[Short-term efficacy and safety of cardiac contractility modulation in patients with heart failure]

Objective: To investigate the short-term efficacy and safety of cardiac contractility modulation (CCM) in patients with heart failure. Methods: This was a cross-sectional study of patients with heart failure who underwent CCM placement at the First Affiliated Hospital of Xinjiang Medical University from February to June 2022. With a follow-up of 3 months, CCM sensation, impedance, percent output, and work time were monitored, and patients were compared with pre-and 3-month postoperative left ventricular ejection fraction (LVEF) values, and 6-minute walk test distance and New York Heart Association (NYHA) cardiac function classification, and the occurrence of complications was recorded. Results: CCM was successfully implanted in all 9 patients. Seven(7/9) of them were male, aged (56±14) years, 3 patients had ischaemic cardiomyopathy and 6 patients had dilated cardiomyopathy. At 3-month postoperative follow-up, threshold was stable, sense was significantly lower at follow-up than before (right ventricle: (16.3±7.0) mV vs. (8.2±1.1) mV, P<0.05; local sense: (15.7±4.9) mV vs. (6.7±2.5) mV, P<0.05), and impedance was significantly lower at follow-up than before (right ventricle (846±179) Ω vs. (470±65) Ω, P<0.05, local sense: (832±246) Ω vs. (464±63) Ω, P<0.05). The CCM output percentage was (86.9±10.7) %, the output amplitude was (6.7±0.4) V, and the daily operating time was (8.6±1.0) h. LVEF was elevated compared to preoperative ((29.4±5.2) % vs. (38.3±4.3) %, P<0.05), the 6-minute walk test was significantly longer than before ((96.8±66.7)m vs. (289.3±121.7)m, P<0.05). No significant increase in the number of NYHA Class Ⅲ-Ⅳ patients was seen (7/9 vs. 2/9, P>0.05). The patient was not re-hospitalised for worsening heart failure symptoms, had no malignant arrhythmic events and experienced significant relief of symptoms such as chest tightness and shortness of breath. No postoperative complications related to pocket hematoma, pocket infection and rupture, electrode detachment, valve function impairment, pericardial effusion, or cardiac perforation were found. Conclusions: CCM has better short-term safety and efficacy in patients with heart failure.

Identification and Validation of a Ferroptosis Prognostic Model for Prostate Cancer Patients through Screening the TCGA and scRNA-seq Datasets

PURPOSE/OBJECTIVE(S)

Ferroptosis is currently a common mode of programmed cell death, and the induction of ferroptosis is a new strategy and idea for current tumor therapy. Therefore, the signaling pathways and genes regulated by ferroptosis are significant markers for current malignant tumor therapy. To construct a prognostic model for predicting the survival prognosis of prostate cancer (PCa) based on the molecules and markers related to ferroptosis, we combined with differentially expressed genes (DEGs) in PCa patients, and further analyze the correlation between this risk score and immune cell infiltration. Finally, to validate the expression of risk genes and analyze the expression and localization of risk genes in using the datasets of single cell RNA-sequencing (scRNA-seq).

MATERIALS/METHODS

Firstly, we screened the DEGs in PCa patients by the expression profiles of TCGA database. Meanwhile, we collected the information of ferroptosis regulatory genes from FerrDb, and these two parts were intersected. Then the impact of genes on the survival and prognosis of PCa patients was confirmed and selected by LASSO regression, further screening of molecules and fitting the risk format. And the efficacy of the model was evaluated by ROC curves. The immune cell infiltration of PCa tissues was predicted using TIMER. Last, the scRNA-seq of PCa (GSM5155455, GSM3735993) were carried to reveal the expression of risk molecules in different cell types. Besides, the expression of risk molecules was validated using PCa cell lines.

RESULTS

We found a total of 259 DEGs associated with ferroptosis in PCa tissues. After LASSO regression, we screened DRD5, LINC00336, ACSF2, RRM2, NOX1, GDF15, ALB, MIOX, and NOX4 as variables to establish a prognostic model, and the specific risk scores was calculated following this format: Risk score = (-1.9465)*DRD5+(-1.6806)*LINC00336+(0.3045)*ACSF2+(0.4747)*RRM2+(-0.2815)*NOX1+(-0.1871)* GDF15+(0.1846)*ALB+(0.2676)*MIOX+(0.1648)*NOX4 (lambda.min = 0.0032), with a 10-yr AUC value of 0.751 (95% CI, 0.549-0.953). Furthermore, we discovered the higher the scores, the fewer CD8+ T cells infiltrated as predicting, showing a negative relationship. By testing the gene sets of scRNA-seq forPCa, we discovered that RRM2, GDF15, ALB, and MIOX were mainly expressed in tumor cells, T cells, B cells and neutrophils of PCa tissues, and not in endothelial cells. Finally, we detected differences in protein expression of RRM2, GDF15, and MIOX in PCa cell lines compared to normal prostate cancer epithelium by WB.

CONCLUSION

We constructed a novel prognostic model for PCa based on ferroptosis-related genes, which showed better predictive validity. And we analyzed the cellular expression of risk genes by scRNA-seq, which will be explored future in relation to prostate cancer radiotherapy.

