Differential accumulation patterns of flavor compounds in Longjing 43 and Qunti fresh leaves and during processing responding to altitude changes

Variations in cultivars and cultivation altitudes have significant impacts on tea flavour compounds however lack of comprehensive understanding. This study provided insights into differential accumulation of crucial flavour compounds in response to cultivars, cultivation altitudes, and processing. Twelve flavonoids (262.4 ∼ 275.4 mg•g-1) and 20 amino acids (AAs) (56.5 ∼ 64.8 mg•g-1) were comparative analyzed in 'Longjing 43' and 'Qunti' fresh leaves harvested at low (80 m, LA) and high (500 m, HA) altitudes. Additionally, an in-depth correlation unravelling of 31 alkaloids, 25 fatty acids, 31 saccharides, 8 organic acids, and 7 vitamins and flavonoids/AAs during green tea (GT) and black tea (BT) processing was performed. Enhenced flavonoid accumulation alongside higher AAs and saccharides in HA GT promoted a sweet/mellow flavour. Abundant flavonoids, AAs, and saccharides derivates in LA BT gave rise to a sweet aftertaste. The study presents an integrated illustration of major flavour compounds' differential accumulation patterns and their interrelations, providing new insights into the influence of cultivation conditions on tea flavour.

Post-operative vestibular and equilibrium evaluation in patients with cholesteatoma-induced labyrinthine fistulas

OBJECTIVE

This study aimed to compare the pre- and post-operative vestibular and equilibrium functions of patients with cholesteatoma-induced labyrinthine fistulas who underwent different management methods.

METHODS

Data from 49 patients with cholesteatoma-induced labyrinthine fistulas who underwent one of three surgical procedures were retrospectively analysed. The three management options were fistula repair, obliteration and canal occlusion.

RESULTS

Patients underwent fistula repair (n = 8), canal occlusion (n = 18) or obliteration procedures (n = 23). Patients in the fistula repair and canal occlusion groups suffered from post-operative vertigo and imbalance, which persisted for longer than in those in the obliteration group. Despite receiving different management strategies, all patients achieved complete recovery of equilibrium functions through persistent efforts in rehabilitation exercises.

CONCLUSION

Complete removal of the cholesteatoma matrix overlying the fistula is reliable for preventing iatrogenic hearing deterioration due to unremitting labyrinthitis. Thus, among the three fistula treatments, obliteration is the optimal method for preserving post-operative vestibular functions.

Comprehensive analysis of pigment alterations and associated flavor development in strip and needle green teas

Strip/needle green teas (SGT/NGT) processed using innovative technologies are in high demand; however, mechanisms behind their color and flavor have not been comprehensively studied. We aimed to reveal the dynamics of major pigmented components (carotenoids, lipids, flavonoids, and Maillard products) and their contributions to the flavor of green teas. The total content of flavonoids in SGT and NGT were 255 ± 4.51 and 201 ± 3.91 mg·g-1, respectively; these values are slightly lower than that in fresh leaves (FLs), resulting in a fresh and sweet aftertaste. In average, carotene content in SGT/NGT (24.8 μg·g-1) was higher than in FL (17.4 μg·g-1), whilst xanthophyll content (603 μg·g-1) decreased to one-half of that in FL (310 μg·g-1). Among the 218 primary metabolites, glutamine, glutamic acid, and arginine were found to accumulate and were dominate contributors for the umami and sweet taste. Notably, more than 96 volatiles were screened and revealed their correlations with carotenoids, lipids, and amino acids. Overall, the synergism between pigments and their non-enzymatic derivates' contribution to GT characterized flavor was illustrated.

[Epidemiological characteristics and survival analysis of reported pneumoconiosis in Chengdu, 2012-2021]

Objective: To explore theepidemiological characteristics and analyse the survival of pneumoconiosis in Chengdu from 2011 to 2021, providing scientific evidence for further prevention and control. Methods: In April 2022, the pneumoconiosis report card of Chengdu from 2012 to 2021 and survival data were collected from the China Disease Control and prevention information system and the occupational pneumoconiosis follow-up survey project.The data of the report card was reorganized and analyzed by R4.4.0 software. Chi-square test was used to compare the case composition ratio between groups. The annual trend of the number of new pneumo coniosis cases was analyzed by linear regression model Kaplan-Meier method was used for survival analysis and log-rank test was used for comparison of survival curves between groups. Results: 816 cases of pneumoconiosis were reported in Chengdu from 2011 to 2021, including 522 cases of stage Ⅰ (63.97%, 522/816), 148 cases of stage Ⅱ (18.14%, 148/816) and 146 cases of stage Ⅲ pneumoconiosis (17.89146/816) ; There were 596 cases of silicosis (73.04%, 596/816), 143 cases of coal worker's pneumoconiosis (17.52%, 143/816). New onset pneumoconiosis was mainly male (810 cases, 99.26%). The median age of diagnosis and the 25th and 75th percentile were 63 (51-71) years old, the median length of dust exposure were 12.00 (5.92-28.00) years, and the types of work were mainly rock drillers (24.63%, 201/816), tunneling workers (19.36%, 158/816) and coal miners (13.60%, 111/816). Among 816 cases of new pneumoconiosis, 35 cases were lost to follow-up (4.29%, 35/816), 605 cases survived and 176 cases died. The 5-year survival rate was 78.6% and the 10-year survival rate was 65.8%. Conclusion: The number of pneumoconiosis reported in Chengdu was relatively stable in recent years. The main type of pneumoconiosis was silicosis, which was concentrated in regions, industries and types of work. We should continue to strengthen the prevention and treatment of pneumoconiosis.

[Diagnostic values of conventional tumor markers and their combination with chest CT for patients with stageⅠA lung cancer]

Objective: To investigate the diagnostic efficiency of conventional serum tumor markers and their combination with chest CT for stage ⅠA lung cancer. Methods: A total of 1 155 patients with stage ⅠA lung cancer and 200 patients with benign lung lesions (confirmed by surgery) treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to October 2020 were retrospectively enrolled in this study. Six conventional serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), squamous cell carcinoma associated antigen (SCCA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), and gastrin-releasing peptide precursor (ProGRP)] and chest thin-slice CT were performed on all patients one month before surgery. Pathology was taken as the gold standard to analyze the difference of positivity rates of tumor markers between the lung cancer group and the benign group, the moderate/poor differentiation group and the well differentiation group, the adenocarcinoma group and the squamous cell carcinoma group, the lepidic and non-lepidic predominant adenocarcinoma groups, the solid nodule group and the subsolid nodule group based on thin-slice CT, and subgroups of ⅠA1 to ⅠA3 lung cancers. The diagnostic performance of tumor markers and tumor markers combined with chest CT was analyzed using the receiver operating characteristic curve. Results: The positivity rates of six serum tumor markers in the lung cancer group and the benign group were 2.32%-20.08% and 0-13.64%, respectively; only the SCCA positivity rate in the lung cancer group was higher than that in the benign group (10.81% and 0, P=0.022). There were no significant differences in the positivity rates of other serum tumor markers between the two groups (all P>0.05). The combined detection of six tumor markers showed that the positivity rate of the lung cancer group was higher than that of the benign group (40.93% and 18.18%, P=0.004), and the positivity rate of the adenocarcinoma group was lower than that of the squamous cell carcinoma group (35.66% and 47.41%, P=0.045). The positivity rates in the poorly differentiated group and moderately differentiated group were higher than that in the well differentiated group (46.48%, 43.75% and 22.73%, P=0.025). The positivity rate in the non-lepidic adenocarcinoma group was higher than that in lepidic adenocarcinoma group (39.51% and 21.74%, P=0.001). The positivity rate of subsolid nodules was lower than that of solid nodules (30.01% vs 58.71%, P=0.038), and the positivity rates of stageⅠA1, ⅠA2 and ⅠA3 lung cancers were 33.33%, 48.96% and 69.23%, respectively, showing an increasing trend (P=0.005). The sensitivity and specificity of the combined detection of six tumor markers in the diagnosis of stage ⅠA lung cancer were 74.00% and 56.30%, respectively, and the area under the curve (AUC) was 0.541. The sensitivity and specificity of the combined detection of six serum tumor markers with CT in the diagnosis of stage ⅠA lung cancer were 83.0% and 78.3%, respectively, and the AUC was 0.721. Conclusions: For stage ⅠA lung cancer, the positivity rates of commonly used clinical tumor markers are generally low. The combined detection of six markers can increase the positivity rate. The positivity rate of markers tends to be higher in poorly differentiated lung cancer, squamous cell carcinoma, or solid nodules. Tumor markers combined with thin-slice CT showed limited improvement in diagnostic efficiency for early lung cancer.

