Integrated analysis of gut metabolome, microbiome, and exfoliome data in an equine model of intestinal injury

BACKGROUND

The equine gastrointestinal (GI) microbiome has been described in the context of various diseases. The observed changes, however, have not been linked to host function and therefore it remains unclear how specific changes in the microbiome alter cellular and molecular pathways within the GI tract. Further, non-invasive techniques to examine the host gene expression profile of the GI mucosa have been described in horses but not evaluated in response to interventions. Therefore, the objectives of our study were to (1) profile gene expression and metabolomic changes in an equine model of non-steroidal anti-inflammatory drug (NSAID)-induced intestinal inflammation and (2) apply computational data integration methods to examine host-microbiota interactions.

METHODS

Twenty horses were randomly assigned to 1 of 2 groups (n = 10): control (placebo paste) or NSAID (phenylbutazone 4.4 mg/kg orally once daily for 9 days). Fecal samples were collected on days 0 and 10 and analyzed with respect to microbiota (16S rDNA gene sequencing), metabolomic (untargeted metabolites), and host exfoliated cell transcriptomic (exfoliome) changes. Data were analyzed and integrated using a variety of computational techniques, and underlying regulatory mechanisms were inferred from features that were commonly identified by all computational approaches.

RESULTS

Phenylbutazone induced alterations in the microbiota, metabolome, and host transcriptome. Data integration identified correlation of specific bacterial genera with expression of several genes and metabolites that were linked to oxidative stress. Concomitant microbiota and metabolite changes resulted in the initiation of endoplasmic reticulum stress and unfolded protein response within the intestinal mucosa.

CONCLUSIONS

Results of integrative analysis identified an important role for oxidative stress, and subsequent cell signaling responses, in a large animal model of GI inflammation. The computational approaches for combining non-invasive platforms for unbiased assessment of host GI responses (e.g., exfoliomics) with metabolomic and microbiota changes have broad application for the field of gastroenterology. Video Abstract.

Gut microbiota, a potential cause of higher insulin sensitivity in children with Prader-Willi syndrome

PURPOSE

Obesity is the main driving factor for comorbidities in Prader-Willi syndrome (PWS) patients due to overeating behaviors. The gut microbiota has been implicated in the etiology of obesity and associated comorbidities. The purpose of the present study was to characterize the fecal microbiota in Chinese patients with PWS and compare it to that of patients with obesity as well as healthy controls.

METHODS

We conducted a cross-sectional study with 35 PWS patients (PWS), 35 patients with obesity (OB), and 35 healthy controls (HC). Metagenomic sequencing was performed in stool samples.

RESULTS

The composition of the fecal microbiota in PWS patients differed from that of participants in the OB and HC groups. It was characterized by increased Akkermansia Eubacterium, Eubacterium rectale, and Roseburia intestinalis and decreased Parabacteroides and Phascolarctobacterium. Additionally, the homeostatic model assessment of insulin resistance (HOMA-IR) was lower in PWS patients than in patients with obesity. Spearman rank correlation analysis showed that Achromobacter, Acidiphilium, Xylophilus, and Frisingicoccus were significantly negatively correlated with HOMA-IR.

CONCLUSION

The composition of the gut microbiota in Chinese PWS patients differed from that in patients with obesity, which might contribute to higher insulin sensitivity in PWS patients.

Germline Cancer Susceptibility in Individuals with Melanoma

BACKGROUND

Prior studies have estimated a small number of individuals with melanoma (2-2.5%) have germline cancer predisposition, yet a recent twin study suggested melanoma has the highest hereditability among cancers.

OBJECTIVE

To determine the incidence of hereditary melanoma and characterize the spectrum of cancer predisposition genes that may increase the risk of melanoma.

METHODS

400 individuals with melanoma and personal or family history of cancers underwent germline testing of >80 cancer predisposition genes. Comparative analysis of germline data was performed on 3 additional oncologic and dermatologic datasets.

RESULTS

Germline pathogenic/likely pathogenic (P/LP) variants were identified in 15.3% (61) individuals with melanoma. Most variants (41, 67%) involved genes considered unrelated to melanoma (BLM, BRIP1, CHEK2, MLH1, MSH2, PMS2, RAD51C). A third (20, 33%) were in genes previously associated with familial melanoma (BAP1, BRCA2, CDKN2A, MITF, TP53). Nearly half (30, 46.9%) of P/LP variants were in HRD genes. Validation cohorts demonstrated P/LP rates of 10.6% from an unselected oncologic cohort, 15.8% from a selected commercial testing cohort and 14.5% from a highly selected dermatologic study.

LIMITATIONS

Cohorts with varying degrees of selection, some retrospective.

CONCLUSION

Germline predisposition in individuals with melanoma is common, with clinically actionable findings diagnosed in 10.6% to 15.8%.

Circular RNA expression profile and functional analysis of circUvrag in light-induced photoreceptor degeneration

BACKGROUND

Circular RNAs (circRNAs) are implicated in retinal pathophysiology; however, their expression profiles and functions in photoreceptor apoptosis are largely unknown. We explored circRNA-expression profiles and circUvrag (host gene: Uvrag, ultraviolet radiation resistance associated gene) function in light-induced photoreceptor apoptosis.

METHODS

Sprague-Dawley rats and 661 W photoreceptor cells were exposed to blue light to establish light-induced photoreceptor degeneration. Differentially expressed circRNAs were identified using microarrays. Potential functions of dysregulated circRNAs were analysed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. CircUvrag expression and localization were evaluated using quantitative RT-PCR and fluorescence in situ hybridization, respectively. CircUvrag overexpression and knockdown were induced using a plasmid and a small interfering RNA, respectively, and retinal function and structure were assessed using scotopic electroretinography, haematoxylin-eosin staining, and TUNEL staining. Microglial migration was assessed using IBA1 immunostaining. The apoptosis ratio of photoreceptor cells in vitro was detected using flow cytometry.

RESULTS

We identified 764 differentially expressed circRNAs, which were potentially related with the development of retinal structures, including neurons, dendrites, and synapses, and might participate in nervous-system pathophysiology. Light exposure enriched circUvrag in the cytoplasm of photoreceptors in the outer nuclear layer (ONL). CircUvrag knockdown decreased photoreceptor apoptosis and microglial migration to the ONL after light exposure, preserving ONL thickness and a-wave amplitude. In vitro, circUvrag knockdown inhibited photoreceptor apoptosis, although circUvrag overexpression slightly promoted photoreceptor apoptosis.

CONCLUSIONS

CircUvrag knockdown attenuated light-induced photoreceptor apoptosis, and might be a potential target in retinal degeneration.

[Effect of recombinant human thrombin for hemostasis in liver resection: a randomized controlled phase Ⅲ clinical trial]

Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95%CI:65.75%-77.36%) in the thrombin group and 44.0% (95%CI: 34.93%-53.00%) in the placebo group, respectively (P<0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.