HPK1 Inhibition Enhancing HFRT Anti-Tumor Immune Response

PURPOSE/OBJECTIVE(S)

Radiation therapy, as one of the canonical treatments for classic tumors, results in impressive clinical responses. Stereotactic body radiotherapy (SBRT) has been increasingly used as one main therapy in early-stage non-small-cell lung cancer (NSCLC). SBRT affords good local tumor control, however, recurrence and metastasis are still the main causes of treatment failure. With the continuous deepening of the relationship between radiotherapy (RT) and immunity, reversing RT induced immunosuppression is considered to be a promising strategy to improve radiotherapy efficacy. Hematopoietic progenitor kinase 1 (HPK1) is mainly expressed in immune cells while rarely expressed in tumor cells. It has been proven to play a negative regulatory role in T cell receptor (TCR) signal. Therefore, we hypothesized that the combination of HPK1 inhibitor with SBRT would boost local and systemic anti-tumor immune responses by potentiating the anti-tumor effects of SBRT.

MATERIALS/METHODS

Using Digital Spatial Profiler (DSP), we analyzed HPK1 expression in the tumor specimens of 39 NSCLC patients treated with SBRT. By establishing mice subcutaneous tumor models, we assessed the combination of a HPK1 inhibitor and local hyper-fractionated radiotherapy (HFRT) on local and systemic tumor control and mouse survival. Using Single-cell RNA sequencing, Flow cytometry and pharmacological treatment, we analyzed and verified Tumor-infiltrating lymphocytes (TILs), and excavated the specific mechanism of the HPK1 inhibitor enhancing HFRT -induced anti -tumor immune response.

RESULTS

In the tumor specimens of NSCLC patients treated with SBRT, we found that high expression HPK1 in TILs predicted poor progression-free survival (PFS). Among the C57BL/6 mice model, HFRT combined with a HPK1 inhibitor promoted local response, and improved the survival rate of mice, showing better anti-tumor curative effects. We further showed that HFRT promoted CD8+ T cell cytotoxic activity, and also aggravated CD8+ T cell exhaustion. After the intervention of HPK1 small molecular inhibitors, the proportion of exhaustion CD8+T cells was significantly reduced, while CD8+T cell cytotoxic activity was further enhanced in the later period. Single-cell RNA sequencing and pharmacological inhibition of HPK1 revealed that HPK1 mediated the exhaustion of CD8+T cells by regulating RGS16. In abscopal effects preclinical models, BGB-15025 induced obvious abscopal effect.

CONCLUSION

Thus, we demonstrate that HPK1 mediates HFRT-induced CD8+T cell exhaustion by regulating RGS16, and HPK1 is an attractive drug target for enhancing local and systemic radiotherapy.

Radiotherapy Resistance in Prostate Cancer Cells: AKR1C3 Inhibition of Ubiquitinated Degradation of Nrf2 through Interaction with KEAP1

PURPOSE/OBJECTIVE(S)

Radiotherapy is the most fundamental treatment for prostate cancer (PCa), and although radiotherapy for overall PCa patients is effective, poor prognosis and resistance to multiple treatments regimes in some highly malignant PCa, such as those with high Gleason Scores (GS) (≥9), are important bottlenecks limiting the improvement of treatment outcomes for clinical. AKR1C3 is a key PCa resistance gene that our team identified previously, but the induction of the specific mechanism of radiotherapy resistance has not been fully revealed and understand.

MATERIALS/METHODS

To analyze the correlation between its expression level and clinical radiotherapy, we used the gene expression profiles data of PCa patients in TCGA database. We generated a stepwise increase of radiotherapy dose to established PCa radiotherapy resistant cell lines and detect the AKR1C3 expression level. In addition, to explore the molecular mechanism of AKR1C3 induced prostate cancer radiation tolerance through functional enrichment analysis. Then, to treat cells with cycloheximide and the protein stability of the Nrf2 was detected. Last, the protein ubiquitination level was assayed by co-immunoprecipitation (co-IP) after treatment with MG132. Finally, protein-protein interactions were identified using co-IP to mine possible binding molecules.

RESULTS

By analyzing the expression profiles data of PCa patients in the TCGA database, we found that in the population of PCa patients treated with radiotherapy, all patients with high AKR1C3 expression died after radiotherapy, suggesting that high AKR1C3 expression may be a biomarker of resistance to radiation. Accordingly, AKR1C3 expression levels showed a positive correlation with GS score, which may be a symbol for patients with highly malignant PCa. A PCa radiotherapy resistant cell line was constructed by a stepwise increase of ionizing radiation (IR) dose, and the total IR dose of radiotherapy was 84Gy, which reached the dose of radical radiotherapy for prostate cancer. The expression of AKR1C3 was further detected by RT-qPCR and WB, and it was found that the expression of AKR1C3 was significantly up-regulated in the resistant cell line, accompanied by milder DNA damage. What's more, by GSEA functional enrichment analysis, we discovered that AKR1C3 overexpression might be related with intracellular oxidative stress damage. After CHX treatment, the protein stability of Nrf2 was significantly enhanced in AKR1C3 overexpression groups than control groups. And the administration of MG132 showed the same results, indicating that the ubiquitinated degradation of Nrf2 was inhibited in AKR1C3 overexpression groups. Further by co-IP, we found that Nrf2 was less ubiquitinated in the cytoplasm after AKR1C3 overexpression, and AKR1C3 could bind Keap1.

CONCLUSION

In sum, we found that AKR1C3 can bind with Keap1 leading to reduced ubiquitination level of Nrf2, causing upregulation of Nrf2 expression and providing new insights into PCa radiotherapy resistance.

The Baseline Serum Lipid Levels and Outcomes of NSCLC Patients Receiving Immunotherapy Combined or Non-Combined with Radiotherapy: A Single Center Retrospective Study

PURPOSE/OBJECTIVE(S)

In recent years, many studies have shown that lipids and lipid-like substances are key regulatory factors in tumor development and play an important role in immune regulation. However, it remains unclear whether serum lipids influence the outcome of immunotherapy. Therefore, determining the serum lipid levels of the immune treatment-beneficiary population may be valuable. The aim of this study is to evaluate the prognostic value of baseline serum lipid levels in non-small cell lung cancer (NSCLC) patients receiving immunotherapy.

