorter maintaining therapy time. First-line endocrine therapy was more suitable than first-line chemotherapy for pts with DFS≥2y, single metastatic site and non-visceral metastatic.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-10-05.

Stimulatory effect of allantoin on imidazoline I₁ receptors in animal and cell line

Allantoin is known as the agonist of imidazoline receptor, especially the I₂ subtype. Effect of allantoin on imidazoline I₁ receptor (I₁R) relating to reduction of blood pressure and its merit in steatosis are still obscure. Also, farnesoid X receptor (FXR) plays an important role in lipid homeostasis related to I₁R activation. Thus, we administered allantoin into high fat diet (HFD)-fed mice showing hypertriglyceridemia and hypercholesterolemia. Allantoin significantly improved hyperlipidemia in HFD mice after 4 weeks of administration. Pretreatment with efaroxan, at a dose sufficient to inhibit I₁R activation, attenuated the action of allantoin. In addition, in cultured HepG2 cells, allantoin increased the expression of farnesoid X receptor (FXR). The allantoin-induced FXR expression was blocked by efaroxan. Similar changes were observed in the expressions of FXR-targeted genes. Otherwise, allantoin also lowered systolic blood pressure (SBP) in HFD mice that can be blocked by efaroxan. Taken together, allantoin has an ability to activate I₁R for improvement of metabolic disorders.

Improvement of hyperphagia by activation of cerebral I(1)-imidazoline receptors in streptozotocin-induced diabetic mice

Imidazoline I1-receptors (I1R) are known to regulate blood pressure and rilmenidine, an agonist, is widely used as antihypertensive agent in clinic. However, the role of I1R in feeding behavior is still unclear. In the present study, we used the agonist of I1R to investigate the effect on hyperphagia in streptozotocin (STZ)-induced diabetic mice. Rilmenidine decreased the food intake of STZ-diabetic mice in a dose-dependent manner. The reduction of food intake was abolished by pretreatment with efaroxan at the dose sufficient to block I1R. Intracerebroventricular (icv) administration of rilmenidine into STZ-diabetic mice also significantly reduced hyperphagia, which was reversed by icv administration of efaroxan. In addition, similar results were observed in STZ-diabetic mice, which received chronic treatment with rilmenidine 3 times daily (t.i.d.) for 7 days. Moreover, the hypothalamic neuropeptide Y (NPY) level was reduced by rilmenidine that was also reversed by pretreatment with efaroxan. In conclusion, the obtained results suggest that rilmenidine can decrease food intake in STZ-diabetic mice through an activation of I1R to lower hypothalamic NPY level.

Activation of imidazoline I-2B receptors by allantoin to increase glucose uptake into C₂C₁₂ cells

Allantoin, an active principle of the yam, belongs to the group of guanidinium derivatives and has been reported to lower plasma glucose in diabetic animals. Recent evidence indicates that activation of the imidazoline I(2B) receptor (I(2B)R) by guanidinium derivatives also increases glucose uptake; however, the effect of allantoin on I(2B)R is still unknown. Glucose uptake into cultured C₂C₁₂ cells was determined using 2-[¹⁴C]-deoxy-D-glucose as a tracer. The changes in 5'-AMP-activated protein kinase (AMPK) expression were also identified by Western blotting analysis. The allantoin-induced glucose uptake action was dose-dependently blocked by BU224, a specific I₂R antagonist, in C₂C₁₂ cells. Moreover, AMPK phosphorylation by allantoin was found to be dose-dependently increased in C₂C₁₂ cells using AICAR treatment as a reference. In addition, both actions of allantoin, the increases in glucose uptake and AMPK phosphorylation, were dose-dependently attenuated by amiloride in C₂C₁₂ cells. Moreover, compound C at concentrations sufficient to inhibit AMPK blocked the allantoin-induced glucose uptake and AMPK phosphorylation. Thus, we suggest that allantoin can activate I(2B)R to increase glucose uptake into cells, and propose I(2B)R as a new target for diabetic therapy.