Effect of Anemia on Tumor Response to Preoperative Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

PURPOSE/OBJECTIVE(S)

Preoperative neoadjuvant chemoradiotherapy (nCRT) and total rectal mesenteric resection (TME) are the primary treatment options for locally advanced rectal cancer (LARC), but their efficacy varies. This study aimed to investigate the impact of anemia on the tumor response of patients with LARC receiving preoperative neoadjuvant chemoradiotherapy.

MATERIALS/METHODS

This study was a retrospective analysis of clinical and pathological data from patients with LARC who underwent nCRT and TME from January 2019 to May 2022 at a single institution. The tumor response was evaluated based on the tumor regression grade (TRG) and T-stage change of the primary tumor. Hemoglobin concentration was measured and graded to determine the presence of anemia. Anemia was categorized into four groups based on the hemoglobin levels: mild anemia (90-120 g/L), moderate anemia (60-90 g/L), severe anemia (30-60 g/L), and extreme anemia (less than 30 g/L). Finally, tumor response was quantified histologically using the AJCC 8th edition tumor regression grading system for rectal cancer and pre- and post-treatment T-grading.

RESULTS

A total of 88 patients with LARC who received nCRT and TME were included in the study, with 17 females and 71 males. Of these patients, 9 were moderately anemic and 37 were mildly anemic. The radiation therapy regimen was administered at a dose of 1.8-2 Gy per fraction, five times a week, for a total dose of 45-50.4 Gy. Capecitabine chemotherapy was also administered orally (825 mg/m2, twice a day) on the days of radiation therapy. Other chemotherapy regimens included XELOX and mFOLFOX6. The TRG was significantly different in anemic patients compared to non-anemic patients (P = 0.039). Only 2 out of 46 anemic patients (4%) showed an excellent response (TRG0), while 8 out of 42 non-anemic patients (19%) showed an excellent response (p = 0.043). There was also a significant difference in the incidence of anemia between cT3 and cT4 stages (p = 0.048), with 44% of cT3 patients and 67% of cT4 patients being anemic. The number of patients with poor response (TRG2-3) decreased as the degree of anemia decreased, but no significant difference was found. The incidence of TRG3 was 11% in patients with moderate anemia and 7% in non-anemic patients (P = 0.863). There was no significant difference in postoperative pathological T-stage between anemic and non-anemic patients. 89% of anemic patients had a pathological stage of ypT3 or less after chemoradiotherapy, while 95% of non-anemic patients did (P = 0.167). The pre- and post-treatment pathological staging did not significantly differ between anemic and non-anemic patients. 67% of anemic patients had descending tumors, while 59.5% of non-anemic patients had descending tumors (p = 0.509).

CONCLUSION

Patients with LARC who have normal hemoglobin concentrations during nCRT have better tumor regression compared to patients with anemia. Additionally, the incidence of anemia was higher among patients with advanced T-stage prior to treatment.

Correlation between Lymph Node Regression Grading and Tumor Regression Grading after Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

PURPOSE/OBJECTIVE(S)

This study aimed to determine the relationship between tumor regression grading (TRG) and lymph node regression grading (LRG) after neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer (LARC).

MATERIALS/METHODS

The study was a retrospective analysis of the clinical data of LARC patients who underwent preoperative nCRT at one institution. A total of 101 rectal cancer patients who received nCRT and underwent total rectal mesenteric excision (TME) were included. Pathologists independently assessed the pathological response of the primary tumor and lymph nodes (LN) to nCRT using TRG and LRG, respectively. The highest LRG score for each patient was defined as LRGmax, and LRGsum was the overall tumor burden of all LNs in the specimen.

RESULTS

The study included 101 LARC patients who underwent nCRT and TME. The patient population consisted of 65 males and 36 females with an average age of 54.86 years (range 20-81 years), of which 68 were aged 60 years or younger and 33 were older than 60. The radiotherapy treatment plan consisted of 1.8-2Gy per dose, administered 5 times per week for a total dose of 45-50.4Gy, along with oral capecitabine chemotherapy (825 mg/m2, bid) on the day of radiation therapy. The chemotherapy treatment plan included XELOX, mFOLFOX6, and FOLFOX4. The cTNM stage of the tumor before surgery was cT2 in 2 cases, cT3 in 63 cases, and cT4 in 36 cases. Eight cases were cN0 and 93 were cN+. After surgery, the ypTNM stage was T0 in 19 cases, T1 in 4 cases, T2 in 27 cases, T3 in 45 cases, and T4 in 6 cases. The N stage was N0 in 76 cases, N1 in 20 cases, and N2 in 5 cases. TRG was 0 in 17 cases (16.8%), 1 in 15 cases (14.9%), 2 in 61 cases (60.4%), and 3 in 8 cases (7.9%). LRGmax scores were 0 in 66 cases (65.3%), 1 in 17 cases (16.8%), 2 in 5 cases (5.0%), 3 in 3 cases (3.0%), 4 in 5 cases (5.0%), and 5 in 5 cases (5.0%). LRGsum scores were ≤3 in 85 cases (84.2%), 4-9 in 11 cases (10.9%), and ≥10 in 5 cases (5.0%). Correlation analysis showed that LRGmax was significantly correlated with TRG, ypT, and ypN (P = 0.038, P = 0.015, P < 0.01), with correlation coefficients of 0.184, 0.212, and 0.626, respectively. There was no significant correlation between LRGmax and cT and cN+. Similarly, LRGsum was significantly correlated with TRG, ypT, and ypN (P = 0.022, P = 0.002, P < 0.01) with correlation coefficients of 0.212, 0.276, and 0.707, respectively. There was no significant correlation between LRGsum and cT and cN. The results of our study indicate a significant correlation between LRG and TRG (P = 0.022). Additionally, LRG was found to be positively correlated with the ypT and ypN stages of the primary tumor and lymph nodes post-surgery, with correlation coefficients of 0.276 and 0.707, respectively (P = 0.002 and P<0.01). No significant correlations were observed between LRG and cT and cN+ stages.

CONCLUSION

Our findings demonstrate a significant association between LRG and TRG, as well as a positive correlation between LRG and the ypT and ypN stages of the primary tumor and lymph nodes following surgery.

[Epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021]

Objective: To explore the present situation and epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021, and to provide scientific evidence for further prevention and control. Methods: In January 2022, the pesticide poisoning report cards of Chengdu City from 2012 to 2021 were collected from the China Disease Control and Prevention Information System. The data of the report card was reorganized and the distribution characteristics of pesticide poisoning such as time, region, gender, age and pesticide types were analyzed. Results: 14326 cases of pesticide poisoning were reported in Chengdu City from 2012 to 2021, 651 deaths, and the fatality rate was 4.54%. The cases of productive pesticide poisoning and unproductive pesticide poisoning were 504 and 13822, respectively. The fatality rates of productive and unproductive pesticide poisoning were 1.39% and 4.66%, which were significant different (χ(2)=11.99, P=0.001). The highest reported cases of pesticide poisoning was in 2013 (1779) and the lowest in 2021 (1047). The number of reported cases showed a downward trend year by year (t=-12.30, P<0.001), and the fatality rates also showed a downward trend year by year (χ(2)(trend)=25.48, P<0.001). The fluctuation range of unproductive pesticide poisoning cases in each month of the year was small, and the productive pesticide poisoning mainly occurred from May to August. The regions with the largest number of reported poisoning cases were Pengzhou (1620), Jianyang (1393), Jintang (1266) and Qionglai (1158). The high incidence of poisoning was among 25-54 years old (50.21%, 7193/14326). The fatality rate in the age group 75-96 years old was the highest (8.98%, 95/1058), and the fatality rates increased gradually with age (χ(2)(trend)=186.03, P<0.001). The pesticides causing poisoning were mainly insecticide (43.86%, 6284/14326) and herbicides (35.75%, 5121/14326). Herbicides paraquat had the highest fatality rate (9.54%, 286/2998) . Conclusion: Pesticide poisoning in Chengdu City is mainly unproductive poisoning. Health education should be carried out for key areas and people, and the control of highly toxic pesticides such as insecticide and herbicides should be strengthened.