MATERIALS/METHODS

We retrospectively included 294 patients with stage III-IV NSCLC who received immunotherapy continuously from December 2018 to November 2021 at our hospital, collecting their pre-treatment lipid levels, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Of these, 160 receiving immunotherapy without combined radiotherapy (ICIs-nRT) and 134 combined with radiotherapy (iRT). The endpoint was the correlation between pre-treatment serum lipid levels and overall survival (OS), as well as progression-free survival (PFS). The X-tile tool was used to determine the optimal cut-off value of the indicators. The Kaplan-Meier survival curves were used to calculate OS and PFS and log rank tests were used for comparison. And the Cox proportional hazard model were used for univariate and multivariate analysis.

RESULTS

In all 294 patients, low TG, low TC, and low HDL-C predicted poor OS (P<0.001) and poor PFS (P<0.05). Low LDL-C was associated with poor OS (P = 0.0001). Among 160 patients receiving ICIs-nRT and 134 iRT patients, low levels of TG (P = 0.0134, 0.0024), TC (P = 0.0003, 0.0023), HDL-C (P = 0.0004, 0.0043), and LDL-C (P = 0.0003, 0.0419) were associated with worse OS compared to high levels of them. In the ICIs-nRT patients, low HDL-C predicted poor PFS (P = 0.0011). In 134 iRT patients, low levels of TG (P = 0.0017), TC (P = 0.0028), and LDL-C (P = 0.0330) were poor prognostic factors for PFS. In the univariate and multivariate analysis with OS in all patients, TG and HDL-C were independent risk factors, while TG was an independent risk factor in the analysis with PFS. In ICIs-nRT patients, HDL-C was an independent prognostic factor for patients' OS and PFS. In iRT patients, both TG and HDL-C were prognostic risk factors for OS.

CONCLUSION

These data confirm that higher serum lipid levels are associated with better outcomes in patients with NSCLC undergoing immunotherapy. Serum lipids may identify tumors that are more likely to respond to immunotherapy. Radiation therapy may affect lipid metabolism within the body to enhance the efficacy of immunotherapy.

A Dosimetric Study Indicates the Spinal Cord Irradiation Contributes to Acute Hematologic Toxicities in Non-Small Cell Lung Cancer Patients Receiving Radiotherapy Combined with Immunotherapy

PURPOSE/OBJECTIVE(S)

To assess the radiation therapy (RT) dose to radiation-associated hematologic toxicities (HTs) in patients with non-small cell lung cancer (NSCLC) after RT combined with immunotherapy.

MATERIALS/METHODS

Cases of NSCLC treated with RT combined with immunotherapy at Shandong Cancer Hospital in China were identified. The mean dose and the volume of the spinal cord receiving at least 5 to 40 Gy (V5-V40) were retrospectively recorded. Logistic regression was used to estimate associations between grade ≥3 HT (HT3+) and dosimetric/clinical parameters. Receiver operating characteristic analysis was used to determine dosimetric cut-points.

RESULTS

Ninety-nine patients were analyzed. The majority were male (n = 78, 78.8%) and received chemotherapy (n = 83, 83.9%). All patients received either anti-PD-1 immune checkpoint (n = 89, 89.9%) or anti-PD-L1 immune checkpoint (n = 10, 10.1%) therapy. The rate of HT3+ was 24.2% (n = 24). Spinal cord mean dose, V5 to V40 and BMI parameters associated with HT3+ were included in the multivariate analysis. On multivariate analysis, increasing mean spinal cord dose (per Gy) was associated with higher odds of developing HT3+ (odds ratio 1.053, 95% confidence interval 1.002-1.105, P = .041), as were increasing spinal cord V5 to V20 (As show in the Table below). The optimal cut-points identified were V5 = 52.5%, V10 = 47.5%, V20 = 39.4%, and mean dose = 23.3 Gy. Patients with values above these cut-points had an approximately 2-fold increased risk of HT3+.

CONCLUSION

We found that mean spinal cord dose and low-dose parameters (V5-V20) were associated with HT3+ in NSCLC patients after RT and immunotherapy. The mean dose of the spinal cord should be kept lower than 23.3 Gy for these patients. These data suggested that efforts to spare doses to the spinal cord might reduce rates of severe HT.

Molecular cloning, expression analysis and functional characterization of chicken cytochrome P450 27A1: A novel mitochondrial vitamin D3 25-hydroxylase

Vitamin D₃ is hydroxylated by cytochrome P450 (CYP) before exerting biological effects. The chicken CYP involved in vitamin D₃ 25-hydroxylation has yet to be cloned, and little is known about its functional characteristics, tissue distribution, and cellular expression. We identified a novel, full-length CYP27A1 gene cloned from chicken hepatocyte cDNA that encodes a putative protein of 518 amino acids. Swiss modeling revealed that chicken CYP27A1 has a classic open-fold form. Multisequence homology alignment determined that CYP27A1 contains conserved motifs for substrate recognition and binding. Quantitative real-time PCR analysis in 2-mo-old Partridge Shank broilers demonstrated that CYP27A1 mRNA levels were highest in the liver, followed by the thigh muscles, the breast muscles, and kidneys. The transcripts of CYP27A1 in breast muscles were significantly higher in males than in females. A subcellular localization analysis demonstrated that CYP27A1 was mainly expressed in the mitochondria. In vitro enzyme assays suggested that recombinant CYP27A1 hydroxylates vitamin D₃ at the C-25 position to form 25-hydroxyvitamin D₃ (25(OH)D₃). The K_m and V_max values for CYP27A1-dependent vitamin D₃ 25-hydroxylation were estimated to be 4.929 μM and 0.389 mol min^-1 mg^-1 protein, respectively. In summary, these results suggest that CYP27A1 encodes a mitochondrial CYP that plays an important physiologic role in the 25-hydroxylation of vitamin D₃ in chickens, providing novel insights into vitamin D₃ metabolism in this species.

