Impacts of cationic lipid-DNA complexes on immune cells and hematopoietic cells in vivo

The inability to systemic administration of nanoparticles, particularly cationic nanoparticles, has been a significant barrier to their clinical translation due to toxicity concerns. Understanding the in vivo behavior of cationic lipids is crucial, given their potential impact on critical biological components such as immune cells and hematopoietic stem cells (HSC). These cells are essential for maintaining the body's homeostasis, and their interaction with cationic lipids is a key factor in determining the safety and efficacy of these nanoparticles. In this study, we focused on the cytotoxic effects of cationic lipid/DNA complexes (CLN/DNA). Significantly, we observed that the most substantial cytotoxic effects, including a marked increase in numbers of long-term hematopoietic stem cells (LT-HSC), occurred 24 h post-CLN/DNA treatment in mice. Furthermore, we found that CLN/DNA-induced HSC expansion in bone marrow (BM) led to a notable decrease in the ability to reestablish blood cell production. Our study provides crucial insights into the interaction between cationic lipids and vital cellular components of the immune and hematopoietic systems.

Medical expenses of patients with severe mental disorders in Beijing, China

OBJECTIVES

Mental health has become a significant public health problem that impacts both economic and social development, with severe mental disorders (SMDs) being the top priority. Over recent years, Beijing, China, has introduced several policies to reduce the economic burden on patients with mental health disorders. The aim of this study was to investigate the current status and composition of patients' medical expenses following the introduction of multiple medical policies, explore the factors that may impact the utilisation of medical services and provide a reference and basis for subsequent policy improvements.

STUDY DESIGN

Multistage sampling was used to select a representative study population. A retrospective survey was used to collect patient information and data on medical expenses in 2019.

METHODS

Descriptive statistics were applied to analyse the current status of patients' medical expenses, and a two-part model was used to examine the factors influencing healthcare utilisation and to model predicted expenses.

RESULTS

Among 4940 participants, the average outpatient expenses of patients with SMD who incurred medical expenses were 8373.61 Yuan, and the average hospitalisation expenses were 81,594.05 Yuan. The out-of-pocket expenses were 29.22% of outpatient expenses and 8.13% of inpatient expenses. Factors such as age, household status, economic status, marital status, participation in the Community Free-Medication Service (CFMS) and the type of disease diagnosed influenced the differences in medical expenses and utilisation of services.

CONCLUSIONS

The medical expenses of patients with SMD in Beijing are high, but a number of introduced policies have effectively reduced these costs for patients. Future studies should focus on the impact of factors such as age, economic status, participation in the CFMS and the type of disease diagnosed on medical expenses.

Maleimide as the PEG end-group promotes macrophage-targeted drug delivery of PEGylated nanoparticles in vivo by enhancing interaction with circulating erythrocytes

Radiotherapy (IR) is capable of enhancing antitumor immune responses. However, IR treatment also aggravates the infiltration of peripheral macrophages into the tumor, resulting in reversing the therapeutic effects of antitumor immunity. Thus, a strategy to effectively prevent tumor infiltration by macrophages may further improved the therapeutic efficacy of radiotherapy. Herein, we found that PEGylated solid lipid nanoparticles with maleimide as PEG end-group (SLN-PEG-Mal) show significantly enhanced adsorption onto RBCs through reacting with reactive sulfhydryl groups on RBCs' surface both in vitro and in vivo, and caused significant changes in the surface properties and morphology of RBCs. These RBCs adsorbed by SLN-PEG-Mal were rapidly removed from circulation due to efficient engulfment by reticuloendothelial macrophages, supporting the usefulness of SLN-PEG-Mal for macrophage-targeted drug delivery. While lacking the use of radioisotope tracing (considered the gold standard for PK/BD studies), our data align with the expected pathway of host defense activation through surface-loaded RBCs. Importantly, injection of paclitaxel-loaded SLN-PEG-Mal effectively inhibited the tumor-infiltration by macrophages, and significantly improved the antitumor immune responses in tumor-bearing mice treated with low-dose irradiation. This study provides insights into the effects of maleimide as PEG end-group on enhancing the interaction between PEGylated nanoparticles and RBCs and offers an effective strategy to inhibit tumor infiltration by circulating macrophages.