[Exposure level of neonicotinoid pesticides and their metabolites in pregnant women in the suburb of Shanghai]

In 2021, a total of 151 pregnant women were selected from the suburb of Shanghai. A questionnaire survey was conducted to obtain data about maternal age, gestational week, total annual household income, education level and passive smoking among pregnant women and one spot urine was collected. The concentrations of eight neonicotinoid pesticides and four metabolites in urine were measured by ultra-high performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. The differences in detection frequencies and concentrations of neonicotinoid pesticides and their metabolites among pregnant women with different characteristics were compared, and the influencing factors of the detection of neonicotinoid pesticides in urine were analyzed. The results showed that at least one neonicotinoid pesticide was detected in 93.4% (141 samples) of urine samples. The detection frequencies of N-desmethyl-acetamiprid, clothianidin, thiamethoxam, and N-desmethyl-clothianidin were high, about 78.1% (118 samples), 75.5% (114 samples), 68.9% (104 samples), and 44.4% (67 samples), respectively. The median concentration of the sum of all neonicotinoid pesticides was 2.66 μg/g. N-desmethyl-acetamiprid had the highest detection concentration with a median concentration of 1.04 μg/g. A lower urinary detection frequency of imidacloprid and its metabolites was seen in pregnant women aged 30-44 years [OR (95%CI): 0.23 (0.07-0.77)]. A higher detection frequency of clothianidin and its metabolites was seen in pregnant women with per capita annual household income≥100, 000 yuan [OR (95%CI): 6.15 (1.56-24.28)]. There was widespread exposure to neonicotinoid pesticides and their metabolites in pregnant women from the suburb of Shanghai, which might pose potential health risks to pregnant women, and maternal age and household income were potential influencing factors of the exposure to neonicotinoid pesticides.

Nomograms for predicting survival in patients with gastric carcinoid or neuroendocrine carcinoma based on the SEER database

OBJECTIVE

The aim of this study was to construct a competent model that can effectively predict the prognosis of patients with gastric carcinoid (GC) or neuroendocrine carcinoma (NEC).

PATIENTS AND METHODS

Data of patients with GC or NEC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2017. Univariable and multivariable Cox analysis was used to determine the independent factors for patients with GC or NEC. Nomograms were established based on the independent factors and the results were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

RESULTS

A total of 214 patients with GC and 65 patients with gastric NEC were extracted from the SEER database. Independent prognostic factors for patients with GC were M stage, gender, age, and chemotherapy. Independent prognostic factors for patients with gastric NEC included age, M stage, and chemotherapy. ROC curves, calibration curves, and DCA confirmed that the nomograms can precisely predict the prognosis of patients with GC and NEC.

CONCLUSIONS

The nomograms can effectively predict survival in patients with GC or NEC, which may assist the clinician in their decision-making and quantitatively judge the prognosis of individual patients.

Reproducibility of T1ρ and T2 quantification in a multi-vendor multi-site study

OBJECTIVE

To evaluate the multi-vendor multi-site reproducibility of two-dimensional (2D) multi-echo spin-echo (MESE) T2 mapping (product sequences); and to evaluate the longitudinal reproducibility of three-dimensional (3D) magnetization-prepared angle-modulated partitioned k-space spoiled gradient echo snapshots (MAPSS) T1ρ and T2 mapping (research sequences), and 2D MESE T2 mapping, separated by 6 months, in a multi-vendor multi-site setting.

METHODS

Phantoms and volunteers (n = 5 from each site, n = 20 in total) were scanned on four 3 T magnetic resonance (MR) systems from four sites and three vendors (Siemens, General Electric, and Phillips). Two traveling volunteers (3 knees) scanned at all 4 sites at baseline and 6-month follow-up. Data was transferred to one site for centralized processing. Coefficients of variation (CVs) were calculated to evaluate reproducibility.

RESULTS

For baseline 2D MESE T2 measures, average CV were 0.37-2.45% (intra-site) and 5.96% (inter-site) for phantoms, and 3.15-8.49% (intra-site) and 14.16% (inter-site) for volunteers. For longitudinal phantom data, intra-site CVs were 1.42-3.48% for 3D MAPSS T1ρ, 1.77-3.56% for 3D MAPSS T2, and 1.02-2.54% for 2D MESE T2. For the longitudinal volunteer data, the intra-site CVs were 2.60-4.86% for 3D MAPSS T1ρ, 3.33-7.25% for 3D MAPSS T2, and 3.11-8.77% for 2D MESE T2.

CONCLUSION

This study demonstrated excellent intra-site reproducibility of 2D MESE T2 imaging, while its inter-site variation was slightly higher than 3D MAPSS T2 imaging (10.06% as previously reported). This study also showed excellent reproducibility of longitudinal T1ρ and T2 cartilage quantification, in a multi-vendor multi-site setting for both product 2D MESE T2 and 3D MAPSS T1p/T2 research sequences.

Association between early vasopressor administration and in-hospital mortality in critically ill patients with acute pancreatitis: A cohort study from the MIMIC-IV database

OBJECTIVE

This study aims to explore the association between early administration of vasopressors and in-hospital mortality in acute pancreatitis (AP) patients admitted to the ICU.

PATIENTS AND METHODS

The MIMIC-IV database was used to identify AP patients who had and had not received vasopressors. Univariate and multivariate logistic regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) were used for statistical analysis.

RESULTS

A total of 894 AP patients admitted to the ICU were included in the study. Among them, AP patients who received vasopressors were associated with an increased risk of in-hospital mortality in the unadjusted model (OR: 7.77, 95% CI 4.92-12.61, p<0.001), multivariable-adjusted model (OR: 2.51,95% CI 1.1-5.76, p<0.05), PSM model (OR: 2.58, 95% CI 1.03-6.85, p<0.05) and IPTW model (OR: 1.82, 95% CI 1.06-3.15, p<0.05) compared with patients who did not receive vasopressors. In the subgroup analysis, age (≥ 65 years old: OR: 2.5, 95% CI 0.82-7.91; <65 years old: OR: 4.63, 95% CI 0.84-26.41), male (OR: 1.19, 95% CI 0.35-4.03), ethnicity (white: OR: 2.49, 95% CI 0.81-7.62; non-white: OR: 4.28, 95% CI 0.85-23.7), usage of norepinephrine (OR: 2.29, 95% CI 0.91-5.78), and single-use of vasopressor (OR: 1.48, 95% CI 0.43-4.95) were not associated with in-hospital mortality in patients with AP, whereas vasopressin (OR: 4.27, 95% CI 1.24-15.13; p<0.05) and phenylephrine usage (OR: 4.75, 95% CI 1.66-13.95; p<0.05), combined vasopressor usage (OR: 4.41, 95% CI 1.55-12.96; p<0.01), and female usage (OR: 7.89, 95% CI 2.03-34.2; p<0.01) were associated with in-hospital mortality.

CONCLUSIONS

Early vasopressor use is significantly associated with increased in-hospital mortality among critically ill AP patients. This association might be greater in females, vasopressin, phenylephrine, and combined vasopressor users. Our results may benefit clinicians as they can guide the rational use of vasopressors in critically ill AP patients admitted to the ICU.

[Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns]

Objective: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of small area secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burns. Methods: A retrospective observational study was carried out. According to the adopted treatment methods, 18 patients (12 males and 6 females, aged (29±6) years) who received autologous FUE transplantation for small area cicatricial alopecia after burns from March 2017 to November 2019 in the First Affiliated Hospital of Air Force Medical University were included in FUE transplantation group, and 18 patients (13 males and 5 females, aged (33±5) years) who were treated with expanded flap transplantation for small area cicatricial alopecia after burns by the same surgery team during the same period in the same hospital were included in expanded flap transplantation group. All the patients were followed up for more than 1 year. At the last follow-up, the follicular unit density in the transplanted area was measured by Folliscope hair detection system and the hair survival rate was calculated; the visual analogue scale (VAS) method was adopted to evaluate the treatment effect; patients were asked their satisfaction with the treatment effect and the occurrence of complications during follow-up; the hair growth and the scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area were recorded. Data were statistically analyzed with Fisher's exact probability test and independent sample t test. Results: At the last follow-up, the follicular unit density in the transplanted area of patients in FUE transplantation group was (46.8±2.0)/cm2, which was significantly higher than (42.5±4.3)/cm2 in expanded flap transplantation group (t=3.84, P<0.01); the hair survival rates of patients were similar between the two groups (P>0.05). At the last follow-up, VAS scores evaluating the treatment effect of patients were similar between the two groups (P>0.05); the satisfaction score of patients toward the treatment effect in FUE transplantation group was 8.6±1.1, which was significantly higher than 7.6±0.8 in expanded flap transplantation group (t=2.89, P<0.01). During the follow-up, no inflammation or infection occurred in patients of the two groups, but only 2 patients in expanded flap transplantation group had postoperative pain. At the last follow-up, the transplanted area of patients in the two groups was covered with new hair, and the hair growth direction was basically consistent with the surrounding normal hair; scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area of patients were similar between the two groups (P>0.05). Conclusions: Autologous FUE transplantation has better long-term follicular unit density and patients' satisfaction than expanded flap transplantation in the treatment of small area cicatricial alopecia after burns, showing better postoperative effect and a good prospect of clinical application.