[The Physician of the Shao Xing School in the Late Qing Dynasty -- Zhao Qingchu]

Zhao Qingchu, a Confucian physician from the Kuaiji area at the end of the Qing Dynasty, learned from famous physicians of the Shao Xing School on exogenous febirle disease (Shang Han) and the You's of the Shi Cai School, drawing from the knowledge of the both medical schools. He quickly became popular for being a physician after giving up his research of Confucianism. He had a wide physician-patient network because of his art of healing as many politicians and celebrities such like Shao Youlian, Zeng Guoquan, Ren Daorong, Xu Yingkui and Ren Fuchang,were his patients. He was taken as a typical example of being good at the medical communication among doctors and doctors-patients in the Yangtze River area in the late Qing Dynasty. For instance, he once had a variety of medical communication with famous physicians, such as Wang Yuezhen, Ma Peizhi, He Lianchen, Zhang Wanxiang, Ling Jialiu and Zhou Bodu. He investigated medical theories in terms of exogenous febirle disease (Shang Han) and integrated his thinking with various medical schools, even attempting to involving western medicine. He was also skilled in teaching his medical thinking to his disciples, such as Zhao Shuan, Yang Zhian, Lu Dongchuan and He Jiren. Zhao Qingchu compiled his medical understanding based on his practice and experiences throughout his life and published this knowledge in Cun Cun Zhai Yi Hua Gao. He had it published many times, leading to a profound influence in Shaoxing and the Jiangnan area at that time.

Development of a 19-plex short tandem repeat typing system for individual identification and parentage testing of horses (Equus caballus)

Individual identification of horses for pedigree verification and registration is important for the sustainable development of the horse industry. Horse individual identification and parentage tests commonly use the 17 short tandem repeats (STRs) recommended by the International Society for Animal Genetics (ISAG) and the locus LEX33. While many multiplex STR typing systems have been established for the horse, a sex determining marker is usually absent, and none of them can simultaneously detect all 17 ISAG recommended loci and the locus LEX33. Here, we present a 19-plex STR typing system that contains the 17 ISAG recommend loci, the locus LEX33 and amelogenin as sex determining loci. The results of our sensitivity, species specificity, stutter analysis and population data analysis, indicate that this system is a specific, sensitive, and robust tool for the identification of individuals, parentage testing and genetic research in the horse.

A novel 13-plex STR typing system for individual identification and parentage testing of donkeys (Equus asinus)

BACKGROUND

Previous studies investigating donkey parentage and genetic diversity used horse-specific multiplex systems. However, several mis-allele and null-allele issues were found with some of the horse primers when used in donkeys. In 2017, the International Society for Animal Genetics (ISAG) recommended 13 dinucleotide short tandem repeats (STRs) (AHT4, ASB23, HMS2, HMS3, HMS6, HMS7, HMS18, HTG7, HTG10, TKY297, TKY312, TKY337 and TKY343) as a core panel that should be used to identify individuals and to test for parentage in donkeys. To date, no single multiplex STR typing system containing all 13 donkey STRs recommended by the ISAG has been reported.

OBJECTIVES

To establish a novel and donkey-specific multiplex STR typing system containing all 13 recommended STRs.

STUDY DESIGN

Assay development and validation in field population.

METHODS

Primers for seven of the STRs were redesigned and conditions for polymerase chain reaction (PCR) were optimised. We analysed the allele sequences, sensitivity, species-specificity and stutter ratios of this new system.

RESULTS

A 13-plex STR typing system for donkey was established. A full profile could be generated from a single PCR reaction using as little as 5 ng of DNA template with the 13 pairs of primers labelled with fluorescent dyes. An allele ladder, containing 101 alleles from the 13 STRs, was generated. No full genotype profile was generated with these primers if DNA from humans, or 11 other commonly encountered animals, was used. Genotypes could be generated for the horse and horse-donkey hybrids (mule and hinny). Stutter ratios and population genetic parameters were calculated based on samples from 150 donkeys. The combined probabilities of paternity exclusion for this system were 0.988907326 (CPEduo) and 0.999665018 (CPEtrio).

MAIN LIMITATIONS

This system cannot detect sex.

CONCLUSIONS

Our results indicate that our donkey-specific 13-plex STR typing system is sensitive, species-specific and robust for individual identification, paternity testing and population genetic analysis in donkeys, and has potential forensic applications.

Validation of Zero TE-MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

BACKGROUND AND PURPOSE

Zero TE-MRA is less sensitive to field heterogeneity, complex flow, and acquisition noise. This study aimed to prospectively validate the feasibility of zero TE-MRA for cerebrovascular diseases assessment, compared with TOF-MRA.

MATERIALS AND METHODS

Seventy patients suspected of having cerebrovascular disorders were recruited. Sound levels were estimated for each MRA subjectively and objectively in different modes. MRA image quality was estimated by 2 neuroradiologists. The degree of stenosis (grades 0-4) and the z-diameter of aneurysms (tiny group ≤3 mm and large group >3 mm) were measured for further quantitative analysis. CTA was used as the criterion standard.