Seven general radiography x-ray detectors with pixel sizes ranging from 175 to 76μm: technical evaluation with the focus on orthopaedic imaging

Aim. Flat panel detectors with small pixel sizes general can potentially improve imaging performance in radiography applications requiring fine detail resolution. This study evaluated the imaging performance of seven detectors, covering a wide range of pixel sizes, in the frame of orthopaedic applications.Material and methods. Pixel sizes ranged from 175 (detector A175) to 76μm (detector G76). Modulation transfer function (MTF) and detective quantum efficiency (DQE) were measured using International Electrotechnical Commission (IEC) RQA3 beam quality. Threshold contrast (CT) and a detectability index (d') were measured at three air kerma/image levels. Rabbit shoulder images acquired at 60 kV, over five air kerma levels, were evaluated in a visual grading study for anatomical sharpness, image noise and overall diagnostic image quality by four radiologists. The detectors were compared to detector E124.Results. The 10% point of the MTF ranged from 3.21 to 4.80 mm-1, in going from detector A175to detector G76. DQE(0.5 mm-1) measured at 2.38μGy/image was 0.50 ± 0.05 for six detectors, but was higher for F100at 0.62. High frequency DQE was superior for the smaller pixel detectors, howeverCTfor 0.25 mm discs correlated best with DQE(0.5 mm-1). Correlation betweenCTand the detectability model was good (R2= 0.964).CTfor 0.25 mm diameter discs was significantly higher for D150and F100compared to E124. The visual grading data revealed higher image quality ratings for detectors D125and F100compared to E124. An increase in air kerma was associated with improved perceived sharpness and overall quality score, independent of detector. Detectors B150, D125, F100and G76, performed well in specific tests, however only F100consistently outperformed the reference detector.Conclusion. Pixel size alone was not a reliable predictor of small detail detectability or even perceived sharpness in a visual grading analysis study.

[Characteristics of serum bile acids among healthy children in Zhejiang province]

Objective: To characterize the serum bile acid profiles of healthy children in Zhejiang Province. Methods: A cross-sectional study was conducted on 245 healthy children who underwent imaging and laboratory biochemical tests during routine physical examinations at the Children's Hospital of Zhejiang University School of Medicine from January 2020 to July 2022. Overnight fasting venous blood samples were collected, and the concentrations of 18 individual bile acids in the serum were accurately quantitated using tandem mass spectrometry. The concentration difference of bile acid were compared between different genders and to explore the correlation between age and bile acid levels. Used the Mann-Whitney U test for intergroup comparison and Spearman test to correlation analysis. Results: A total of 245 health children with a age of 10 (8, 12) years including 125 boys and 120 girls. There were no significant differences in levels of total bile acids, primary and secondary bile acids, free and conjugated bile acids between the two gender groups (all P>0.05). The serum concentrations of ursodeoxycholic acid and glycoursodeoxycholic acid in girls were significantly higher than those in boys (199.0 (66.9, 276.5) vs. 154.7 (49.3, 205.0) nmol/L, 274.0 (64.8, 308.0) vs. 181.0 (43.8, 209.3) nmol/L, Z=2.06, 2.71, both P<0.05). The serum taurolithocholic acid in both boys and girls were positively correlated with age (r=0.31, 0.32, both P<0.05). The serum chenodeoxycholic acid and glycochenodeoxycholic acid in the boys group were positively correlated with age (r=0.20, 0.23, both P<0.05), whereas the serum tauroursodeoxycholic acid in the girls group was negatively correlated with age (r=-0.27, P<0.05), and the serum cholic acid was positively correlated with age (r=0.34, P<0.05). Conclusions: The total bile acid levels are relatively stable in healthy children in Zhejiang province. However, individual bile acids showed gender differences and were correlated with age.

Structural and Functional Analysis of Multiple Subretinal Fluid Blebs after Successful Surgery for Rhegmatogenous Retinal Detachment

INTRODUCTION

This retrospective study investigated the clinical characteristics of multiple subretinal fluid blebs (MSFBs) after successful surgery for rhegmatogenous retinal detachment (RRD) and explored the association between MSFB with best-corrected visual acuity (BCVA) and metamorphopsia.

METHODS

The study comprised 206 patients after successful surgery for RRD, with 58 and 148 eyes undergoing, respectively, scleral buckling (SB), and pars plana vitrectomy (PPV). The clinical characteristics of MSFBs were analyzed by optical coherence tomography (OCT). The choroidal vessels in some cases were evaluated with OCT angiography. M-charts were used to determine the metamorphopsia.

RESULTS

MSFBs occurred in 17 (29.3%) and 8 (5.4%) eyes given SB and PPV, respectively. MSFBs appeared 5.6 ± 5.5 weeks after surgery and required 34.9 ± 13.8 weeks to disappear. Disrupted external limiting membrane and ellipsoid zone could still be seen in 83.3% and 66.7% of the patients 12 months after surgery; these rates were significantly higher than those of patients without MSFBs (p = 0.047, 0.022, respectively). Twelve months post-surgery, BCVA and metamorphopsia scores of the patients with MSFBs were statistically comparable to those of the controls.

CONCLUSIONS

MSFBs occur more commonly after SB than PPV. MSFBs may delay the recovery of the outer retina structure but do not affect postoperative BCVA and metamorphopsia.

[Analysis of the application of radiotherapy facility construction project evaluation standard in health management institutions]

Objective: To investigate the application of GBZ/T 220.2-2009 "The Specification of Radiological Protection Assessment for Occupational Hazard in Construction Project-Part 2: Radiotherapy Facility" in health management institutions, and to understand the scientificity, practicability and problems existing in the implementation of the standard. Methods: The method of multistage stratified sampling and questionnaire survey were used to collect the standard application status among 96 radiological health managers who had participated in the evaluation of radiotherapy facility construction projects in 6 provinces and cities from November 2020 to April 2021. A descriptive statistical analysis method was used to analyze the basic information of the survey object, the knowledge of the standard, the publicity and implementation of the standard. Results: The radiological health management personnel mainly came from health supervision agencies (62.5%, 60/96) , and 86.5% (83/96) were engaged in the pre-evaluation of radiotherapy device construction project and the approval and supervision of control effect evaluation. The awareness rate and training rate of radiological health managers on GBZ/T 220.2-2009 were 88.5% (85/96) and 31.3% (30/96) , respectively. 89.6% (86/96) managers thought it could meet the needs of radiotherapy facility construction project approval or supervision. 49.0% (47/96) of managers believed that the standard needed to be revised. Conclusion: The content of GBZ/T 220.2-2009 is basically scientific and reasonable, but the publicity, implementation and training of radiological health administrator still need to be strengthened. It is suggested to revise some clauses in the standard that do not meet the requirements.

Does China’s green economic recovery generate a spatial convergence trend: an explanation using agglomeration effects and fiscal instruments

China’s urbanization process has entered a period of rapid development, and cities have become key to driving regional economic development. This paper uses data from 286 cities in China in the period 2005–2018 to construct an urban economic growth quality index system and examine the influence of spatial factors on the convergence trend of China’s urban economic growth quality. It is found that there is a β absolute convergence trend of economic growth quality in Chinese cities across the whole country. After controlling for the initial conditions of individual economies, spatial factors strengthen the spatial convergence trend of urban economic growth quality and significantly increase the corresponding convergence rate. Among the areas studied, the western region has the fastest convergence rate, followed by the central and eastern regions, and the convergence rates of both the central and western regions are higher than the national average. Agglomeration economies and fiscal policy tools are important for the promotion of the urban economic growth quality. The agglomeration of productive service industries significantly improves the spatial convergence rate of urban economic growth quality. This effect is mainly due to the spatial spillover of industrial agglomeration. The expansion of government fiscal expenditure also contributes to the spatial convergence trend of urban economic growth quality. Local economic growth quality is also affected by government fiscal expenditure in neighboring cities.