Comprehensive investigation on non-volatile and volatile metabolites in four types of green teas obtained from the same tea cultivar of Longjing 43 (Camellia sinensis var. sinensis) using the widely targeted metabolomics

In this study, we produced roasted, baked, steamed, and sun-dried green tea products using the same batch of fresh tea leaves (FTL) of Longjing 43 (Camellia sinensis var. sinensis), and explored processing effects on the metabolic profiles of four types of green teas (FGTs) using the widely targeted metabolomics. Results showed that 146 differential metabolites including flavonoids, amino acids, lipids, and phenolic acids were screened among 1034 non-volatiles. In addition, nineteen differential metabolites were screened among 79 volatiles. Most of non-volatiles and volatiles metabolites changed notably in different manufacturing processes, whereas there were no significant differences (p＞0.05) in the levels of total catechins between FGTs and FTL. The transformation of metabolites was the dominant trend during green tea processing. The results contribute to a better understanding of how the manufacturing process influences green tea quality, and provide useful information for the enrichment of tea biochemistry theory.

Insights into crucial odourants dominating the characteristic flavour of citrus-white teas prepared from citrus reticulata Blanco 'Chachiensis' and Camellia sinensis 'Fudingdabai'

Citrus-white teas (CWs), which possess a balanced flavour of tea and citrus, are becoming more popular worldwide; however, their characteristic flavour and odourants received limited research. Volatile components of two types of CWs prepared from Citrus reticulata Blanco 'Chachiensis' and Camellia sinensis 'Fudingdabai' were comprehensively investigated using a combination of stir bar sorptive extraction and gas chromatography-mass spectrometry (GC-MS). Ninety-nine crucial odourants in the CWs were quantified by applying GC-olfactometry/MS, significant differences were compared, and their odour activity values (OAVs) were calculated. Twenty-two odourants (in total 2628.09 and 1131.18 mg/kg respectively) were further confirmed as traditional CW (CW-A) and innovated CW (CW-B) characteristic flavour crucial contributors which all possessed > 1 OAVs, particularly limonene (72919 in CW-A) and trans-β-ionone (138953 in CW-B). The unravelling of CWs aroma composition will greatly expanding our understanding of tea aroma chemistry and the potential aroma interactions will offer insights into tea blending technologies.

[Dihydromyricetin improves cardiac insufficiency by inhibiting HMGB1 in diabetic rats]

OBJECTIVE

To investigate the effect of dihydromyricetin (DHM) on cardiac insufficiency in diabetic rats and explore the underlying mechanism.

METHOD

Twenty-four male SD rats were randomized equally into normal control group, type 2 diabetes (T2DM) group fed on a high-glucose and high-fat diet for 6 weeks with low-dose streptozotocin (STZ) injection, metformin (MET) group with daily intragastric administration of MET (150 mg/kg) for 8 weeks after T2DM modeling, and dihydromyricetin (DHM) group with daily intragastric administration of DHM (250 mg/kg) for 8 weeks after modeling. The levels of fasting blood glucose, low density lipoprotein (LDL-C), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C) and glycosylated hemoglobin (HbA1c) of the rats were measured, and plasma levels of insulin and high mobility group protein-1 (HMGB1) were detected with ELISA. The cardiac function of the rats was assessed using color echocardiography, ECG was measured using a biological signal acquisition system, and myocardial pathology was observed with HE staining. The protein expressions of HMGB1, nuclear factor-κB (NF-κB) p65 and phospho-NF-κB p65 (p-NF-κB p65) in the myocardial tissue were detected using Western blotting.

RESULTS

Compared with the control group, the rats in T2DM group showed significant anomalies in cardiac function after modeling with significantly increased plasma HMGB1 level and expressions of HMGB1, NF-κB p65 and p-NF-κB p65 proteins in the myocardial tissue (P < 0.05 or 0.01). Treatment with DHM significantly improved the indexes of cardiac function of the diabetic rats (P < 0.05 or 0.01), decreased plasma HMGB1 level and down-regulated the protein expressions of HMGB1 and p-NF-κB p65 in the myocardial tissue (P < 0.05 or 0.01).

CONCLUSION

DHM treatment can improve cardiac function in diabetic rats possibly by down-regulation of HMGB1 and phospho-NF-κB p65 expressions in the myocardium.

Comparison between a phenomenological approach and a morphoelasticity approach regarding the displacement of extracellular matrix

Plastic (permanent) deformations were earlier, modeled by a phenomenological model in Peng and Vermolen (Biomech Model Mechanobiol 19(6):2525–2551, 2020). In this manusctipt, we consider a more physics-based formulation that is based on morphoelasticity. We firstly introduce the morphoelasticity approach and investigate the impact of various input variables on the output parameters by sensitivity analysis. A comparison of both model formulations shows that both models give similar computational results. Furthermore, we carry out Monte Carlo simulations of the skin contraction model containing the morphoelasticity approach. Most statistical correlations from the two models are similar, however, the impact of the collagen density on the severeness of contraction is larger for the morphoelasticity model than for the phenomenological model.

Hypolipidaemic and antioxidant effects of various Chinese dark tea extracts obtained from the same raw material and their main chemical components

In order to investigate the hypolipidaemic and antioxidant effects of various dark teas produced from different post-fermentation using the same raw material, a hyperlipidaemia zebrafish model combined with binding bile salts assay and antioxidant assays were performed in this study. Results showed that the hypolipidaemic effect of dark tea extracts increased significantly (p < 0.05) while the antioxidant ability decreased sharply compared with raw material. Particularly, Liupao tea (50%) and Pu-erh tea (48%) showed promising hypolipidaemic potential; however, the antioxidant capacity of Pu-erh tea decreased (31-49%) most dramatically. Besides, the levels of total polyphenols and catechins decreased sharply, but theabrownin, gallic acid, and caffeine increased significantly after post-fermentation. Moreover, the potential mechanisms of regulating hyperlipidaemia by dark tea extracts were discussed. These results suggest that microbial fermentation significantly affects the bioactivity of dark teas, and provide theoretical basis for processing and improving of dark tea products for hyperlipidaemia therapy.

1459 Intravesical Chemohyperthermia Versus Bacillus Calmette-Guerin Instillation for Intermediate- And High-Risk Non-Muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

Introduction

Traditional intravesical chemotherapy instillations under room temperature post trans-urethral resection (TUR) of non-muscle invasive bladder cancer (NMIBC) have lower efficacies than maintenance BCG installations. Intravesical chemo-hyperthermia (CHT) at higher temperatures is developed to improve the efficacy of chemotherapy instillation. This systematic review aims to compare the use of CHT and BCG instillation post-TUR.

Method

The protocol of this review is registered on PROSPERO(CRD42020223277). A comprehensive literature search was performed on Medline, EMBASE, and Cochrane CENTRAL to identify studies comparing CHT and BCG post-TUR for intermediate- or high-risk NMIBC. Primary outcomes include recurrence-free survival (RFS) and progression-free survival (PFS). Secondary outcomes include adverse events (AE).

Results

From 2,375 identified records, four randomised control trials incorporating 327 patients were included for meta-analysis. The use of CHT was found to be non-inferior to BCG in RFS, PFS and AEs (Grades 1-3) (p &gt; 0.05). Sensitivity analysis, excluding patients with BCG failures, show 24-36 months recurrence rate to be significantly lower in CHT group (RR 0.64, 95% CI 0.42-0.98, p = 0.04) compared to the BCG group. In patients without carcinoma in situ (CIS), RFS is also significantly better in CHT patients (HR 0.52, 95% CI 0.32- 0.85, p &lt; 0.01). Safety profile remains non-inferior to the BCG group in sensitivity analyses. Quality of evidence across all outcomes ranged from moderate to low.