RESULTS

Zero TE-MRA achieved significantly lower subjective perception and objective noise reduction (37.53%). Zero TE-MRA images showed higher signal homogeneity (3.29 ± 0.59 versus 3.04 ± 0.43) and quality of venous signal suppression (3.67 ± 0.47 versus 2.75 ± 0.46). The intermodality agreement was higher for zero TE-MRA than for TOF-MRA (zero TE, 0.90; TOF, 0.81) in the grading of stenosis. Zero TE-MRA had a higher correlation than TOF-MRA (zero TE, 0.84; TOF, 0.74) in the tiny group and a higher consistency with CTA (intraclass correlation coefficient, 0.83; intercept, -0.5084-1.1794; slope -0.4952 to -0.2093) than TOF-MRA (intraclass correlation coefficient, 0.64; intercept, 0.7000-2.6133; slope -1.0344 to -0.1923). Zero TE-MRA and TOF-MRA were comparable in the large group. Zero TE-MRA had more accurate details than TOF-MRA of AVM and Moyamoya lesions.

CONCLUSIONS

Compared with TOF-MRA, zero TE-MRA achieved more robust performance in depicting cerebrovascular diseases. Therefore, zero TE-MRA was shown to be a promising MRA technique for further routine application in the clinic in patients with cerebrovascular diseases.

[Clinical significance of exosomal miR-1231 in pancreatic cancer]

Objective: To investigate the expression and clinical significance of exosomal miR-1231 in plasma of pancreatic cancer (PC) patients and pancreatic cancer cells. Methods: A total of 16 patients who were diagnosed with pancreatic cancer in Hunan Cancer Hospital were collected from April 2016 to August 2017. Meanwhile, 16 healthy volunteers were recruited as the healthy control group at the same period. The plasma exosomes were extracted, and the levels of miR-1231 were detected by qRT-PCR in PC and healthy control groups. Moreover, the clinicopathological significance of exosomal miR-1231 expression was analyzed. Furthermore, the expression of exosomal miR-1231 was detected in several pancreatic cancer cells (MIA PaCa-2, PANC-1, SW1990, AsPC-1 and BxPc-3) and two normal pancreatic epithelial cells (HPDE and human primary pancreatic epithelial cell). Results: qRT-PCR results showed that the expression level of miR-1231 in plasma exosomes of pancreatic cancer patients (1.06±0.46) was significantly lower than that in healthy controls (2.30±0.99; P<0.05). The levels of exosomal miR-1231 in patients with stage Ⅰ-Ⅱ (1.515±0.531), no distant metastasis (1.236±0.461) and no lymph node metastasis (1.337±0.522) were significantly higher than those with stage Ⅲ-Ⅳ (0.848±0.224), distant metastasis (0.757±0.278) and lymph node metastasis (0.838±0.261), respectively (P<0.05 for all). In addition, there were no correlation between exosomal miR-1231 expression and age, sex, smoking history, CA19-9 levels and tumor sites (P>0.05). Furthermore, the expression level of exosomal miR-1231 in pancreatic cancer cell lines (0.142±0.135) was significantly lower than that in normal epithelial cells (1.127±0.179; P<0.05). Conclusions: The downregulation of exosomal miR-1231 in plasma of pancreatic cancer patients and pancreatic cancer cells suggests that it is related to the initiation and development of PC. It may be a new diagnostic and prognostic marker for PC.

Short communication: Genotyping and single nucleotide polymorphism analysis of bovine leukemia virus in Chinese dairy cattle

Bovine leukemia virus (BLV) causes enzootic leucosis in cattle and is classified into 10 genotypes with a worldwide distribution, except for several European countries, Australia, and New Zealand. Although BLV is widespread in Chinese cows with the positive rate of 49.1% at the individual level, very little is known about the BLV genotype in dairy cattle in China. To determine BLV genetic variability in cows in China, 112 BLV-positive samples from 5 cities in China were used for BLV molecular characterization in this study. Phylogenetic analysis using the neighbor-joining method on partial env sequence encoding gp51 obtained from 5 Chinese cities and those available in GenBank (n = 53, representing BLV genotype 1-10) revealed the Chinese strains belonged to genotype 6. Seven unique SNP were identified among Yancheng, Shanghai, and Bengbu strains out of the total 12 SNP identified in Chinese strains. The genotyping coupled with SNP analysis of BLV can serve as a useful molecular epidemiological tool for tracing the source of pathogens. This study highlights the importance of genetic analysis of geographically diverse BLV strains to understand BLV global genetic diversity.

Expressions and clinical significance of factors related to acute coronary syndrome

Acute coronary syndrome (ACS) is the acute stage of coronary artery disease, which remains a major cause of mortality and morbidity. It is essential to explore the role of matrix metalloproteinase -2 (MMP-2) and interleukin (IL)-18 and their association with disease in patients with severe ACS. Circulating MMP-2 and IL-18 levels were measured using enzyme linked immunosorbent assay (ELISA) in 94 subjects with acute coronary syndrome (ACS, n=38), stable angina pectoris (SAP, n=27) and healthy individuals (control group, n=29). We examined the correlations between the levels of MMP-2 and IL-18 and cardiac risk factors in ACS. Logistic regression analysis was performed to screen for factors that predict ACS. Both MMP-2 and IL-18 concentrations were increased in the ACS group compared to the SAP group or control group (P less than 0.01). Especially, MMP-2 and IL-18 were highly expressed in the patients with ST elevated myocardial infarction (STEMI). Both serum levels of MMP-2 and IL-18 in the single-, double- and triple-vessel lesion group were higher compared to the control group (P less than 0.01). MMP-2 levels were positively correlated with IL-18 (r=0.639, P less than 0.01), CK-MB (r=0.47, P=0.003) and hs-CRP levels (r=0.583, P less than 0.01). The logistic regression analysis showed that increases in MMP-2 levels may be a powerful predictor of ACS. Thus, the changes in levels of serum MMP-2 and IL-18 may be useful in the diagnosis of ACS and prediction of its prognosis.