Progression Patterns of Myopic Traction Maculopathy in the Fellow Eye After Pars Plana Vitrectomy of the Primary Eye

Purpose

This retrospective study investigated the patterns and risk factors of progression of myopic traction maculopathy (MTM) of fellow eyes after pars plana vitrectomy (PPV) of primary eyes.

Methods

The study population comprised 153 patients with MTM in both myopic eyes who sequentially underwent PPV (2006–2021). Observation periods were from PPV of the primary eye (baseline) to PPV of the fellow (end). MTM was graded based on optical coherence tomography (OCT) images and the ATN (atrophy [A], traction [T], and neovascularization [N]) system. An increase in T grade was considered MTM progression.

Results

MTM progressed in 43.8% of fellow eyes during 34.57 ± 34.08 months. The progression of fellow eyes correlated with T grade of primary eyes (P < 0.001). Risk factors for the progression of MTM in fellow eyes were primary eyes in T4–T5, age at baseline <60 years, and fellow eyes with partial posterior vitreous detachment (PVD; P < 0.001, P = 0.042, and P = 0.002, respectively). Fellow eyes in T1/T2 at baseline progressed faster compared with those in T0 (P < 0.001); the annual rate of progression to T3–T5 of the T0 (T1–T2) groups was 9.98% (24.59%).

Conclusions

Risk factors for the progression of MTM in fellow eyes included PPV when relatively young, primary eye at high T grade, and partial PVD of the fellow eye. Personalized follow-up for fellow eyes should be based on the severity of MTM of both eyes.

METTL3-Dependent Glycolysis Regulates Dental Pulp Stem Cell Differentiation

N⁶-methyladenosine (m⁶A) is a eukaryotic messenger RNA modification catalyzed by methyltransferase-like 3 (METTL3), which is involved in various developmental and disease processes. However, the connection between the epigenetic modification of m⁶A and glucose metabolism during osteogenesis is still unclear. Here, we show that interference with METTL3 in dental pulp stem cells (DPSCs) inhibits cell proliferation and osteogenic differentiation. Moreover, transcriptome sequencing and metabolic testing were used to explore the mechanism between glucose metabolism and m⁶A modification in METTL3-knockdown DPSCs. Methylated RNA immunoprecipitation-quantitative polymerase chain reaction and RNA stability assays were used to determine the target genes of METTL3. Mechanistically, METTL3 directly interacts with ATP citrate lyase (ACLY) and a mitochondrial citrate transporter (SLC25A1) and then further affects the glycolytic pathway. M⁶A-mediated ACLY and SLC25A1 stability depends on the m⁶A readers IGF2BP2 and IGF2BP2/3, respectively. Our experiments uncovered the potential molecular mechanism of epigenetic modification in osteogenic differentiation, providing new ideas for the clinical application of stem cells and the intervention of metabolic bone diseases.

[Research progress on the human health risks assessment of radionuclides in water environment]

The quality of the water environment is one of the most important factors that can directly affect the health of human beings and other non-human species. The levels of the radionuclides in water environment are the key indicator while assessing the quality of water environment. Recently, with the development of the nuclear energy in China, the public people have paid a focus attention on the levels and the health risks of the radionuclides. This paper introduced the sources, the health effects, the health risk assessment methods and the current status of the health risk assessment study about the radionuclides, in order to provide basis for the health risk assessment of radionuclides in water environment and the protection of human health.

MiRNA-128-3p induces osteogenic differentiation of bone marrow mesenchymal stem cells via activating the Wnt3a signaling

OBJECTIVE

To clarify the biological function of miRNA-128-3p in influencing the progression of osteoporosis by inducing osteogenic differentiation of MSCs via activating the Wnt3a signaling.

PATIENTS AND METHODS

Dynamic expression levels of miRNA-128-3p in osteogenically differentiated MSCs at the different time points were detected by qRT-PCR. The binding sites in the seed sequence of miRNA-128-3p and Wnt3a were predicted using the bioinformatic tool, and their interaction was further confirmed by Dual-Luciferase reporter assay. Co-regulation of miRNA-128-3p and Wnt3a on relative levels of osteogenesis-associated genes, ALP activity and mineralization ability in glucocorticoid-induced MSCs were assessed.

RESULTS

MiRNA-128-3p was gradually upregulated with the prolongation of osteogenic differentiation of MSCs. Overexpression of miRNA-128-3p reversed the declines in glucocorticoid-induced expression levels of osteogenesis-associated genes (Bglap, RUNX2 and BMP-2), ALP activity and mineralization ability in MSCs. Wnt3a was able to bind miRNA-128-3p. Its level was positively regulated by miRNA-128-3p in MSCs. Enhanced ALP activity and mineralization ability in glucocorticoid-induced MSCs overexpressing Wnt3a were partially abolished by knockdown of miRNA-128-3p.

CONCLUSIONS

By positively regulating Wnt3a, miRNA-128-3p alleviates the progression of osteoporosis through inducing osteogenic differentiation of MSCs.

Resolution of Harada disease-like uveitis after quadrivalent human papillomavirus vaccination: a case report

This article describes a patient who developed Harada disease-like uveitis after quadrivalent human papillomavirus (HPV4) vaccination and experienced resolution without any systemic treatment. To achieve this aim, a case report and a review of related literature on HPV vaccination causing uveitis were conducted. The results of this study show a diagnosis of Harada disease-like uveitis after HPV4 vaccination based on the vaccination history, clinical symptoms, and multimodal imaging. Resolution without any systemic corticosteroid treatment was observed. According to these findings, patients may develop uveitis with Harada-like features, which can be a mild and self-limiting process, after HPV4 vaccination.

Synaptic changes and the response of microglia in a light-induced photoreceptor degeneration model

Purpose

To explore synaptic changes and the response of microglia in a light-induced photoreceptor degeneration model.

Methods

Sprague-Dawley rats were euthanized 1 h, 1 day, 3 days, 7 days, and 14 days after being exposed to intense blue light for 24 h. Hematoxylin and eosin (H&E) and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining were used to evaluate changes in the outer nuclear layer (ONL). Transmission electron microscopy (TEM) was applied to observe the ultrastructural changes in the synapses between the photoreceptors and second-order neurons. Western blotting was conducted to evaluate specific proteins, including postsynaptic density-95 (PSD-95), metabotropic glutamate receptor 6 (mGluR6), synapsin I, and synaptophysin. Immunofluorescence of CD11b and PKC-α or mGluR6 was used to explore the spatial relationships between microglial processes and synaptic elements. Immunoelectron microscopy of PSD-95 was performed to further confirm its engulfment of synaptic materials.

Results

H&E and TUNEL staining showed that the thickness of the ONL decreased markedly, and the number of apoptotic photoreceptors peaked at day 1. TEM revealed darkened photoreceptor terminals and that ribbons of them were floating in the cytoplasm, coinciding with the downregulation of PSD-95 and mGluR6. Downstream synaptic protein synapsin I and synaptophysin exhibited upregulation in the inner plexiform layer. Activated microglia migrated to the outer retina, and their processes were found in close proximity to synapses in the outer plexiform layer under light and electron microscopy levels. Double immunostaining of CD11b and mGluR6 showed colocalization. PSD-95-immunoreactive electron-dense materials were observed inside the microglia suggesting engulfment of synaptic components.

Conclusions

The study showed that there are early synaptic impairment and late compensatory changes in downstream synapses in this photic injury model. Activated microglia touched and directly engulfed synaptic materials. Microglia may play a role or a partial role in synaptic changes.