Conclusions

In well-selected patients, intravesical CHT has superior oncological outcomes and non-inferior safety profile when compared to BCG maintenance therapy for patients with intermediate- and high-risk NMIBC. CHT is a possible alternative treatment during BCG shortage.

Insight into the pigmented anthocyanins and the major potential co-pigmented flavonoids in purple-coloured leaf teas

Tea cultivars possessing purple shoots have attracted global interest. In order to gain a better understanding of the major chemical constituents responsible for the purple colouration, we applied widely targeted metabolomics to investigate the pigmented flavonoids of freeze-dried purple-coloured tea leaves (PTLs) in comparison with green-coloured tea leaves (GTLs). Thirty-three anthocyanins were identified, and delphinidin 3-O-galactoside and cyanidin 3-O-galactoside were found to be the most abundant in PTLs. A total of 226 metabolites including 193 flavonoids and 33 tannins were identified, and the methylated, acylated, and glycosylated flavonoids differed significantly between PTLs and GTLs. Moreover, significant differences (p < 0.01) in the average anthocyanin, flavonoid, chlorophyll and catechin contents were also observed. Four PTLs were found to contain high levels of (-)-epigallocatechin-3-(3″-O-methyl) gallate (>10 mg/g). These results suggest that structurally modified anthocyanins and major potential co-pigmented flavonoids are the chemicals primarily responsible for the purple colouration of the tea leaves.

AB0809 PADUA PREDICTION SCORE COMBINED WITH SERUM ALBUMIN FOR THE IDENTIFICATION OF VENOUS THROMBOEMBOLISM OF HOSPITALIZED PATIENTS IN THE DEPARTMENT OF RHEUMATOLOGY

Background:

Venous thromboembolism (VTE) includes thrombotic disease of venous system, but primarily includes lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE). Population-based epidemiological studies have shown an association between systemic autoimmune diseases and VTE[1]. The Padua prediction score(PPS) is a new 20-point risk assessment model proposed by Professor Barbar et al[2] in 2010. A large number of researches have shown that low serum albumin concentration is associated with an increased risk of VTE [3],but there is a lack of studies on serum albumin in VTE, and there are no reports on PPS in rheumatology inpatients.

Objectives:

To investigate the status of VTE in patients in the department of rheumatology, and to explore the value of PPS combined with serum albumin in the identification of VTE in this patient population.

Methods:

Baseline data of inpatients in rheumatology department were collected at Sichuan Provincial People’s Hospital from September 2018 to September 2020. Occurrence of VTE was compared between high and low risk groups. PPSs were analyzed in VTE and non-VTE patients. Multivariate logistic regression was used to analyze the independent risk factors of VTE. The receiver operating characteristic curve was used to evaluate the probablity of value of rheumatic inpatients with VTE assessed by PPS,serum albumin and PPS with serum albumin. P<0.05 indicates that the difference was statistically significant.

Results:

A total of 2282 patients were included in this study, and 50(2.2%) had symptomatic VTE. Among the symptomatic VTE cases,38(1.6%) had DVT only,8(0.4%) had PE only, and 4(0.2%) were diagnosed with DVT and PE. PPSs in VTE and non-VTE groups were 3.00(2.00~6.00) and2.00(1.00~2.00) respectively (P< 0.05). One hundred and eighty-eight cases was divided into high-risk group of VTE (PPS≥4), while 2094 cases (PPS<4) were in the low-risk group. Logistic regression analysis showed that known thrombophilic condition, history of VTE, reduced mobility, and D-dimer were independent risk factors of VTE in rheumatology patients, the odd ration(OR) values were 161.90, 26.08, 8.73,and1.04. Serum albumin was the independent protection factor [OR= 0.92(95%CI:0.87~0.98)]. The AUC of PPS model, serum albumin model and the combined predictive model were 0.77, 0.75, 0.84, respectively. The difference between the combined prediction model and PPS model was statistically significant (Z=3.813, P<0.05). The optimal sensitivity of PPS and serum albumin models is 60%, 82%, respectively, and the optimal specificity of is 82.5%,58.6%, respectively. The combination model corresponds to a sensitivity of 62% and a specificity of 90.4%.

Conclusion:

The incidence of symptomatic VTE was relatively higher in hospitalized patients in rheumatology department. Serum albumin was the protective factor. The combination of albumin and PPS can improve the accuracy of screening for VTE in rheumatology in-patients.

References:

[1]Tamaki H,Khasnis A.Venous thromboembolism in systemic autoimmune diseases: A narrative review with emphasis on primary systemic vasculitides.[J].Vasc Med, 2015, 20: 369-76.

[2]Barbar S, Noventa F, Rossetto V,et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score[J]. J Thromb Haemost,2010,8(11):2450–2457.

[3]Kunutsor SK,Seidu S,Katechia DT et al. Inverse association between serum albumin and future risk of venous thromboembolism: interrelationship with high sensitivity C-reactive protein.[J].Ann Med, 2018, 50: 240-248.

Disclosure of Interests:

None declared

Long noncoding RNA Linc00210 promotes non-small cell lung cancer progression via sponging miR-16-5p/PTK2 axis

OBJECTIVE

Long noncoding RNAs (lncRNAs) are important regulators involved in a variety of cancer development. However, the role of Linc00210 in non-small cell lung cancer (NSCLC) remains unknown. This study aims to investigate the clinical value of Linc00210 in NSCLC patients and the biological functions of Linc00210 in NSCLC.

PATIENTS AND METHODS

Gene expression in NSCLC tissues and cell lines was detected using qRT-PCR or Western blot. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and colony formation assays were conducted to evaluate the effect of Linc00210 on NSCLC cell proliferation. Transwell assay and annexin V-Fluorescein 5-isothiocyanate (FITC)/Propidium Iodide (PI) were done to analyze the effect of Linc00210 on cancer cell invasion and apoptosis, respectively. Luciferase reporter assay and RIP assay were performed to determine the target of Linc00210 and miR-16-5p. Besides, these assays were used to determine reciprocally inhibition of each other-controlled NSCLC cell behaviors. In vivo tumorigenesis experiments were applied to exhibit subcutaneous tumor growth.

RESULTS

Linc0021 was highly expressed in NSCLC tissues and cell lines. Knockdown of Linc00210 inhibited cancer cell proliferation and invasion, and increased cell apoptosis, and regulated the expression of Cyclin A1, proliferating cell nuclear antigen (PCNA), E-cadherin, N-cadherin, Bax, and Bcl-2 in NSCLC cells. Further data showed Linc00210 bound to and directly modulated the miR-16-5p levels. Impressively, overexpression of miR-16-5p suppressed NSCLC cell proliferation and invasion, but increased cell apoptosis, and these behaviors could be overturned by overexpression of Linc00210 in vitro and in vivo. Finally, Linc00210 and miR-16-5p cooperatively controlled expression of protein tyrosine kinase 2 (PTK2), a miR-16-5p target.

CONCLUSIONS

Linc00210/miR-16-5p/PTK2 signaling suggests a promising novel strategy for anti-NSCLC therapy.

Integrated proteomic and metabolomic analyses reveal the importance of aroma precursor accumulation and storage in methyl jasmonate-primed tea leaves

In response to preharvest priming with exogenous methyl jasmonate (MeJA), tea plants adjust their physiological behavior at the molecular level. The whole-organism reconfiguration of aroma formation from the precursor to storage is poorly understood. In this study, we performed iTRAQ proteomic analysis and identified 337, 246, and 413 differentially expressed proteins in tea leaves primed with MeJA for 12 h, 24 h, and 48 h, respectively. Furthermore, a total of 266 nonvolatile and 100 volatile differential metabolites were identified by utilizing MS-based metabolomics. A novel approach that incorporated the integration of extended self-organizing map-based dimensionality was applied. The vivid time-scale changes tracing physiological responses in MeJA-primed tea leaves are marked in these maps. Jasmonates responded quickly to the activation of the jasmonic acid pathway in tea leaves, while hydroxyl and glycosyl jasmonates were biosynthesized simultaneously on a massive scale to compensate for the exhausted defense. The levels of α-linolenic acid, geranyl diphosphate, farnesyl diphosphate, geranylgeranyl diphosphate, and phenylalanine, which are crucial aroma precursors, were found to be significantly changed in MeJA-primed tea leaves. Green leaf volatiles, volatile terpenoids, and volatile phenylpropanoids/benzenoids were spontaneously biosynthesized from responding precursors and subsequently converted to their corresponding glycosidic forms, which can be stably stored in tea leaves. This study elucidated the physiological response of tea leaves primed with exogenous methyl jasmonate and revealed the molecular basis of source and sink changes on tea aroma biosynthesis and catabolism in response to exogenous stimuli. The results significantly enhance our comprehensive understanding of tea plant responses to exogenous treatment and will lead to the development of promising biotechnologies to improve fresh tea leaf quality.