Abstract P4-05-12: MultiOmyx™ screening for prognostic indicators of breast cancer

Over the last three decades, the incidence of early-stage breast cancer has doubled while the incidence of late stage breast cancer has slightly decreased; however, the standard treatment for both has not changed significantly in the last 10 years. Of those diagnosed with early-stage breast cancer, 30% will develop recurrent disease, though there is currently no diagnostic available to identify these cases. Conversely, identifying late stage patients with a low- risk for recurrence could spare them from post-surgical chemotherapy. We have developed a technology that allows in situ staining and analysis of up to 60 proteins on a single tissue slide. In this exploratory study we evaluated 25 known biomarkers on a cohort of more than 800 breast cancer cases assembled onto three tissue arrays. The cohort spans clinical grades and breast cancer subtypes, and is thus useful in novel associations of biomarker expression across a variety of clinical features. Twenty-five markers were chosen based on literature reports for marker association with disease recurrence and represent a range of biological features including signaling pathways and cell phenotypes. The slides were sequentially stained with antibodies that were directly conjugated to Cy3 and Cy5 dyes, imaged, evaluated for quality and subject inclusion, and subsequently analyzed for statistical correlations of expression values to clinical features. The images were then processed using a single cell analysis algorithm which allows for quantification of individual tumor cells and signal intensities for the markers to be extracted from sub-cellular domains (nucleus, cytoplasm, and membrane of each cell) allowing unique patterns of protein expression to be determined. Univariate Cox proportional hazards analysis was first applied to determine those features with strongest association with ‘death due to disease’. Of the 25 markers analyzed, several markers (e.g. API3, AMPH2, beta-catenin, CD44, CEACAM5, CK15, CK19, cMET, Her2, Ki67, TRIM29) were found to have strong association with poor outcome (FDR &lt; 0.05). After adjusting for clinical variables (stage, number of positive nodes, grade), a number of markers (e.g. CD44, CEACAM5, cMET, TRIM29) still show a strong association with poor clinical outcome (FDR &lt; 0.05, Cox proportional hazards model). CEACAM5 is part of the MammostratTM panel of markers used for determining prognosis in ER positive breast cancers after Tamoxifen® treatment. CD44, a cancer stem cell marker, and TRIM 29, a transcriptional regulatory factor involved in carcinogenesis, have been associated with basal-like breast cancers which have the worst prognosis of all the breast cancer subtypes. High levels of cMET have been associated with poor prognosis for all breast cancer subtypes and cMET is being explored as a therapeutic target. The MultiomyxTM methodology enabled us to verify a subset of biomarkers that are clinically relevant to breast cancer outcome. Using this technology could lead to identification of novel biosignatures that stratify patients and enable precision medicine that results in better treatment decisions and prognosis for patients.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-05-12.

Temporal expression of metalloproteinase-8 and -13 and their relationships with extracellular matrix metalloproteinase inducer in the development of ligature-induced periodontitis in rats

BACKGROUND AND OBJECTIVE

Matrix metalloproteinases (MMPs) play important roles in extracellular matrix degradation and may be regulated by extracellular matrix metalloproteinase inducer (EMMPRIN). The aim of this study was to investigate the temporal expression and localization of MMP-8 and MMP-13 during the development of ligature-induced periodontitis in rats, and to analyze the correlations of EMMPRIN with MMP-8 and MMP-13 in periodontitis.

MATERIAL AND METHODS

Periodontitis was simulated in rats by ligaturing the cervix of the lower first molars, as described in our previous method. The rats were killed 0, 3, 5, 7, 11, 15 and 21 d after ligation. Micro-computed tomography examinations were performed to detect alveolar bone loss. Semiquantitative western blotting was used to assess the temporal changes in the levels of MMP-8, MMP-13 and EMMPRIN proteins in gingival tissue. Immunohistochemistry was applied to detect the expression and locations of MMP-8 and MMP-13 in gingival tissue and alveolar bone.

RESULTS

Alveolar bone loss showed an exponential increase from days 3 to 11, followed by a slower rate of loss at subsequent study time points. MMP-8 showed a rapid increase of expression from baseline to a peak on day 3, a gradual decrease from days 5 to 7 and then stabilized thereafter. MMP-8 was predominantly located in neutrophil-like cells. Statistically, the expression of MMP-8 was not correlated with the expression of EMMPRIN. The expression of MMP-13 and of EMMRPIN increased from days 3 to 7, and showed a moderate decrease thereafter. The immunoreactivity of MMP-13 was mainly detected in monocytes/macrophages, on the alveolar bone surface, in osteoclasts and in gingival epithelial cells. Statistically, MMP-13 had a strong, positive correlation with EMMPRIN (r = 0.855, p < 0.01).

CONCLUSION

The levels of expression of MMP-8 and MMP-13 are temporally varied at different periods during the development of experimental periodontitis. The level of expression of EMMPRIN is closely associated with the expression of MMP-13, but not with the expression of MMP-8. In addition, MMP-13 might be involved in alveolar bone destruction, as well as in physiological bone remodeling.