In Vivo Immune Adjuvant Effects of CaCO3 Nanoparticles through Intracellular Ca2+ Concentration Regulation

Calcium (Ca) is a vital component of the human body and plays a crucial role in intracellular signaling and regulation as a second messenger. Recent studies have shown that changes in intracellular Ca2+ concentration can influence immune cell function. In this study, we developed calcium carbonate nanoparticles (CaNPs) of various sizes using a Nanosystem Platform to modulate intracellular Ca2+ concentration in vitro and in vivo. Our findings demonstrate that intravenous administration of CaNPs led to changes in the number and ratio of immune cells in the spleen and stimulated the activation of dendritic cells (DCs) and macrophages. Notably, CaNPs exhibited strong adjuvant properties in the absence of antigenic stimuli. These results indicate that CaNPs have the potential to regulate immune cell function by modulating Ca2+ concentrations, offering a novel approach for disease prevention and treatment in combination with antigens or drugs. Overall, our study emphasizes the importance of modulating intracellular Ca2+ concentration as a means of regulating immune cell function.

Co-delivery of vitamin D3 and Lkb1 siRNA by cationic lipid-assisted PEG-PLGA nanoparticles to effectively remodel the immune system in vivo

The imbalance of the immune system can lead to the occurrence of autoimmune diseases. Controlling and regulating the proliferation and function of effector T (Teff) cells and regulatory T (Treg) cells becomes the key to treating these diseases. Dendritic cells (DCs), as dedicated antigen-presenting cells, play a key role in inducing the differentiation of naive CD4+ T cells. In this study, we designed a cationic lipid-assisted PEG-PLGA nanoparticle (NPs/VD3/siLkb1) to deliver 1,25-dihydroxyvitamin D3 (VD3) and small interfering RNA (siRNA) to DC cells in the draining lymph nodes. By modulating the phenotypic changes of DC cells, this approach expands Treg cells and reduces the occurrence of autoimmune diseases. Thus, this study provides a novel approach to alleviating the occurrence and development of autoimmune diseases while also minimizing the risk of unwanted complications.

[Preventive effect of atropine premedication on vagal reflex in patients undergoing suspension laryngoscopy during anesthesia induction]

Objective: To evaluate the preventive effect of atropine premedication during anesthesia induction on vagal reflex in patients undergoing suspension laryngoscopy. Methods: A total of 342 patients (202 males and 140 females) scheduled for suspension laryngoscopy under general anesthesia in Beijing Tongren Hospital from October 2021 to March 2022 were prospectively enrolled, with a mean age of (48.1±11.9) years. The patients were randomly divided into two groups using the random number table method: the treatment group (n=171) and the control group (n=171). Patients in the treatment group were administrated with 0.5 mg atropine intravenously guttae (ivgtt) while patients in the control group were given equivalent volume of normal saline. For all patients, if heart rate (HR)<50 beats/min happened during the insertion of the suspension laryngoscope, the operation should be stopped and the laryngoscope should be removed. Patients without HR recovery after the removal of the laryngoscope should be given 0.5 mg atropine, and the operation should be continued after the HR recovered. The primary outcome was the incidence of HR fluctuation over 20% (ΔHR>20%) before and immediately after suspension laryngoscope fixation, and the secondary outcomes included HR, mean arterial pressure (MAP) of the two groups recorded before and after anesthesia induction, before and immediately after suspension laryngoscope fixation, and the incidences of sinus bradycardia, laryngoscope removal and atropine treatment during operation. Results: The incidences of ΔHR>20% and bradycardia immediately after the suspension laryngoscope fixation were 14.6% (25/171) and 12.9% (22/171) in the treatment group, which were significantly lower than those in the control group [28.1% (48/171) and 29.8% (51/171)] (both P<0.05). The HR immediately after the suspension laryngoscope fixation in the treatment group [(66.4±13.5) beats/min] and in the control group [(60.8±15.7) beats/min] was significantly lower than those before the suspension laryngoscope fixation [(74.7±11.1) beats/min and (67.6±12.8) beats/min, respectively] (both P<0.05). There were no significant differences in MAP between the two groups at each time point (all P>0.05). The incidence of laryngoscope removal once plus 0.5 mg atropine administration, laryngoscope removal twice plus 0.5 mg atropine administration and laryngoscope removal twice plus 1.0 mg atropine administration was 9.9% (17/171), 1.8% (3/171) and 0 (0) in the treatment group, respectively, which was significantly lower than those in the control group [24.0% (41/171), 5.8% (10/171) and 2.3% (4/171), respectively] (all P<0.05). Conclusion: Atropine premedication during anesthesia induction can effectively reduce the occurrence of vagal reflex in patients undergoing suspension laryngoscopy.