Rate and Treatment of Retinopathy of Prematurity in Extremely Low Birth Weight Infants with Gestational Age ≤28 Weeks in Eastern China

Purpose

To investigate the incidence and clinical characteristics of ROP in extremely preterm (EP) and extremely low birth weight (ELBW) infants in eastern China.

Patients and Methods

This retrospective study included 104 infants with a birth weight (BW) ≤ 1000 g and gestational age (GA) ≤ 28 weeks, who were admitted to the Eye and ENT Hospital of Fudan University over 10 years. The infants were examined for ROP with RetCam. Infants with type 1 ROP and aggressive posterior ROP (AP-ROP) were treated. The risk factors evaluated were GA and BW.

Results

Mean GA was 26.63 ± 0.88 weeks and mean BW was 892.39 ± 108.06 g. Of the 104 infants, 83 (79.8%) developed ROP, three (2.9%) had AP-ROP, 14 (13.5%) had type 1 ROP, and 10 (9.6%) had type 2 ROP. The proportions of infants with BW ≤750 g and 751-1000 g were 8.7% and 91.3%, respectively, and the incidences of severe ROP in these infants were 22.2% and 15.8%, respectively. The infants with severe ROP had a mean GA of 26.56 ± 0.68 weeks and mean BW of 860.00 ± 163.48 g, and 47.1% of severe ROP occurred in infants with a GA of 26 weeks. However, multivariate logistic regression showed that the severity of ROP was not directly inversely related to GA or BW in this study population.

Conclusion

In EP and ELBW Chinese infants, who were admitted to the Eye and ENT Hospital of Fudan University, the development of ROP was more frequent and the incidence of severe ROP that progressed to the stage that required treatment was high.

[Clinical characteristics and ketogenic diet therapy of glucose transporter type 1 deficiency syndrome in children: a multicenter clinical study]

Objective: To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT). Methods: Clinical data of 19 children with GLUT1 DS admitted to Children's Hospital of Fudan University, Tianjin Children's Hospital, Shenzhen Children's Hospital, Children's Hospital of Nanjing Medical University and Jiangxi Provincial Children's Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results: Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT. Conclusions: The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

PURPOSES

To develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).

METHODS

A multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.

RESULTS

Of the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.

CONCLUSIONS

The incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

LncSNHG16 promotes proliferation and migration of osteosarcoma cells by targeting microRNA-146a-5p

OBJECTIVE

The aim of this study was to elucidate the regulatory role of lncSNHG16 in the progression of osteosarcoma (OS) and its underlying mechanism.

MATERIALS AND METHODS

Expressions of lncSNHG16, microRNA-146a-5p and NOVA1 in OS tissues and adjacent normal tissues were determined by quantitative Real-time polymerase chain reaction (qRT-PCR). Their expressions in OS cell lines were detected by qRT-PCR as well. We analyzed the relationship between lncSNHG16 expression and tumor stage, diagnosis and survival prognosis of OS patients, respectively. Cell counting kit-8 (CCK-8) and transwell experiments were conducted to explore proliferative and migratory changes of OS cells. Dual-luciferase reporter assay was used to verify the binding relationship of lncSNHG16 to microRNA-146a-5p, and microRNA-146a-5p to NOVA1. Finally, rescue experiments were performed to elucidate the regulatory effect of lncSNHG16 on the cellular behaviors of OS cells.

RESULTS

LncSNHG16 was highly expressed in OS tissues and cell lines. Its expression was positively correlated with the tumor stage of OS patients. Receiver operating characteristic (ROC) curves suggested that lncSNHG16 can be used as a clinical indicator to distinguish OS patients from healthy controls. Survival analysis indicated a negative correlation between lncSNHG16 expression and survival of OS patients. Overexpression of lncSNHG16 enhanced the proliferative and migratory potentials of OS cell lines 143B and MNNG/HOS. MicroRNA-146a-5p was predicted to be the target gene of lncSNHG16, which was lowly expressed in OS tissues and cell lines. Overexpression of lncSNHG16 downregulated the expression of microRNA-146a-5p in 143B and MNNG/HOS cells. Furthermore, we verified that lncSNHG16 could bind to microRNA-146a-5p. The promotive role of lncSNHG16 in proliferative and migratory potentials of OS cells was reversed by microRNA-146a-5p. Subsequently, NOVA1 was predicted to be the target gene of microRNA-146a-5p, and was further verified by dual-luciferase reporter gene assay. Correlation analysis showed that microRNA-146a-5p expression was negatively correlated with NOVA1 expression in OS. More importantly, NOVA1 reversed the inhibitory effect of microRNA-146a-5p on the proliferative and migratory capacities of 143B and MNNG/HOS cells.

CONCLUSIONS

LncSNHG16 is highly expressed in OS tissues and cell lines, participating in the development of OS by downregulating microRNA-146a-5p to upregulate NOVA1 expression.

0348 Sleep EEG-Based Brain Age Index is Reduced Under Continuous Positive Airway Pressure Treatment

Introduction

Continuous positive airway pressure (CPAP) is a treatment for apnea. With long-term CPAP, changes in electroencephalogram (EEG) include increased delta power (1 - 4Hz) and sigma power (11 - 15Hz, spindle). However, the short-term EEG response to CPAP in a split-night study is less quantified. We recently developed a “brain age” model using sleep EEG features. The brain age index (BAI) is defined as the difference between chronological age and brain age (BA - CA). Here we first quantify how BAI changes during CPAP in the same patient, and then investigate how much brain age features during the diagnostic part can predict the reduction in apnea-hypopnea index (AHI) during CPAP.

Methods

The dataset consisted of 160 subjects. The average age was 59 years with 53% male, 24% female and 23% unknown. We extracted 480 features including band powers, and then computed the BAIs for both diagnostic and CPAP parts. To predict the reduction in AHI during CPAP, we fit a Bayesian regression model using the brain age features, demographics, and sleep parameters during the diagnostic part, and assessed the feature importance using dominance analysis.

Results

The BAI from the diagnostic part is significantly reduced compared to BAI during CPAP for the same subject (paired t-test, p &lt; 0.01). The diagnostic part has an average BAI 2.24 years; and the CPAP part -4.75 years. The brain age features that are increased during CPAP include sigma powers in N2 and N3. The prediction of AHI reduction has Pearson’s correlation 0.85. The features predictive of reduced AHI are the diagnostic AHI (explained variance 69%), followed by high/low waveforms during N2 (e.g. K-complex, measured by kurtosis) (8.6%), delta power during REM (4.5%) and N1 (2%). The feature predictive of increased AHI is frontal alpha power during quiet awake (2.6%).

Conclusion

The average BAI is reduced during CPAP. BAI provides a novel view of the acute response to CPAP in sleep EEG. Future study with more CPAP failure patients has the potential of predicting CPAP failure.

Support

MBW is supported by Glenn Foundation for Medical Research. RJT is supported by Category I AASM Foundation.

0670 The Outcome Of Cpap Titration Under Drug-induced Sleep Endoscopy: A Randomized Controlled Crossover Trial

Introduction

The titration pressure of continuous positive airway pressure (CPAP) is an important issue for patients with obstructive sleep apnea (OSA). The aim of this study was to understand the impact of drug-induced sleep endoscopy (DISE)-guided CPAP pressure and doctor-guided CPAP pressure on patients with OSA.