Rescue of a living donor with liver transplantation

Postoperative liver failure is a rare complication after living donor liver resection. This is a case report of a 22-year-old healthy donor who was rescued with liver transplantation 11 days after right hemihepatectomy. Nine months later the patient is alive, and has fully recovered from his multiple organ failure. According to a review of the literature, there are four additional living liver donors, who received a liver transplant. Our own patient is the only survivor, so far. This case demonstrates that even in supposedly healthy living donors postoperative complications cannot be completely prevented. Although liver failure is rare in these patients, timely transplantation may need to be considered as the only life-saving treatment.

DNA repair contributes to the drug-resistant phenotype of primary acute myeloid leukaemia cells with FLT3 internal tandem duplications and is reversed by the FLT3 inhibitor PKC412

The presence of internal tandem duplications (ITD) mutations in the FMS-like tyrosine kinase 3 (FLT3) receptor influences the risk of relapse in acute myeloid leukaemia (AML). We have investigated DNA repair in FLT3-ITD and wild-type (WT) cells. Using the comet assay, we have demonstrated that the FLT3 inhibitor PKC412 significantly inhibits repair of DNA damage in the MV4-11-FLT3-ITD cell line and FLT3-ITD patient samples but not in the HL-60-FLT3-WT cell line or FLT3-WT patient samples. Following the discovery that transcript levels of the DNA repair gene RAD51 are significantly correlated with FLT3 transcript levels in FLT3-ITD patients, we further investigated the role of RAD51 in FLT3-ITD-AML. The reduction in DNA repair in PKC412-treated FLT3-ITD cells was shown to be associated with downregulation of RAD51 mRNA and protein expression and correlates with the maintenance of phosphorylated H2AX levels, implying that PKC412 inhibits the homologous recombination double-strand break repair pathway in FLT3-ITD cells. Using FLT3-short interfering RNA (siRNA), we also demonstrated that genetic silencing of FLT3 results in RAD51 downregulation in FLT3-ITD cells but not in FLT3-WT cells. This work suggests that the use of FLT3 inhibitors such as PKC412 may reverse the drug-resistant phenotype of FLT3-ITD-AML cells by inhibiting repair of chemotherapy-induced genotoxic damage and thereby reduce the risk of disease relapse.

Proteomics for the early detection and treatment of hepatocellular carcinoma

The prognosis for hepatocellular carcinoma (HCC) is poor and has not improved in recent years, largely owing to lack of early diagnosis, frequent recurrence after surgery and resistance to chemotherapy. Proteomics holds the promise of improving our understanding of HCC carcinogenesis and progression as well as of discovering novel diagnostics and therapeutics. Proteomic analyses of HCC cell lines, animal models and serum and tumor tissue from patients with HCC have been performed to date. Proteomic technologies have greatly improved in the past few years as reviewed here. It is anticipated that with the recent development of protein tagging, protein separation methods and mass spectrometry sensitivity, proteomic studies of HCC will allow the identification of diagnostic and prognostic biomarkers as well as therapeutic targets, which could greatly improve the clinical management of HCC patients.

Determination of the six major human herpesviruses in cerebrospinal fluid and blood specimens of children

AIM

To detect and differentiate six major human herpesviruses in the cerebrospinal fluid (CSF) and blood of children by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP).

METHODS

We synthesized two pairs of primers in the well-conserved regions of the DNA polymerase gene in human herpesviruses. One pair was designed to amplify cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), and the other pair to amplify varicella-zoster virus (VZV) and human herpesvirus 6 (HHV-6) by PCR. Virus species identification was achieved by restriction enzyme digestion with BamHI and BstUI. Ninety-eight CSF and 75 blood specimens were analysed by this technique. At the same time, all blood specimens were also examined by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Thirteen (13.3%) of 98 CSF specimens and 26 (34.7%) of 75 blood specimens were positive for herpesvirus DNA in this PCR assay. Only 10 (13.3%) of the blood specimens were positive in ELISA for virus-IgM antibody. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PCR in detecting herpesvirus infections compared with ELISA were 100% (10/10), 75.4% (49/65), 38.5% (10/26) and 100% (49/49), respectively. These results indicate that the positive rate of PCR was significantly higher than that of ELISA (p < 0.05). The herpesvirus type of these positive specimens was rapidly detected using restriction enzyme digestion with BamHI and BstUI.

CONCLUSIONS

PCR-RFLP is a specific, sensitive and accurate technique for the identification of herpesvirus infections in the CSF and blood of children.

[Mutations of mitochondrial 12S rRNA gene in type 2 diabetes]

OBJECTIVE

To investigate mutations at points 1310, 1438 and 1442 of mitochondrial 12S rRNA gene in Chinese type 2 diabetes and screen for new mutations associated with type 2 diabetes in this area.

METHODS

The mitochondrial DNAs (mtDNAs) of 86 patients with type 2 diabetes and those of 70 normal controls were analyzed using PCR-SSCP and PCR product direct sequencing technique.

RESULTS

One patient was found with the mitochondrial DNA G --> A mutation at point 1438, and one with the G two head right arrow A mutation at point 1442, whereas none of the normal controls was found to have mutation at these two points. No C --> T mutation at nucleotide pair 1310 of the mitochondrial 12S rRNA gene was identified.

CONCLUSION

The G --> A mutation at points 1438 and 1442 is likely to be associated with the development of type 2 diabetes; the occurrence of the C -->T mutation at point 1310 is probably rare in the blood cells, and the development of type 2 diabetes may be related to heterogeneity in mitochondrial genetic changes.