Seasonal variation and health risk assessment of polycyclic aromatic hydrocarbons in Miaoli city, Taiwan

The ambient PAHs levels in the downtown area of a traditional small city were analyzed for winter and summer seasons. A total of 16 PAHs in gaseous and particulate phase were quantified. The average gaseous PAHs were 2,189 ± 1,194 and 623.8 ± 545.1 ng/m(3) in winter and summer seasons, respectively. For the PAHs in particulate phase, they were 40.32 ± 12.15 and 11.99 ± 5.63 ng/m(3) in winter and summer seasons, respectively. These values were comparable to those reported for large cities or even higher. The estimated BaPeq was 12.32 ± 6.34 ng/m(3). As low-molecular-weight PAHs primarily existed in gaseous phase, high-molecular-weight PAHs in particulate phase became a significant fraction of total particulate phase PAHs. Particulate phase PAHs was significantly inversely associated with the ambient temperature for each individual PAHs species. However, this relationship did not exist for high-molecular-weight PAHs in gaseous phase. The results indicated the photo-degradation of high-molecular-weight PAHs should warrant a further thoughtfully investigation.

Characteristics of polycyclic aromatic hydrocarbon emissions of particles of various sizes from smoldering incense

Release of polycyclic aromatic hydrocarbons (PAHs) in particles of various sizes from smoldering incenses was determined. Among the three types of incense investigated, yielding the total PAH emission rate and factor ranges for PM0.25 were 2,139.7-6,595.6 ng/h and 1,762.2-8,094.9 ng/g, respectively. The PM0.25/PM2.5 ratio of total PAH emission factors and rates from smoldering three incenses was greater than 0.92. This study shows that total particle PAH emission rates and factors were mainly <0.25 μm. Furthermore, the total toxic equivalency emission rates and factors of PAHs for PM0.25 were 241.3-469.7 and 198.8-576.2 ng/g from the three smoldering incenses. The benzo[a]pyrene accounted for 65.2%-68.0% of the total toxic equivalency emission factor of PM2.5 for the three incenses. Experimental results clearly indicate that the PAH emission rates and factors were influenced significantly by incense composition, including carbon and hydrogen content. The study concludes that smoldering incense with low atomic hydrogen/carbon ratios minimized the production of total polycyclic aromatic hydrocarbons of both PM2.5 and PM0.25.

AP2 protein expression as a diagnostic marker in soft tissue tumours

Purpose/Methods: The aP2 gene product (aP2 protein) is known to be expressed by preadipocytes and other immature fat cells in vitro. A mouse monoclonal antibody raised against an 18 amino acid segment of the aP2 protein was found to react with lipoblasts and fetal fat cells in paraffin sections of soft tissue tumours of adipose differentiation. In this immunohistochemical study, we have further examined the diagnostic utility of aP2 expression in distinguishing tumours of adipose differentiation from other benign and malignant soft tissue tumours.

Result and discussion aP2 was strongly expressed by lipoblasts in lipoblastomas and all types of liposarcoma as well as brown fat cells in hibernomas. Optimal conditions for immunohistochemical identification of lipoblasts in tumours of adipose differentiation was noted when the antibody was diluted 1:30 to 1:50. Small lipoblast-like fat cells in pleomorphic lipoma and spindle cell lipoma also showed variable staining for aP2 at this dilution of the antibody. Most benign and malignant soft tissue tumours were distinguished by their absence of staining for aP2 protein, but some cases of myxoma, malignant fibrous histiocytoma, synovial sarcoma and leiomyosarcoma contained tumour cells which reacted for aP2. aP2 protein expression is likely to prove a useful means of distinguishing lipoblasts in liposarcoma but it should be used as part of a tumour panel to exclude expression in other forms of mesenchymal tumour.

[The changes of palate cleft gap of complete unilateral cleft lip and palate infants before and after presurgical orthodontic and cheiloplasty]

OBJECTIVE

To study the changes of palate cleft gap of complete unilateral cleft lip and palate (UCLP) infants before and after presurgical orthodontic and cheiloplasty.

METHODS

The sample consisted of 18 complete UCLP infants who were treated using presurgical nasoalveolar molding (PNAM) appliance and cheiloplasty. The maxillary models were obtained at the initial visit, after PNAM treatment 1 month before cheiloplasty, and 2 months after cheiloplasty. The change of palate cleft gap were compared.

RESULTS

After PNAM treatment and cheiloplasty, the lip profile was obviously improved, cleft gap was reduced, and the height of ala nasi fornix was recovered.

CONCLUSION

PNAM treatment can improve the lip shape and nasal deformity degree of UCLP patient. The cleft gap and upper lip tension are reduced.