Methods

In this randomized controlled single-blinded crossover trial, we compared the effects of 1 month CPAP treatment on patients with OSA. Twenty-four patients with OSA were recruited and completed this study. They all underwent polysomnography, DISE-guided CPAP titration and accommodation. Doctor-guided CPAP pressure was determined before DISE. Patients were randomly assigned to receive DISE-guided or Doctor-guided CPAP pressure treatment for 1 month. Then, they switched to another CPAP pressure for another 1 month. Epworth sleepiness scale (ESS) will be recorded at baseline, 1 month and 2 months.

Results

The DISE-guided CPAP pressure and Doctor-guided CPAP pressure had no significant difference (13.9±0.7 cm H2O vs 13.5±0.5 cm H2O; P=0.92). In addition, residual AHI and compliance were also no significant difference between two groups. The ESS was significantly improved from baseline to 1 month CPAP treatment in both groups. Epiglottis (anterior-posterior collapse) was significant associated with AHI (P &lt; 0.001, by Spearman correlation). Both Epiglottis (anterior-posterior collapse) and tongue base collapse were significant associated with 95% CPAP pressure (P = 0.031 and 0.038). After multivariate regression analyses, epiglottis (anterior-posterior collapse) is the independent factor for 95% CPAP pressure.

Conclusion

The DISE-guided CPAP pressure and Doctor-guided CPAP pressure had no significant difference on the improvement of ESS. Epiglottis (anterior-posterior collapse) is the independent factor for AHI and 95% CPAP pressure.

Support

Chang Gung Memorial Hospital and Chang Gung University

0661 Comparison Between Ventilator Detected Apnea Hypopnea Index and Manual Scored Results

Introduction

The apnea hypopnea index and percentage of periodic breathing detected by the ventilator machine are often used by sleep doctors to evaluate whether sleep apnea has been adequately treated or need further interventions. There are concerns about the accuracy of this autodetection.

Methods

Patients with sleep apnea who were treated with positive airway pressure at the Beth Israel Deaconess Medical Center (Boston) and tracked by the EncoreAnywhere system were included. The machine detected AHI(AHIm) and PB(PBm) were extracted from the first week data in every month from the start of use. The manual scored AHI(AHIs) and PB(PBs) were calculated from the last waveform graph during every month. The apnea hypopnea index as well as periodic breathing in 1st, 2nd, 3rd,6th month AHIm, AHIs, PBm and PBs were compared respectively.

Results

A total of 128 patients were included. The mean age was 56.5 and 66% of them were male. In the first month, the mean AHIs was significantly higher than AHIm, 16.27 vs. 5.36, p&lt;0.001. There was also a large difference between percentage of PBs and PBm, 15.55% vs. 1.96, p&lt;0.001. 78% patients whose AHIm &lt;5 were actually has AHIs &gt;5. The Kappa value for the AHIm and AHIs were 0.074, p=0.069; the value of PBm and PBs was 0.216, p=0.015. In the 2nd, 3rd and 6th months, the mean difference between AHIs and AHIm was 10.58, 10.68, 10.12, respectively. The mean difference between PBs and PBm was 12.32%,11.53%,and 9.18%.

Conclusion

Autodetection of respiratory events consistently under-estimates the severity of residual events. Mean differences remained stable over 6 months. Caution is recommended when attributing non-apnea reasons for residual symptoms in patients with apparently low machine estimated AHI and PB.

Support

This study is supported by American Academy of Sleep Medicine Foundation, category-I award to RJT

Optical coherence tomography features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis

Background

To evaluate the optical coherence tomography (OCT) features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis (ECE).

Methods

We performed a retrospective review of patients diagnosed with ECE at one medical center. The medical records of the patients including predisposing risk factors, treatment and visual acuity were reviewed. And we focused on the analysis of OCT images of retinal lesions before and after treatment.

Results

A total of 16 Chinese patients (22 eyes) were included in this study. The most frequent predisposing risk factors were intravenous use of corticosteroids or antibiotics, lithotripsy for urinary calculi, and diabetes. After treatment, visual acuity was improved in 13 (59.1%) of the 22 eyes, and remained the same in the other 9 (40.9%) eyes. Pre-treatment OCT images obtained at presentation were available for 17 of the 22 eyes. Four types of the OCT manifestations of retinal lesions were identified: type 1 (subretinal macular lesions), type 2 (lesions are located in the inner retinal layer), type 3 (lesions involve the full-thickness retina and accompanied with macular edema), type 4 (sub-inner limiting membrane lesions). Pre-treatment OCT imaging of the 17 eyes revealed five as type 1, four as type 2, six as type 3, and two as type 4. After treatment, OCT images revealed epiretinal membrane and subretinal fibrosis as the most common post-treatment complications of ECE. Epiretinal membrane was detected in 2/4 type 2 lesions, in 4/6 type 3 lesions, and in 1/2 type 4 lesions, while subretinal fibrosis was mainly seen in type 1 lesions (4/5). Among the types, visual prognosis was best in eyes with type 2 lesions.

Conclusions

In this case series, the OCT manifestations of retinal lesions in ECE could be classified into four types. The post-treatment OCT manifestations were different in four types of lesions. We preliminarily found that the OCT morphology of retinal lesions was associated with the visual prognosis of ECE.

Lentivirus vector-mediated knockdown of Sox9 shows neuroprotective effects on light damage in rat retinas

PURPOSE

To investigate whether reduced Sox9 function exerts neuroprotection in light-induced retinal damage in rats and to explore the potential mechanism behind it.

METHODS

Retinal light damage was used as a model for retinal degeneration. Two weeks before light damage in adult Sprague Dawley (SD) rats, the Sox9-shRNA lentiviral vector was intravitreally injected. On days 3, 7, and 14, retinal function was assessed using electroretinography (ERG), and the thickness of the outer nuclear layer (ONL) was measured in hematoxylin and eosin (HE) stained sections. The protein levels of glial fibrillary acidic protein (GFAP), vimentin, nestin, and chondroitin sulfate proteoglycans (Cspgs), which are related to gliosis and extracellular matrix (ECM) remodeling, were observed using western blot analysis. The expression of GFAP was further evaluated by immunohistochemistry.

RESULTS

On days 3, 7, and 14 after light damage, the thickness of the ONL and the amplitudes of the ERG waves were significantly better preserved in the Sox9-shRNA group when compared with the control group. The protein levels of GFAP, vimentin, nestin, and Cspgs were significantly downregulated in the Sox9-shRNA group. Furthermore, the staining intensity and the spatial distribution of GFAP in the retinas were also obviously attenuated at every studied time point.

CONCLUSIONS

Intravitreal injection of the Sox9-shRNA lentiviral vector preserved rat retinal morphology and function after light damage and downregulated GFAP, vimentin, nestin, and Cspgs, which are related to Müller cell gliosis and ECM remodeling. The results indicate that Sox9 might be a potential therapeutic target for retinal degenerative diseases.

[Trend in proportion and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer]

Objective: To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China. Methods: The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient's stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed. Results: (1) The total number of hospitalized patients with stage Ⅰa2 to Ⅱa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01) . The constituent ratio of patients aged 35 years or younger was significantly greater during 2004-2010 than that during 2011-2016 [12.6% (820/6 484) and 8.5% (1 068/12 557) , respectively; χ(2)=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stage Ⅰ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05). Conclusions: The trend in proportion among hospitalized patients for stage Ⅰa2 to Ⅱa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion >1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.