The altered expression of cytoskeletal and synaptic remodeling proteins during epilepsy

The cytoskeleton plays an important role in epilepsy; however, the mechanism is unknown. Therefore, this study aimed to reveal the mechanism of cytoskeletal proteins in epilepsy by investigating the expression of cytoskeletal proteins and synaptophysin (SYP) in mice at 0, 3, 6, and 24 h, 3 days, and 7 days in a kainic acid (KA)-induced epileptic model. Our results demonstrated that the expression of F-actin decreased significantly between 3 and 6 h, 6 and 24 h, and 24 h and 3 days (P < 0.05). Meanwhile, the expression of the neurofilament light chain, neurofilament medium chain, and neurofilament heavy chain subunits was significantly decreased (P < 0.001) at 3 h after the KA injection compared to the KA 0 h group, followed by an elevation at 6 h and a further decrease at 24 h compared to at 6 h. SYP expression was significantly decreased between 0 and 3 h as well as between 3 and 6 h (P < 0.05). At 24 h, the level was increased compared to at 6 h and continued to increase at 3 days after the KA injection. Thus, we propose that cytoskeletal proteins may be involved in the pathogenesis of epilepsy.

Mn substitution in the topological metal Zr2Te2P

Results are reported for Mn intercalated Zr₂Te₂P, where x-ray diffraction , energy dispersive spectroscopy, and transmission electron microscopy measurements reveal that the van der Waals bonded Te-Te layers are partially filled by Zr and Mn ions. This leads to the chemical formulas Zr_0.07Zr₂Te₂P and Mn_0.06Zr_0.03Zr₂Te₂P for the parent and substituted compounds, respectively. The impact of the Mn ions is seen in the anisotropic magnetic susceptibility, where Curie-Weiss fits to the data indicate that the Mn ions are in the divalent state. Heat capacity and electrical transport measurements reveal metallic behavior, but the electronic coefficient of the heat capacity (γ_Mn≈ 36.6 mJ (mol·K²)^-1) is enhanced by comparison to that of the parent compound. Magnetic ordering is seen atTM≈4 K, where heat capacity measurements additionally show that the phase transition is broad, likely due to the disordered Mn distribution. This transition also strongly reduces the electronic scattering seen in the normalized electrical resistance. These results show that Mn substitution simultaneously introduces magnetic interactions and tunes the electronic state, which improves prospects for inducing novel behavior in Zr₂Te₂P and the broader family of ternary tetradymites.

A biocompatible nanoparticle-based approach to inhibiting renal ischemia reperfusion injury in mice by blocking thrombospondin-1 activity

Thrombospondin-1 (TSP-1) is a key mediator of renal ischemia-reperfusion injury (IRI), a major cause of kidney dysfunction under various disease conditions and a risk factor of renal allograft rejection. In this study, we developed a nanotechnology-based therapy targeting TSP-1 to prevent renal IRI. A biocompatible nanoparticle (NP) capable of specific binding to TSP-1 was prepared by conjugating NPs with TSP-1-binding (LSKL) peptides. LSKL/NPs not only effectively adsorbed recombinant TSP-1 proteins in vitro, but also efficiently neutralized TSP-1 in mice undergoing renal IRI. IRI-induced elevation of TSP-1 in the kidney was significantly inhibited by post-IR treatment with LSKL/NPs, but not free LSKL or NPs. Furthermore, TSP-1 proteins adsorbed on LSKL/NPs were functionally inactive and unable to induce apoptosis in renal tubular epithelial cells. Importantly, LSKL/NPs induced strong protection against renal IRI, as shown by markedly diminished serum creatinine levels and improved histological lesions of the kidney. Thus, LSKL/NPs provide a useful means of depleting and inactivating TSP-1 and a potential therapy for renal IRI.

Kidney functional stages influence the role of PEG end-group on the renal accumulation and distribution of PEGylated nanoparticles

Modification with polyethylene glycol (PEG), or PEGylation, has become a popular method to improve the efficiency of drug delivery in vivo using nanoparticle-based delivery systems. The PEG end-group plays an important role in the in vivo fate of PEGylated nanoparticles through its interactions with proteins in the serum and the cell membrane. However, the effects of PEG end-groups on the renal clearance of PEGylated nanoparticles remain unclear. Kidney function may also affect the renal accumulation and distribution of nanoparticles. Herein, we demonstrate that the accumulation and distribution of PEGylated nanoparticles in kidneys are significantly affected by both the PEG end-group and kidney function damage. Interestingly, compared to PEG with an amino or methoxy end-group, PEG with maleimide as the end-group markedly enhanced the accumulation of PEGylated nanoparticles in normal kidneys, which may improve renal clearance. However, obvious enhancements in the renal accumulation and medullary distribution of PEGylated nanoparticles are detected in kidneys with functional impairment. Damage to renal function further affects how the PEG end-group influences the accumulation and distribution of PEGylated nanoparticles in kidneys in vivo. Collectively, the findings provide deep insights into the interactions between PEGylated nanoparticles and kidneys in vivo.