Opening of ATP-sensitive potassium channel by insulin in the brain-induced insulin secretion in Wistar rats

Cerebral insulin can regulate glucose homeostasis via activation of the parasympathetic nervous system, which results in the reduction of hepatic glucose output. However, the precise mechanism(s) through which cerebral insulin directly exerts an effect on insulin secretion remains unclear. In the present study, we found that cerebral administration of insulin caused an increase of plasma insulin concentration and a concomitant decrease in plasma glucose levels within one hour. These effects were blocked by vagotomy or intraperitoneal injection of 1,1-dimethyl-4-diphenylacetoxypiperidinium iodide, a specific M (3) antagonist. The mediating influence of parasympathetic activation can thus be considered. The adenosine triphosphate-sensitive potassium (K-ATP) channel is a key mediator of the cerebral action of insulin. The plasma glucose-lowering action of insulin was abolished by cerebral administration of glibenclamide or repaglinide at concentrations sufficient to block K-ATP channels. In conclusion, our findings suggest that cerebral insulin may induce insulin release by stimulating the opening of K-ATP channels, which in turn activate parasympathetic tone in pancreatic tissue.

[Two new compounds from Psoralea corylifolia L]

To study the chemical constituents of the fruits of Psoralea corylifolia L., the constituents were isolated and purified by chromatography. Two new compounds were isolated from the ethyl acetate-soluble fraction of the ethanol extract. On the basis of chemical and spectroscopic data 1D and 2D NMR, they were identified as 2-(3, 4-dihydroxyphenyl)-8, 8-dimethyl-8H-pyrano[2, 3-h]chromen-4-one (1) and 5-(2-hydroxyl-1-methyl)-ethyl-4, 5-dihydrofurano[2, 3-h](4'-hydroxyl-3', 5'-dimethoxy)-isoflavone (2), and named as coryfolia D and bavarigenin separately.

Determination of particulate-bound formaldehyde from burning incense by solid phase microextraction

This work studied the feasibility of using a solid phase microextraction (SPME) fiber for sampling and analysis of gaseous formaldehyde as well as particulate-bound formaldehyde from burning Chinese incense. The SPME fiber with PDMS/DVB coating were partially coated with o-(2,3,4,5,6-pentafluorobenzyl)-hydroxylamine hydrochloride (PFBHA), and used for sampling formaldehyde. The sampling rate for formaldehyde and its dependence on temperature, relative humidity and sampling time were observed. The same PFBHA treated fibers were, in parallel, exposed to incense burning smoke with pre-filtration and without pre- filtration for 0.5-1 min. The NIOSH method 2541 using an XAD-2 tube at a flow rate of 0.1 Lpm was also applied for sampling simultaneously. The results demonstrate that commercially available PDMS/DVB fibers partially coated with PFBHA are capable of sampling the gas phase of formaldehyde as well as particulate-bound formaldehyde. The determined level of formaldehyde was close to the result obtained by the NIOSH method 2541. However, a reduction of the fiber's formaldehyde loading capacity in the aerosol sampling in comparison with gas sampling was noticed. This indicates that the particulate characteristics, and their bound chemicals other than formaldehyde may influence the maximum loading capacity of formaldehyde, and some characteristic particulates in high concentrations may even deteriorate the fiber coating.

[Assessment of upper jaw extraction versus upper and lower jaw extraction treatment for class II division 1 malocclusion using peer assessment rating index]

OBJECTIVE

To assess the outcome of orthodontic treatment with upper jaw or upper and lower jaw extraction for Class II division 1 malocclusion using the peer assessment rating (PAR) index.

METHODS

28 patients with Class II division 1 were extracted two first premolars or second premolars of upper jaw, and 24 patients were extracted four premolars of upper and lower jaw N. The PAR was applied on pre-and post-orthodontic treatment dental casts for the fifty-two cases.

RESULTS

The upper and lower jaw extraction groups had significantly higher initial PAR scores and the weighted PAR total scores (P<0.05). Although significantly different before treatment, both groups were not statistically different after treatment (P>0.05).

CONCLUSION

The upper and lower jaw extraction cases showed more severe dental displacement. Both treatment can acquire successful results.

[Isolation and structure identification of a new isoflavone from Psoralea corylifolias]

AIM

To study the chemical constituents of the fruits of Psoralea corylifolia L.

METHODS

The constituents were separated and purified by column chromatography with normal phase silica gel and polyamide. Their structures were identified on the basis of physical and spectral data (MS, NMR, HMBC and HMQC).

RESULTS

Six compounds were isolated and identified as psoralen (1), isopsoralen (2), bavachalcone (3), psoralidin (4), daidzin (5) and bavadin (6).