Diagnostic Performance of MALDI-TOF MS Compared to Conventional Microbiological Cultures in Patients with Suspected Endophthalmitis

Purpose: To evaluate the performance and speed of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) when identifying the pathogenic microorganism of endophthalmitis compared to conventional microbiological culturing.Methods: Forty-four patients with suspected endophthalmitis who had undergone vitrectomy were enrolled. Vitreous specimen was analyzed using either conventional culturing or MALDI-TOF MS.Results: The identification rates of the conventional microbiological culture and MALDI-TOF MS were 45.5% (20/44) and 65.9% (29/44), respectively (Kappa value 0.787, P < 0.000). The mean detection times by the standard culturing method and MALDI-TOF MS were 5.39 ± 0.56d and 3.17 ± 0.40d (P < 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MALDI-TOF MS were 70.59%, 54.17%, 80.00%, and 86.67%, respectively. Polymicrobial endophthalmitis was identified in 6.82% of the patients (3/44) using conventional microbiological culturing. However, MALDI-TOF MS failed to identify any polymicrobial infection.Conclusions: With a higher sensitivity, acceptable specificity and a shorter detection time, MALDI-TOF MS was an efficient technique for the rapid identification of a pathogenic microorganism in endophthalmitis.

Photoswitchable chevron topographies of glassy nematic coatings

We report a strategy to create photoswitchable chevron topographies via buckling of glassy nematic coatings with zigzag director alignments on soft elastic substrates. The idea is confirmed by numerical simulations where the nonlinear deformation of the coating is modeled by the Föppl-von Kármán plate theory. It is remarkable that the inclination angle of the chevron pattern may deviate significantly from the director orientation and depends on the period of director alignment. Our quantitative analysis shows that the phenomena are caused by in-plane shear stress which alters the direction of maximum principal stress in the coating and decreases monotonically with decreasing period of the director distribution.

The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer

BACKGROUND

The clinical value of perineural invasion (PNI) in patients with localized prostate cancer (PCa) is widely explored. However, its role in metastatic PCa (mPCa) remains unknown.

OBJECTIVES

We aim to investigate the clinical significance of PNI in patients with mPCa.

MATERIALS AND METHODS

Data of 515 mPCa patients between 2012 and 2018 were retrospectively studied. PNI and its intensity were identified by prostate biopsy. The prognostic value of PNI was evaluated by Kaplan-Meier curves and Cox proportional-hazards model.

RESULTS

Perineural invasion was detected in 170/515 (33.0%) cases. Among them 73/170 (42.9%) and 97/170 (57.1%) harbored unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. Compared to patients without PNI, those with PNI had statistically shorter castration-resistant PCa-free survival (CFS) and numerically shorter overall survival (OS) (mCFS: 15.4- vs. 18.5-Mo, p = 0.015; mOS: 63.8- vs. 71.4-Mo, p = 0.108). Patients harboring multi-PNI were associated with poorer clinical outcomes than those with uni-PNI (mCFS: 12.4- vs. 18.0-Mo, p = 0.040; mOS: 39.7-Mo vs. NR, p = 0.018) or those without PNI (mCFS: 12.4- vs. 18.5-Mo, p = 0.002; mOS: 39.7- vs. 71.4-Mo, p = 0.002). Totally, neither uni-PNI nor multi-PNI was an independent risk factor impacting survival outcomes in multivariate analyses. While remarkably, for patients with favorable/intermediate-risk mPCa, multi-PNI was an independent adverse prognosticator for both CFS and OS (CFS: HR: 1.705, 95% CI: 1.029-2.825, p = 0.038; OS: HR: 3.294, 95% CI: 1.464-7.413, p = 0.004).

DISCUSSION AND CONCLUSION

This study filled the blank of the clinical significance of PNI in mPCa. We found that multi-PNI could distinguish men with relatively poor prognosis from patients initially regarded as with favorable survival outcomes by other prognosticators, and thus, avoid disease underestimation in this group of patients. Our finding would help physicians have a deeper understanding of the heterogeneity of mPCa and make better individualized therapeutic strategy.

Next Generation Sequencing Identified a Novel Multi Exon Deletion of the NF1 Gene in a Chinese Pedigree with Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) is a genetic disease involving neurocutaneous abnormalities. Neurofibromatosis type 1 is an autosomal dominant disorder characterized by the neurofibromas and café-au-lait spots. Mutation in the NF 1 gene causes NF1. The NF 1 gene encodes neurofibromin. In this study, we found a 31-year-old Chinese boy with NF1. He presented only with café-au-lait spots over the whole body. The proband's mother had a severe phenotype with neurofibroma and café-au-lait macules over her whole body, mostly in the facial region. A novel multi exon deletion c.(4661+1_4662-1)_(5748+1_5749-1)del; [EX36_39DEL] on the NF 1 gene has been identified in the proband. Quantitative real-time polymerase chain reaction (qPCR) confirmed that this mutation is co-segregated well and was inherited from the proband's mother. The mutation was absent in the proband's father and normal individuals. The novel multi exon deletion results in the formation of a truncated NF1 protein that caused the NF1 phenotype in this family. Our present study also emphasized the significance of rapid, accurate and cost-effective screening for the patient with NF1 by next generation sequencing (NGS).

Effects of chronic dexamethasone exposure on bile acid metabolism and cecal epithelia function in goats

Bile acids (BAs) are synthesized in the liver via the oxidation of cholesterol and further metabolized by microbiota in the gut, where they simultaneously impact gut function. In the present study, 10 goats were randomly divided into 2 groups; 1 group was injected with dexamethasone (Dex; 0.2 mg/kg), and the other group was injected with saline as the control (Con) for 21 d. Expression levels of key genes and proteins in the liver and gut mucosa were analyzed and compared to investigate the impact of chronic stress on BA metabolism and related functions in ruminants. The results revealed that Dex decreased plasma total BAs (TBAs) concentration (P < 0.05) but increased TBA concentration in the cecal digesta (P < 0.05). Total cholesterol in the liver decreased moderately in response to Dex. The protein expression of cytochrome P450 family 7 subfamily A member 1 and cytochrome P450 family 27 subfamily A member 1, 2 enzymes that control BA synthesis in the liver, remained unchanged by Dex administration (P > 0.05). The expression of several genes in the cecal mucosa encoding epithelial tight junction proteins, including occludin (P < 0.05), tight junction protein 1 (P < 0.01), and claudin 1 (P < 0.05), increased significantly in response to Dex, and expression of defensin beta 1, which can strengthen the innate immune system, was also upregulated (P < 0.05). In addition, BAs increased the expression of the Solute Carrier family 9 member A 2 (P < 0.01) that encodes a sodium hydrogen exchanger. These results suggest that the Dex-induced disruption of BA homeostasis might be mediated through a liver-independent pathway in goats, and the Dex-induced accumulation of TBAs in the cecal digesta may improve volatile fatty acid transportation and mucosal defense.

Intravitreal injection of ranibizumab in severe retinopathy of incontinentia pigmenti

Incontinentia pigmenti (IP) is a rare X-linked multisystem disorder that mainly affects females and is usually lethal to males in utero. Mutations in the NEMO gene on chromosome Xq28 (IKBKG, inhibitor of kB kinase gamma) have been shown to cause IP. Approximately 35% of patients have ophthalmic manifestations, and 20% develop vision-threatening diseases. Retinal vascular abnormalities, from peripheral retinal avascularity to neovascular proliferation, have been described in IP patients. Laser photocoagulation and cryotherapy are traditionally effective therapy for retinopathy of IP. However, some cases still progress to retinal detachment. We report 2 cases of IP infants treated with intravitreal ranibizumab with subsequent resolution of the vasculopathy.