Impact of Various Microbial-Fermented Methods on the Chemical Profile of Dark Tea Using a Single Raw Tea Material

In the present study, we produced Pu-erh, Liubao, Qingzhuan, and Fuzhuan teas using a single raw tea material and applied widely targeted metabolomics to study the impact of various microbial-fermented methods on the chemical profile of dark tea. The contents of catechins and free amino acids decreased drastically, whereas the contents of gallic acid and theabrownins increased significantly during microbial fermentation. Pu-erh tea had the highest content of theabrownins (11.82 ± 0.49%). Moreover, MS-based metabolomics analysis revealed that the different types of dark teas were significantly different from their raw material. A total of 85 differential metabolites were screened among 569 metabolites identified referring to self-compiled database. Glycosylated, hydroxylated, methylated, and condensed and oxidated products originating from microbial bioconversion of their corresponding primitive forms were significantly increased in dark teas. These results suggest that various microbial-fermented methods greatly affect the metabolic profile of dark tea, which can provide useful information for dark tea biochemistry research.

Discrimination and Identification of Aroma Profiles and Characterized Odorants in Citrus Blend Black Tea with Different Citrus Species

Citrus blend black teas are popular worldwide, due to its unique flavor and remarkable health benefits. However, the aroma characteristics, aroma profiles and key odorants of it remain to be distinguished and cognized. In this study, the aroma profiles of 12 representative samples with three different cultivars including citrus (Citrus reticulata), bergamot (Citrus bergamia), and lemon (Citrus limon) were determined by a novel approach combined head space-solid phase microextraction (HS-SPME) with comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (GC×GC-TOFMS). A total of 348 volatile compounds, among which comprised esters (60), alkenes (55), aldehydes (45), ketones (45), alcohols (37), aromatic hydrocarbons (20), and some others were ultimately identified. The further partial least squares discrimination analysis (PLS-DA) certified obvious differences existed among the three groups with a screening result of 30 significant differential key volatile compounds. A total of 61 aroma-active compounds that mostly presented green, fresh, fruity, and sweet odors were determined in three groups with gas chromatography-olfactometry/mass spectrometry (GC-O/MS) assisted analysis. Heptanal, limonene, linalool, and trans-β-ionone were considered the fundamental odorants associated with the flavors of these teas. Comprehensive analysis showed that limonene, ethyl octanoate, copaene, ethyl butyrate (citrus), benzyl acetate, nerol (bergamot) and furfural (lemon) were determined as the characterized odorants for each type.

Plasminogen improves lung lesions and hypoxemia in patients with COVID-19

BACKGROUND

Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin and 'ground-glass' opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection.

AIM

We aimed to investigate whether plasminogen can improve lung lesions and hypoxemia of COVID-19.

DESIGN

Thirteen clinically moderate, severe or critical COVID-19 patients were treated with atomization inhalation of freeze-dried plasminogen.

METHODS

Levels of their lung lesions, oxygen saturation and heart rates were compared before and after treatment by computed tomography scanning images and patient monitor.

RESULTS

After plasminogen inhalation, conditions of lung lesions in five clinically moderate patients have quickly improved, shown as the decreased range and density of 'ground glass' opacity. Improvements of oxygen saturation were observed in six clinically severe patients. In the two patients with critical conditions, the oxygen levels have significantly increased from 79-82% to 91% just about 1 h after the first inhalation. In 8 of 13 patients, the heart rates had slowed down. For the five clinically moderate patients, the difference is even statistically significant. Furthermore, a general relief of chest tightness was observed.

CONCLUSION

Whereas it is reported that plasminogen is dramatically increased in adults with ARDS, this study suggests that additional plasminogen may be effective and efficient in treating lung lesions and hypoxemia during COVID-19 infections. Although further studies are needed, this study highlights a possible hope of efficiently combating this rapid epidemic emergency.

FRI0443 CLINICAL CHARACTERISTICS AND RELATED FACTORS OF COMMON RHEUMATIC DISEASES COMPLICATED WITH TUBERCULOSIS INFECTION

Background:

Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and syndrome(SS) are common rheumatic diseases with high incidence. Patients with those rheumatic diseases are at high risk of tuberculosis (TB) infection. However, manifestations can be atypical and easily confused with those of rheumatic disease itself. For those patients, diagnosis is usually much more difficult and further make treatment delayed. Sometimes it may lead to mistreatment. Therefore, it is important to recognize the clinical characteristics of those patients.

Objectives:

To explore the clinical characteristics and high risk factors of common systemic rheumatism complicated with tuberculosis infection.

Methods:

A total of 3,906 cases of RA, SLE, and SS common systemic rheumatism diagnosed in the People’s Hospital of Sichuan Province from January 2007 to January 2017 were collected with carefully exclusion with other infectious diseases and neoplastic disease. One hundred and five patients with TB were included as infection group, including 42 cases of RA, 41 cases of SLE, and 22 cases of SS. In the control group, 84 patients with RA, 82 patients with SLE, and 44 patients with SS were randomly selected from the corresponding rheumatoid non-infected patients hospitalized during the same period.

Results:

Fever was the most common symptom among 42 cases of RA, 41 cases of SLE, and 22 cases of SS with TB, accounting for 83.3%, 92.7%, and 68.2%, respectively. Cough, weight loss or fatigue was less common. For 41 cases of SLE and 22 cases of SS with TB, the proportion of pulmonary was 46.3%, 59.01%, respectively.In TB infection group, 27 cases of RA, 21 cases of SLE, and 13 cases of SS with TB had two or more chest CT findings, accounting for 59%, 57%, 62%, respectively. Lesions located in the posterior or posterior segment which TB usually affected were 9 cases(33.3%),9cases(42.9%),6cases(27.2%),respectively.The daily average dose of hormones within 1 year in TB infection group was higher than that in the control group (P<0.05). For SLE patients, lower counts of CD4+TL were found in TB infection group (P<0.05), while no such differences were found in RA and SS group.

Conclusion:

Patients with RA who have TB infection are mainly pulmonary TB. For SLE and SS patients, the chance of pulmonary tuberculosis and extra-pulmonary tuberculosis is similar.Symptoms of RA, SLE, SS with TB, such as fever, cough, weight loss, fatigue, are similar with the primary disease or other infection. Chest imaging is diversity. It is difficult to diagnose.Daily average dose of hormone within one year may be a common risk factor for RA, SLE and SS patients with TB. Decreased CD4+TL may also be a risk factor for SLE patients with TB.

References:

[1]Cantini F, Nannini C, Niccoli L, et al. Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics[J]. Mediators of Inflammation, 2017, 2017(6):1-15.

[2]Ruangnapa K, Dissaneewate P, Vachvanichsanong P. Tuberculosis in SLE patients: rare diagnosis, risky treatment.[J]. Clinical & Experimental Medicine, 2015, 15(3):429-432.

[3]Manuela D F, Bruno L, Martina S, et al. Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections[J]. International Journal of Molecular Sciences, 2017, 18(2):293-315.

[4]Disseminated tuberculosis masquerading as a presentation of systemic lupus erythematosus.Li JC, Fong W, Wijaya L, Leung YY.Int J Rheum Dis. 2017 Oct 2. doi: 10.1111/1756-185X.13195.

[5]Handa R, Upadhyaya S, Kapoor S, et al. Tuberculosis and biologics in rheumatology: India – A special situation[J]. International Journal of Rheumatic Diseases, 2017, 51(2):115.

Disclosure of Interests:

None declared

SAT0209 PREVALENCE AND RELATED FACTORS OF SLEEP DISTURBANCE IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME

Background:

The incidence of primary Sjögren’s syndrome(pSS) is increasing gradually,and it was ranking second among connective tissue diseases(CTDs)in China.Studies recently have shown that many patients with various CTDs have sleep disturbances,which seriously degraded the patient’s quality of life.As well known, Sleep is an important physiological process to maintain human metabolism, tissue repair,and homeostasis. At present,there are relatively several studies on sleep quality in patients with Rheumatoid arthritis(RA)and Systemic lupus erythematosus(SLE),but less reports on pSS in China have been published.Therefore,it is important to explore the quality of sleep and its influencing factors in such patients.