CONCLUSION

Compound 6 is a new compound. Compound 5 was isolated from this plant for the first time.

Oral immunization with a live recombinant attenuated Salmonella typhimurium protects mice against Toxoplasma gondii

The natural site of infection for T. gondii is the mucosal surface of the intestine, so the protective immunity obtained after natural infection with T. gondii points to the importance of developing a vaccine that stimulates mucosal defences. In this study, an aroA- and aroD- attenuated strain of Salmonella typhimurium (BRD509) has been used to deliver the recombinant eukaryotic plasmid pSAG(1-2)/CTA2/B expressing a multi-antigenic gene encoding SAG1 and SAG2 of T. gondii linked to A2/B subunits of cholera toxin as a candidate oral T. gondii vaccine. Immunoblot analysis showed compound gene expression in HeLa cells in vitro and intragastric immunization of mice with the recombinant salmonella resulted in the induction of humoral and Th1 type cellular immune responses and afforded protection against RH strain T. gondii challenge. Anti-T. gondii IgG values increased markedly in the BRD509/pSAG(1-2)-CTA2/B immunized group; these values were significantly higher than those in the negative controls (P = 0.008). With CTA2/B genetic adjuvant, the T. gondii-specific response was predominantly Th1, indicating that the CTA(2)/B genetic adjuvant was able to overcome the strong Th2-bias of the antigen (IgG2a >> IgG1). Antigen-specific T cell proliferative responses and CTL activity were significantly enhanced when cholera toxin CTA2/B genetic adjuvant was used (P = 0.009; P = 0.006). Culture supernatants from antigen-stimulated splenocytes from mice in these groups were also examined by ELISA for Th1- and Th2-type cytokines; mean IFN-gamma levels produced after oral immunization with BRD509/pSAG(1-2)-CTA2/B were about nine-fold higher than after immunization with BRD509/pSAG(1-2) (P = 0.007). On the other hand, the levels of IL-4 were low for all groups and no increase was seen in the presence of CTA2/B genetic adjuvant. When the immunized mice were intraperitoneally challenged with 10(3) tachyzoites of the highly virulent RH strain, the survival time of the mice immunized with BRD509/pSAG(1-2)-CTA2/B was markedly longer than other groups (P = 0.003) and a 40% survival rate was achieved. This is the first report that demonstrates that an oral attenuated salmonella DNA vaccine can induce protective immunity against the acute phase of T. gondii infection.

Comparison of fMRI activation at 3 and 1.5 T during perceptual, cognitive, and affective processing

Previous studies comparing fMRI data acquired at 1.5 T and higher field strengths have focused on examining signal increases in the visual and motor cortices. No information is, however, available on the relative gain, or the comparability of data, obtained at higher field strengths for other brain regions such as the prefrontal and other association cortices. In the present study, we investigated fMRI activation at 1.5 and 3 T during visual perception, visuospatial working memory, and affect-processing tasks. A 23% increase in striate and extrastriate activation volume was observed at 3 T compared with that for 1.5 T during the visual perception task. During the working memory task significant increases in activation volume were observed in frontal and parietal association cortices as well as subcortical structures, including the caudate, globus pallidus, putamen, and thalamus. Increases in working memory-related activation volume of 82, 73, 83, and 36% were observed in the left frontal, right frontal, left parietal, and right parietal lobes, respectively, for 3 T compared with 1.5 T. These increases were characterized by increased activation at 3 T in several prefrontal and parietal cortex regions that showed activation at 1.5 T. More importantly, at 3 T, activation was detected in several regions, such as the ventral aspects of the inferior frontal gyrus, orbitofrontal gyrus, and lingual gyrus, which did not show significant activation at 1.5 T. No difference in height or extent of activation was detected between the two scanners in the amygdala during affect processing. Signal dropout in the amygdala from susceptibility artifact was greater at 3 T, with a 12% dropout at 3 T compared with a 9% dropout at 1.5 T. The spatial smoothness of T2* images was greater at 3 T by less than 1 mm, suggesting that the greater extent of activation at 3 T beyond these spatial scales was not due primarily to increased intrinsic spatial correlations at 3 T. Rather, the increase in percentage of voxels activated reflects increased sensitivity for detection of brain activation at higher field strength. In summary, our findings suggest that functional imaging of prefrontal and other association cortices can benefit significantly from higher magnetic field strength.