[Clinical application of Acutegastrointestinal injury grading system assocaited with clinical severity outcome in critically ill patients: a multi-center prospective, observational study]

Objective: To investigate the feasibility of utilizing the current acute gastrointestinal injury(AGI) grading system, and explore the association of severity of AGI grade with clinical outcome in critically ill patients. Methods: The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24 h were recruited, and all clinical, laboratory, and survival data were prospectively collected. The AGI grade was daily assessed based on GIsymptoms, feeding details and organ dysfunctionon the first week of admission to ICU.The intra-abdominal pressures(IAP) was measured using AbViser device. Results: Of 550 patients enrolled, mean values for age and APACHE Ⅱ score were (64.9±17.2) years and (19.5±7.4), respectively. 456 patients(82.9%) took mechanical ventilation, and 470 patients were identified for AGI. The distribution of AGI grade on the frist day of ICU admission were 50.6%(Ⅰ grade, n=238), 34.2%(Ⅱ grade, n=161), 12.4%(Ⅲ grade, n=58) and 2.8%(Ⅳ, n=13), respectively, while the distribution of the global AGI grade based on the 7-day AGI assessment of ICU admission were 24.5%(Ⅰ grade, n=115), 49.4%(Ⅱ grade, n=232), 20.6%(Ⅲ grade, n=97) and 5.5%(Ⅳ, n=26), respectively. 28- and 60-day mortality rate was 29.3%(n=161) and 32.5%(n=179), respectively. The patients with AGI had a higher 28-(31.1% vs 18.8%, P=0.025) and 60-day survival rate(34.7% vs 20.0%, P=0.01) than those with non-AGI, and also there were positive correlations between AGI grade and 28- and 60-day mortality(P<0.001). Univariate Cox regression analysis showed that age, the source of medicial admission, diabetes mellitus, coronary heart disease, the use of vasoactive drugs, serum creatinine and lactate, mechanical ventilation, APACHE Ⅱ score, the AGI grade in the first day of ICU admission and feeding intolerance within the first week of ICU stay were significantly(P≤0.02) associated with mortality. In multivariate analysis including all these variables, the source of medical admission(χ(2)=4.34, P=0.04), diabete mellitus(χ(2)=3.96, P=0.05), the use of vasoactive drugs(χ(2)=6.55, P=0.01), serum lactate(χ(2)=4.73, P=0.03), the global AGI grade in the 7-day of ICU admission(χ(2)=7.10, P=0.008), and APACHE Ⅱ score(χ(2)=12.1, P<0.001) remained independent predictors for 60-day mortality.In the further subgroup analysis including 402 patients with 7-day survival, the feeding intolerance within the first week of ICU stay could provide independent and incremental prognostic value of 60-day mortality wtih increased χ(2)value of Cox regression model(χ(2)=52.2 vs 41.9, P=0.007) . Conclusion: The AGI grading system is useful for identifying the severity of gastrointestinal dysfunction, and could be used as a strong predictor of impaired outcome. The results provide evidence to support that feeding intolerance within 7 days of admission to ICU was an independent determinant of mortality.

A single dose of intravenous combretastatin A4-phosphate is reasonably well tolerated and significantly reduces tumour vascularization in canine spontaneous cancers

Combretastatin A4-phosphate (CA4P) is an anti-tumour vascular targeting agent which selectively blocks tumour blood flow. Research on CA4P in rodent tumour models is extensive; however, knowledge of its effect on spontaneous cancer is scarce. This study was conducted in canine patients with spontaneous solid tumours. The goal was to assess the toxicity and efficacy of CA4P in various spontaneous tumour types. Eight dogs with spontaneous tumours were enrolled and treated with a single dose of 75 mg m^-2 intravenous CA4P. The dogs were screened and monitored before and after injection. Pre- and post-treatment tumour blood flow was analysed in vivo by power Doppler ultrasound (PDUS) and contrast-enhanced ultrasound (CEUS). Vessel destruction and tumour necrosis were evaluated by histopathology. Clinically relevant toxicity was limited to one case of temporary tetraparesis; other adverse events were mild. Significant cardiovascular changes were mostly confined to changes in heart rate and cTnI levels. Macroscopic tumour size reduction was evident in 2 dogs. Based on PDUS and CEUS, CA4P induced a significant decrease in vascular index and tumour blood flow. Post-treatment, histopathology revealed a significant increase of necrotic tumoural tissue and a significant reduction in microvessel density in tumoural tissue. Anti-vascular and necrotizing effects of CA4P were documented in a variety of canine spontaneous cancers with only minimal side effects. This is the first study reporting the administration of CA4P to canine cancer patients with in vivo and ex vivo assessment, and a first step toward implementing CA4P in combination therapies in veterinary oncology patients. The use of CA4P in canine patients was approved and registered by the Belgian Federal Agency for Medicines and Health Products (FAMHP) (approval number 0002588, registration number 6518 ID 2F12).

ROCK Inhibitor Y-27632 Promotes Human Retinal Pigment Epithelium Survival by Altering Cellular Biomechanical Properties

Purpose:

Dysfunction or death of retinal pigment epithelial (RPE) cells is a common pathogenesis of various types of retinal degenerative diseases. Recent reports indicated that ROCK pathway inhibitors regulate cell proliferation or apoptosis in a cell-type-dependent manner. Here, we aim to investigate the effect of ROCK inhibitor Y-27632 on the human retinal pigment epithelium (RPE) in vitro.

Methods:

Cell proliferation and apoptosis were analyzed by CCK-8 and flow cytometry respectively. Cell proliferation markers were detected by immunofluorescence and western blot. Cell morphology was evaluated using scanning electron microscopy. The topography and biomechanical properties of living cells were assessed using atomic force microscope (AFM). In addition, cytoskeleton and epithelial-mesenchymal transition (EMT) markers were detected by western blot and immunofluorescence.

Results:

30μM Y-27632 significantly promoted cell proliferation and decreased apoptosis. Compared with control group, human retinal pigment epithelial cell line ARPE-19 cells treated with 30μM Y-27632 exhibited significantly decreased cytomembrane roughness (Ra: 41.04±1.63nm vs. 24.41±0.75nm, P<0.01; Rq: 51.56±2.03nm vs. 30.81±0.95nm, P<0.01) and increased elasticity modulus (16.66±0.83KPa vs. 32.55±1.48KPa, P<0.01). In addition, the inhibition of ROCK activity by Y-27632 caused cell elongation and reorganization of microfilaments and microtubules of cytoskeletons.

Conclusion:

Taken together, our data demonstrated that Y-27632 could alter biomechanical properties and reorganized cytoskeletons to promote RPE cell survival. These results are an important step toward the future application of Y-27632 in retinal degenerative diseases.

Abstract P5-07-03: Withdrawn

This abstract was withdrawn by the authors.