Detection of bacterial DNA by PCR and reverse hybridization in the 16S rRNA gene with particular reference to neonatal septicemia

AIM

The clinical diagnosis of sepsis is difficult, particularly in neonates. It is necessary to develop a rapid and reliable method for detecting bacteria in blood and cerebrospinal fluid (CSF). Polymerase chain reaction (PCR) and reverse hybridization of the 16S rRNA gene would permit fast and sensitive determination of the presence of bacteria and differentiate gram-positive bacteria from gram-negative ones in clinical specimens.

METHODS

We developed a pair of primers according to the gene encoding 16SrRNA found in all bacteria. DNA fragments from different bacterial species and from clinical samples were detected with PCR, and with reverse hybridization using a universal bacterial probe, a gram-positive probe and a gram-negative probe.

RESULTS

A 371 bp DNA fragment was amplified from 20 different bacterial species. No signal was observed when human DNA and viruses were used as templates. The sensitivity could be improved to 10(-12) g. All 26 culture-positive clinical samples (22 blood samples and 4 CSF samples) were positive with PCR. The gram-negative and gram-positive probes hybridized to clinical samples and to known bacterial controls, as predicted by Gram's stain characteristics.

CONCLUSIONS

Our results suggest that the method of PCR and reverse hybridization is rapid, sensitive and specific in detecting bacterial infections. This finding may be significant in the clinical diagnosis of sepsis in neonates.

Intravenous infusion ascitic fluid during hemodialysis: a study of 108 treatments in 13 uremic cases

Nephrogenic ascites is a clinical diagnosis defined as persistent ascites in an uremic patient without evidence for a causative underlying disease. It imperils the patient's life with intradialytic hypotension, however there is no effective therapy other than renal transplantation so far. In 13 cases, 108 treatments with i.v. ascites infusion were performed with hemofilter alone or combined with plasmafilter during hemodialysis over past 7-years. The ascitic fluid was filtrated and dialyzed before it was intravenously infused into the blood compartment of the hemofilter. There were a mean of 8.38 treatments per patient in a period of 56 days and 3,275.9 +/- 1,359.5 ml of ascitic fluid were removed per treatment. The patients' appetite and physical ability were considerably improved and the intradialytic hypotensions disappeared immediately following the initiation of ascitic fluid infusions. In this study, one patient was transplanted successfully. The longest interval without ascitic fluid infusion was 127 days. Main side effect was light pyrogenic reaction, which was presented in 12.96% of the total treatments. It is concluded that this method permits to continue hemodialysis, improves the nutritional condition and prolongs the lifespan by conserving and reusing the ascites protein.

[Detection of human cytomegalovirus infection in pregnant women and their fetuses by nested polymerase chain reaction]

OBJECTIVES

To evaluate the applicability of nested polymerase chain reaction (PCR) and restriction endonucleases analyses (REA) for the diagnosis of human cytomegalovirus (HCMV) in pregnant women and their fetuses.

METHODS

Nested PCR and REA, virus isolation, anti-HCMV-IgM and anti-HCMV-IgA were used for detection of HCMV in peripheral blood of pregnant women, umbilical blood and tissues of stillbirths.

RESULTS

Among 367 pregnant women, the HCMV infections rate in the first, second and third trimester of gestation were 8.6%, 1.6% and 7.0%, respectively. The nested PCR had significantly higher detective rate (4.9%) than that of virus isolation (3.0%, P < 0.025). Among 6 samples of maternal HCMV DNA positive blood, 3 matched umbilical samples were HCMV DNA positive as well. Of these 3 cases, HCMV intrauterine infection was considered. HCMV was detected with all measurements in both maternal and umbilical blood except in 1 paired samples specific-IgM were negative. HCMV DNA was found in the lung tissue of one of the 28 stillbirds.

CONCLUSION

The diagnostic specificity and sensitivity of HCMV can be raised by nested PCR.

[Determination of copper, zinc, calcium, magnesium and iron microelements in whole blood samples from human's ear using microsample-injection FAAS]

This paper established a new and convenient method for the determination of Cu, Zn, Ca, Mg and Fe microelements content in whole blood samples from human's ear by using flame AAS with microsample injection. The results show that recoveries of these microelements are above 96.0% and relative standard deviation of Zn, Ca, Mg and Fe are less than 2.0%, Cu is less than 3.9%. Satisfactory results are obtained with only 10 microL whole blood samples from human's ear.

[Study on microwave hydrolysis for the analysis of amino acids in egg by high performance liquid chromatography]

A new hydrolysis method which only needs 7min--microwave hydrolysis used for the analysis of amino acids in egg by Pico-Tag high performance liquid chromatography (HPLC) is reported. The experimental results show that the satisfactory recovery could be obtained by use of 6mol/L HCL and 1% phenol as hydrolysing solution and a microwave oven with power of 300W. These conditions can also be used for the hydrolysis of other samples, such as rice, meat and so on. The average recovery of this method is 95% with a RSD of 2%. The accuracy is better than the conventional one (hydrolysis 24 at 110 degrees C) and Pico-Tag (hydrolysis 24h at 105 degrees C). Furthermore, the microwave hydrolysis decreases the loss of some unstable amino acids, e.g. Ser, Thr, Tyr, etc. In the process the method is convenient, rapid, accurate and reproducible.

[Chemical constituents of Vaccinium scopulorum W.W. Smith]

Seven compounds were isolated from the radix of Vaccinium scopulorum. On the basis of spectral analysis, physico-chemical constants and derivative preparations, they were identified as beta-amyrin, 3-epi-ursolic acid, methyl maslinate, 3 beta-acetoxy-delta 7-cholest-7-ene, protocatechuic acid, ethyl n-hexacosanoate and ethyl n-tetracosanoate respectively.