Objectives:

The purpose of this study is to evaluate the quality of sleep and related factors in China Mainland patients with primary Sjögren’s syndrome(pSS),and to provide reference and theoretical basis for constructing targeted sleep interventions and improve their quality of life.

Methods:

A all of 103 pSS patients and 40 matched healthy controls were enrolled in a comparative study of sleep quality using the Pittsburgh Sleep Quality Index(PSQI),and demographic,clinical,and laboratory data were collected from them.The patients completed questionnaires on the European League Against Rheumatism (EULAR)SS Patient Reported Index(ESSPRI), EULAR SS Disease Activity Index (ESSDAI),Xerostomia inventory(XI)with the help of researchers,Pain and fatigue were evaluated with a 100-mm visual analogue scale(VAS).Generalized Anxiety Disorder(GAD-7) and Patient Health Questionnaire(PHQ-9) were used to assess anxiety and depression separately,and whether they have autonomic symptoms (such as sweating, palpitations.)will be asked.

Results:

The PSQI score and the frequency of poor sleep quality(PSQI>7) were higher in the pSS patients (11.60±5.03,71.8%)than the healthy controls(5.98±3.85,25%).Poor sleepers had a significantly higher GAD-7,PHQ-9,XI,ESSPRI,pain and fatigue VAS,and longer disease duration than good sleepers.Additionally, poor sleepers show more frequent autonomic symptoms.Sleep quality of patients with pSS was positive correlated with GAD-7,PHQ-9,XI,ESSPRI,pain and fatigueVAS scores,but no correlation with disease activity.Meanwhile,depression is a independent factor of sleep quality.

Conclusion:

Our study showed that the sleep disturbance seen in patients with pSS may contribute to the depression associated with this disease,Future research should investigate that whether antidepressant treatment improve sleep and directly improve quality of life.

References:

[1]AustadC, Kvien TK, Olsen I C.Sleep disturbance in patients with rheumatoid arthritis is related to fatigue, disease activity,and other patient-reported outcomes[J]. Scandinavian journal of rheumatology, 2017, 46(2): 95-103.

[2]Lewis I, Hackett K L,Ng W F,et al.A two-phase cohort study of the sleep phenotype within primary Sjögren’s syndrome and its clinical correlates[J].Clinical and experimental rheumatology,2019,37(3):78-82.

[3]Chung S W, Hur J, Ha Y J, et al. Impact of sleep quality on clinical features of primary Sjögren’s syndrome[J]. The Korean journal of internal medicine, 2019,34(5):1154.

[4]Liu X, Tang M, Hu L. Reliability and validity of the Pittsburgh sleep quality index[J].Chinese journal of psychiatry,1996,29:103-107.

[5]Grabovac I,Haider S, Berner C,et al.Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity[J].Journal of clinical medicine,2018,7(10):336.

Disclosure of Interests:

None declared

Sustained IFN-I stimulation impairs MAIT cell responses to bacteria by inducing IL-10 during chronic HIV-1 infection

Mucosal-associated invariant T (MAIT) cells in HIV-1-infected individuals are functionally impaired by poorly understood mechanisms. Single-cell transcriptional and surface protein analyses revealed that peripheral MAIT cells from HIV-1-infected subjects were highly activated with the up-regulation of interferon (IFN)-stimulated genes as compared to healthy individuals. Sustained IFN-α treatment suppressed MAIT cell responses to Escherichia coli by triggering high-level interleukin-10 (IL-10) production by monocytes, which subsequently inhibited the secretion of IL-12, a crucial costimulatory cytokine for MAIT cell activation. Blocking IFN-α or IL-10 receptors prevented MAIT cell dysfunction induced by HIV-1 exposure in vitro. Moreover, blocking the IL-10 receptor significantly improved anti-Mycobacterium tuberculosis responses of MAIT cells from HIV-1-infected patients. Our findings demonstrate the central role of the IFN-I/IL-10 axis in MAIT cell dysfunction during HIV-1 infection, which has implications for the development of anti-IFN-I/IL-10 strategies against bacterial coinfections in HIV-1-infected patients.

Correction to: Pelvic fat volume reduction with preoperative very low energy diet (VLED): implications for rectal cancer surgery in the obese

Due to substantial contributions by Dr. Phillip Malouf and Dr. Stephen Bell.

Pelvic fat volume reduction with preoperative very low energy diet (VLED): implications for rectal cancer surgery in the obese

BACKGROUND

Obese patients have higher complication rates after pelvic surgery. Laparoscopic rectal surgery may not be possible in the obese individual due to mesorectal, total pelvic and general visceral fat volumes. Very low energy diets reduce visceral fat but the changes within the pelvis and mesorectum are unknown. The aim of the present study was to quantify the proportion of fat lost from total pelvic and mesorectal fat with a very low energy diet (VLED) and define simple, accessible measurements that correlate with expected volume reduction.

METHODS

A study was conducted on proportion change in mesorectal and intrapelvic fat volumes in patients on a VLED prior to bariatric surgery at the Alfred Hospital in Melbourne. The VLED was a standardized 4-week meal replacement. Proportion change in mesorectal and intrapelvic fat volumes were measured. Patients had standardized pre-diet and post-diet magnetic resonance imaging (MRI) of the pelvis. Body mass index, weight and girth measures were obtained. Adipose quantification analysis was performed using Q-Fat.

RESULTS

Nine patients were included in this study, who were preparing for bariatric (not colorectal) surgery (5 females, median age 42 years, range 27-59 years) pre-protocol body mass index was 55.8 (range 39.5-60.6 kg/m²); median weight was 163 kg. Median mesorectal fat reduction was 29.9% (range 11.6-66.6%). Linear regression showed a relationship between the amount of mesorectal fat reduction and two variables: patient height and the distance from S1 to the posterior aspect of the rectum on MRI. The relationship predicted response to the diet (R² 67%, p = 0.040).

CONCLUSIONS

Very low energy diets result in a clinically significant reduction in mesorectal fat with a lesser change in total pelvic fat, suggesting that very low energy diets may be useful for preparation for pelvic surgery in the obese. The distance from S1 to the posterior rectum correlates well with mesorectal reduction, making this a valuable clinical tool when volumetric analysis is not possible. This analysis is limited to the quantification of the effect of the diet and cannot comment on the safety of this approach before pelvic cancer surgery.

[Effects of parthenolide on estradiol-synthesizing enzyme, ER isoforms and VEGF in human endometriotic stromal cells]

Objective: To evaluate the effects of parthenolide on estradiol-synthesizing enzyme, steroidogenic acute regulatory protein (StAR), and ER isoforms,VEGF in human endometriotic stromal cells. Methods: Primary endometriotic stromal cells were treated with different concentrations (1, 5, 10 and 20 μmol/L) of parthenolide. The mRNA of StAR, ER isoforms (ERα and ERβ), PR, vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), tumour necrosis factor-α (TNFα), tumour necrosis factor receptor (TNFR) 1, TNFR2 were measured by real-time PCR. The levels of estradiol and progesterone in the cell supernatant were measured by ELISA. Results: Different concentrations of parthenolide could up-regulate the mRNA of StAR in primary endometriotic stromal cells (F=5.722, P<0.05); the mRNA of StAR in the group of 20 μmol/L was significantly higher than that of the control group [2.6±0.3 versus 1.0, P<0.01]. Different concentrations of parthenolide could down-regulate the mRNA of ERα (F=6.921, P<0.01); the mRNA of ERα in the group of 20 μmol/L and 10 μmol/L were significantly lower than those of the control group [0.2±0.3 versus 0.3±0.3 versus 1.0, all P<0.05]. Different concentrations of parthenolide could down-regulate the ratios of ERα/ERβ mRNA levels (F=4.209, P<0.05). Different concentrations of parthenolide could up-regulate the mRNA of VEGF and TNFR1 (F=10.964, P<0.01; F=7.286, P<0.01). There were no statiscal significances with different concentrations of parthenolide on the mRNA of ERβ, PR, IL-6, TNFα and TNFR2, and the levels of estradiol and progesterone in the cell supernatant (all P>0.05). Conclusions: Parthenolide may regulate the expression of estradiol-synthesizing enzyme, ER isoforms and angiogenesis in endometriotic stromal cells. Parthenolide may promote the development of endometriosis.