[Research on the relationship between atmospheric inhalable particulate matter and cardiovascular diseases burden in Tianjin]

Objective: To evaluate the association between atmospheric inhalable particulate matter (PM(10)) concentration and cardiovascular diseases burden in Tianjin. Methods: The data on daily mean concentrations of main pollutants (PM(10), nitrogen dioxide(NO(2)) and sulfur dioxide(SO(2))), meteorological factors (temperature and relative humidity) and population death monitoring data in Tianjin, from January 1, 2001 to December 31, 2010, were collected and analyzed in this study. The death counts and years of life lost were simultaneously used as the indicators of disease burden. The generalized additive model was used to assess the associations between PM(10) and daily death counts and years of life lost due to cardiovascular system diseases in Tianjin by adjusting the confounding factors such as long-term trend, seasons, meteorological factors and other factors related to the long-term variability. Results: The daily average concentration of PM(10) was 117.6 μg/m³ in Tianjin during 2001 to 2011. The daily average number of deaths of cardiovascular system diseases, cerebrovascular diseases and ischemic heart diseases in Tianjin were 38.4, 14.8 and 17.2 people respectively, and the daily average years of life lost were 776.8, 306.5 and 326.1 person years respectively. The effects of PM(10) on the daily death counts of the three diseases categories were statistically significant (all P<0.01) in Tianjin and the maximum effect occurs at the moment when PM(1)0 was at moving average concentration of today and lagged 1-day (Lag01). The effects of decreasing order were ischemic heart diseases, cardiovascular system diseases and cerebrovascular diseases, excess risks were 0.53% (95% CI 0.35%-0.71%), 0.40% (95%CI 0.28%-0.53%) and 0.38% (95%CI 0.19%-0.56%). The effects of atmospheric PM(10) on the years of life lost of the three diseases were also statistically significant on the different lag days (all P<0.01) in Tianjin and the maximum effect of PM(10) appeared in Lag01. The effects from the largest to the lowest were 2.86 (95%CI 1.79-3.93) person years for cardiovascular system diseases, 1.59 (95%CI 0.95-2.23) person years for ischemic heart diseases and 1.07 (95%CI 0.43-1.71) person years for cerebrovascular diseases, respectively. In multi-pollutant models, after controlling SO(2), the effect of PM(10) on the daily life loss of above 3 kinds of diseases was higher than that of single pollutant model. In contrast, after controlling SO(2) or SO(2) with NO(2), the effect was lower. After controlling NO(2), the effect of PM(10) on the daily life loss of cerebrovascular disease was no longer statistically significant (P>0.05). Conclusions: Exposure to atmospheric PM(10) can significantly increase the cardiovascular diseases burden in Tianjin, especially for ischemic heart diseases. These results suggested that particular attention should be paid to reduce the exposure to atmospheric inhalable particulate matter for patients with ischemic heart diseases.

Biodistribution and tolerance of intravenous iodine-131-labelled hypericin in healthy dogs

Hypericin (Hyp) is a necrosis-avid compound that can be efficiently labelled with radioiodine for both diagnostic and therapeutic purposes. Before ¹³¹ I-Hyp can be considered as a clinically useful drug in a combination therapy for canine cancer patients, evaluation of its toxicity is necessary. The aim of this study was to investigate the biodistribution and tolerance of a single dose administration of ¹³¹ I-Hyp. Three healthy dogs were included. ¹³¹ I-Hyp at a dose of 0.2 mg/kg and an activity of 185 MBq was intravenously injected. The effects on physical, haematological and biochemical parameters were characterized and the biodistribution and elimination pattern, the effective half-life and dose rate were assessed. Drug-related adverse events were limited to mild gastrointestinal signs, resolving within 48 hours. No significant differences were found in blood haematology and serum biochemistry before and after treatment. Following administration, highest percentage of injected dose (%ID ± SD) was found in the liver (5.5 ± 0.33), the lungs (4.17 ± 0.14) and the heart (3.11 ± 0.78). After 24 hours, highest %ID was found in colon (4.25 ± 1.45) and liver (3.45 ± 0.60). Clearance from all organs was effective within 7 days. Effective half-life was established at 80 hours, and the dose rate fell below <20 μSv/h at 1 m within 1 day. The current study reveals that single dose treatment with ¹³¹ I-Hyp at the described dose is well tolerated by healthy dogs and supports the use of radioiodinated hypericin in a combination therapy for canine cancer patients.

[The effect of short-term exposure to ambient NO(2) on lung function and fractional exhaled nitric oxide in 33 chronic obstructive pulmonary disease patients]

Objectives: To investigate the effect of short-term exposure to ambient NO(2) has influence on lung function and fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) patients. Methods: A panel of doctor-diagnosed stable COPD patients (n=33) were recruited and repeatedly measured for lung function and FeNO from December 2013 to October 2014. The patients who lived in Beijing for more than one year and aged between 60 and 85 years old were included in the study. We excluded patients with asthma, bronchial tensor, lung cancer and other respiratory disorders other than chronic obstructive pulmonary disease and occupational exposure and chest trauma surgery patients. Because the frequency of each subject visiting to the hospital was different, a total of 170 times of lung function measurements and 215 times of FeNO measurements were conducted. At the same time, the atmospheric NO(2) data of Beijing environmental monitoring station near the residence of each patient during the study period were collected from 1 day to 7 days lag before the measurement. Effects of short-term NO(2) exposure on lung function and FeNO in COPD patients were estimated by linear mixed-effects models. Results: The subjects' forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), peak expiratory flow (PEF), and exhaled NO of subjects were (3.26±0.83) L, (1.66±0.61) L, (4.13±1.77) L/s, and (48.99±14.30) μg/m(3), respectively. The concentration of NO(2) was (70.3±34.2) μg/m(3) and the interquartile range (IQR) was 39.0 μg/m(3). Short-term exposure to NO(2) resulted in a significant decrease in FVC among COPD patients' which was most obvious in 2 days lag. Every quartile range increased in NO(2) (39 μg/m(3), 2 day) would cause a 1.84% (95%CI: -3.20%- -0.48%) reduction in FVC. The effects of exposure to higher concentration of NO(2) (≥58.0 μg/m(3)) on FVC estimate was -2.32% (95%CI: -4.15%- -0.48%)(P=0.02). No significant relevance of FeNO and NO(2) was observed in this study. Conclusions: Short term exposure to ambient NO(2) may bring down pulmonary function in COPD patients.

Sperm cystic fibrosis transmembrane conductance regulator expression level is relevant to fecundity of healthy couples

Cystic fibrosis transmembrane conductance regulator (CFTR) is relevant to sperm quality, sperm capacitation and male fertility. However, it is still unknown whether CFTR can be a potential parameter for fecundity prediction in healthy couples. In this study, 135 healthy couples were divided into groups according to their fertility. We demonstrated that the sperm CFTR expression level of healthy males who never impregnated their partners (49 cases, 38.68 ± 2.71%) was significantly lower than that of fertile men (86 cases, 46.35 ± 2.32%). Sperm CFTR expression level accurately corresponded with fertility through the logistic regression model. Receiver operating characteristic (ROC) curve analysis showed that the cut-off value of sperm CFTR expression level for fecundity prediction was 43.75%. Furthermore, cumulative pregnancy rates (CPRs) of CFTR > 43.75% group and CFTR ≤ 43.75% group during the follow-up periods were 80.6% and 49.3% respectively. Meanwhile, the mean time to pregnancy (TTP) of CFTR ≤ 43.75% group (26.79 ± 2.35) was significantly longer than that of CFTR > 43.75% group (16.46 ± 2.42). Therefore, sperm CFTR expression level is relevant to fecundity of healthy couples and shows potential predictive capacity of fecundity.