Endoscopic submucosal multi-tunnel dissection for large early esophageal cancer lesions

OBJECTIVE

To evaluate the safety and efficacy of endoscopic submucosal multi-tunnel dissection (ESMTD) for early esophageal cancer lesions larger than 3 cm in diameter or cumulatively greater than 1/2 lumen size.

METHOD

Early esophageal cancer lesions in 15 patients were detected by endoscopy and endoscopic ultrasonography in our endoscopy center from December 2012 to June 2015. All lesions were successfully resected by ESMTD and diagnosed by pathology, and therapeutic efficiency and safety were followed after surgery.

RESULTS

All 15 of the early esophageal cancer lesions were resected by ESMTD. The pathological results showed 9 moderately differentiated and 6 highly differentiated squamous cell carcinomas. En bloc resection was achieved in 13 lesions, with negative lateral and basal margins on pathology, whereas the other 2 required additional surgery. The average diameter of the resected lesions was 4.2±0.9 cm. The mean procedure time was 94.7±52.9 min. Esophageal stenosis was observed in 7 patients for whom esophageal water balloon dilatation was performed. No residual or recurrent lesion was found during the 6-36-month follow-up period.

CONCLUSION

ESMTD is a safe and efficient technique for treating large early esophageal cancer lesions. Grasping the key techniques of this procedure can reduce operating difficulty and shorten the operating time.

[Prediction of syncope with nonlinear dynamic analysis during head-up tilt in vasovagal syncope patients]

OBJECTIVE

To quantify the relationship between cerebral blood flow velocity and peripheral blood pressure during hypotension period, aiming to predict the brain hypotension before symptomatic occurrence.

METHODS

Twenty vasovagal syncope (VVS) patients who had a previous clinical history were selected in groups and 20 pair-matched control subjects underwent 70° tilt-up test. The subjects remained supine for 30 minutes before recordings when Doppler probes, electrodes and Finapres device were prepared. After continuous baseline recordings for 10 min, the subjects underwent head up tilt (HUT) test (70°), and were standing upright for 30 minutes or until syncope was imminent. For ethical reasons, the subjects were turned back to supine position immediately after SBP dropped to ≥20 mmHg, when their consciousness persisted. The point of syncope was synchronized for all the subjects by the point SBP reached the minima. Their beat-to-beat blood pressures (BP) were recorded continuously and bilateral middle cerebral artery (MCA) flow velocities were obtained with two 2 MHz Doppler probes from a transcranial Doppler ultrasonography (TCD) system. A nonlinear dynamic method--multimodal pressure flow (MMPF) analysis was introduced to access cerebral autoregulation during different time intervals. We introduced a new indicator--syncope index (SI), which was extracted from blood flow velocity (BFV) signal to evaluate the variation of cerebral vascular tension, and could reflect the deepness of dicrotic notch in BFV signal.

RESULTS

Compared with the syncope index of the baseline value at the beginning of the tilt test, SI in VVS group showed significantly lower when the VVS occurred (0.16±0.10 vs.0.27±0.10,P<0.01),while there was no significant difference in syncope index between the control group at the end of the tilt test and the baseline value at the beginning of the tilt test. For those VVS patients, pulse index and resistance index had no significant change. Syncope index decreased significantly 3 minutes before the point of syncope (0.23±0.07 vs.0.29±0.07,P<0.01).

CONCLUSION

Dynamic regulation is exhausted when vasovagal syncope occurred. Tension decrease of small vessels could have some relationship with loss of the cerebral autoregulation capability. The proposed syncope index could be a useful parameter in predicting syncope of VVS patients since it decreased significantly up to 3 minutes earlier from the point of syncope.

Methyl Jasmonate-Induced Changes of Flavor Profiles During the Processing of Green, Oolong, and Black Tea

Tea aroma is one of the most important factors affecting the character and quality of tea. Here we describe the practical application of methyl jasmonate (MeJA) to improve the aroma quality of teas. The changes of selected metabolites during crucial tea processing steps, namely, withering, fixing and rolling, and fermentation, were analyzed. MeJA treatment of tea leaves (12, 24, 48, and 168 h) greatly promotes the aroma quality of green, oolong, and black tea products when comparing with untreated ones (0 h) and as confirmed by sensory evaluation. MeJA modulates the aroma profiles before, during, and after processing. Benzyl alcohol, benzaldehyde, 2-phenylethyl alcohol, phenylacetaldehyde, and trans-2-hexenal increased 1.07- to 3-fold in MeJA-treated fresh leaves and the first two maintained at a higher level in black tea and the last two in green tea. This correlates with a decrease in aromatic amino acids by more than twofold indicating a direct relation to tryptophan- and phenylalanine-derived volatiles. MeJA-treated oolong tea was characterized by a more pleasant aroma. Especially the terpenoids linalool and oxides, geraniol, and carvenol increased by more than twofold.

Vibrational spectroscopic study on feed molecular structure properties of oil-seeds and co-products from Canadian and Chinese bio-processing and relationship with protein and carbohydrate degradation fractions in ruminant systems

The objective of this study was to apply ATR-FTIR spectroscopy to reveal feed molecular structure properties of oil-seeds and co-products and relationship with protein and carbohydrate degradation fractions in ruminant systems. The oil-seeds and co-products were from both various bio-processing industries in Canada and China. The protein and carbohydrate degradation fractions were evaluated with updated CNCPS system. Results showed that in the co-products from canola processing industries there are strong relationship between 1) soluble true protein (PA2) fraction and the following protein molecular structure spectral characteristics; spectral peak area of amide I and amide II (r = 0.56, P = 0.001), area of amide I (r = 0.67, P < 0.001), height of amide I (r = 0.74, P < 0.001), amide I and II ratio (r = 0.57, P = 0.001), α-helix (r = 0.82, P < 0.001), and β-sheet (r = 0.61, P < 0.001), 2) slowly degradable true protein (PB2) fraction and height of amide I (r = -0.60, P = 0.001), α-helix (r = -0.72, P < 0.001), and β-sheet (r = -0.51, P = 0.004), 3) soluble fiber (CB2) fraction and α-helix and β-sheet height ratio (r = -0.63, P < 0.001), and 4) unavailable NDF (CC) fraction and height of amide I (r = 0.55, P = 0.002). These results indicated feed molecular structure spectral properties of the oil-seeds and co-products related to CNCPS protein and carbohydrate degradation fractions in ruminant systems.

[Comparison of parameters for diffusion-weighted intravoxel incoherent motion imaging in lung cancer patients with different histopathological subtypes]

Objective: To explore the intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) model in lung cancer patients with different histopathological subtypes. Methods: A total of 105 patients were recruited, including 68 cases of adenocarcinoma, 22 cases of squamous carcinoma and 15 cases of small cell carcinoma. All patients underwent magnetic resonance examination consisting of axial IVIM-DWI sequence on a 3.0 T whole body scanner, then the standard ADC (sADC), diffusion coefficient (D), pseudo-diffusion coefficient(D(*)), perfusion fraction (f), distributed diffusion coefficient (DDC) and water diffusion heterogeneity index (α) were calculated for each lesion within the IVIM-DWI model. Results: Mean sADC values were (1.45±0.26) ×10(-3)mm(2)/s, (1.36±0.48) ×10(-3)mm(2)/s and (1.35±0.40) ×10(-3)mm(2)/s for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean f values were (59.75±16.37) %, (47.41±18.69) % and (48.96±19.88) % for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean α values were 0.72±0.13 for adenocarcinoma, 0.62±0.12 for squamous carcinoma, and 0.63±0.11 for small cell carcinoma, respectively. Statistical analyses indicated that the sADC, f and α values among different histopathological subtypes were significantly different (P<0.05), while there was no significant difference in D, D(*) and DDC values (P>0.05). Furthermore, the comparison showed that the sADC, f and α values of patients with adenocarcinoma were significantly higher than those with squamous carcinoma or small cell carcinoma (P<0.05), whereas there was no significant difference between squamous carcinoma group and small cell carcinoma group (P>0.05). Conclusions: The sADC, f and α values derived from the IVIM-DWI model can be used for comprehensive non-invasive evaluation of diffusion, perfusion and heterogeneity of microenvironment in lung cancer patients. And the IVIM-DWI model may be a promising tool for predicting histopathological subtypes of lung cancer.