[A qualitative systematic review and enlightenment of teaching models and evaluation in the general education of epidemiology in China and abroad]

Objective: This study aims to systematically sort out the effectiveness evaluation of the general education teaching models in epidemiology at home and abroad and provide a reference for the development and reform of epidemiology education. Methods: A systematic search of English databases such as PubMed, Embase, and Web of Science and Chinese databases such as CNKI, Sinomed, Wanfang, etc., were used to screen out the literature on different general teaching models of education in epidemiology. Each literature's teaching effect will be summarized and evaluated to conduct a systematic qualitative review in the narrative integration method, Results: A total of 45 articles (28 in Chinese and 17 in English) were included in this study, involving 14 teaching models, including mixed teaching models, PBL (problem-based learning), project designing models, and CBL (case-based learning) and other teaching models. Except for some teaching models such as project design, network platform, and flipped classroom model, the teaching effect of other innovative models is better than that of the traditional model. The distribution of teaching models was different in Chinese and foreign literature. Foreign teaching models were diverse, mainly concentrated in mixed teaching models and software/network platform learning. Domestic teaching models were relatively fixed. The mixed teaching model and PBL model were the most widely used in China, and there were fewer comparative studies between different teaching models than in foreign countries. Conclusion: General education in epidemiology is still in the early exploration stage. Compared with the traditional lecture model, the effect of various innovative teaching models has been improved. According to teaching objectives and student characteristics, we encourage extensive use of different teaching strategies, combining theoretical knowledge with practical applications and integrating epidemiological knowledge with inter-professional knowledge. Thus, students who can apply what they learn are becoming interdisciplinary talents our society needs.

[Effects of topical anesthesia with 1% tetracaine on hemodynamic responses in microlaryngosurgery]

Objective: To observe the effects of topical anesthesia with 1% tetracaine on hemodynamic responses in general anesthesia patients undergoing microlaryngosurgery. Methods: From October 2021 to December 2021, 92 patients (46 males and 46 females) in Beijing Tongren Hospital, with a median age [M (Q₁, Q₃)] of 51 (42, 57) years who scheduled for microlaryngosurgery under general anesthesia, were divided into two groups (n=46 in each group) using the random number table method. Group T received topical anesthesia with 1% tetracaine at the root of the tongue and epiglottis and glottis on the basis of general intravenous anesthesia induction, with 0.5 ml at each position, while the control group (group C) received equal volume of normal saline. Heart rate (HR) and mean arterial pressure (MAP) were recorded at the time of patients entering the operating room (baseline), after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation. The recovery profiles, including time to recover breathing, time to open eyes, time to extubation and adverse reactions were evaluated during recovery period. Results: The MAP of patients in group T at baseline, after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation were (99.4±12.9), (78.5±8.8), (79.2±10.2), (100.6±17.0), (101.9±14.7), (100.8±13.9), (97.4±12.1), (107.3±16.8) mmHg (1 mmH=0.133 kPa), respectively, while in group C were (99.5±11.6), (80.9±12.8), (90.5±16.0), (109.5±20.4), (108.0±18.9), (103.7±15.5), (100.1±13.3), (114.2±17.3) mmHg, respectively. The two critical time points of MAP after intubation and immediately suspending laryngoscopy in group C were significantly higher than group T (P<0.05).The HR of patients in group T at baseline, after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation was (71.3±10.6), (66.0±10.1), (69.5±11.4), (61.3±14.2), (69.8±9.8), (71.0±10.6), (70.6±11.0), (78.8±11.6) bmp, respectively, while in group C were (73.1±10.9), (67.8±9.9), (79.5±12.9), (57.1±18.1), (69.2±12.8), (71.4±11.7), (70.7±11.5), (85.3±13.0) bmp, respectively. The two critical time points of HR after intubation and after extubation in group C were significantly higher than that of group T (P<0.05). The time to recover breathing in the two groups was (11.8±3.5) min and (11.3±4.6) min, respectively. The time to open eyes was (12.0±3.3) min and (11.5±5.0) min, respectively. The time to extubation was (13.2±3.7) min and (12.6±4.9) min, respectively. There were no statistically significant difference in time to recovery between the two groups (P>0.05). Likewise, there were no toxic reactions to local anesthetics, respiratory depression, hypoxemia, laryngospasm and cough occurred in either group. Conclusion: Topical anesthesia with 1% tetracaine can effectively reduce the hemodynamic changes without influencing patient's recovery, and does not increase the incidence of adverse reactions.

AB1346 ULTRASOUND ASSESSMENT OF SUB-CLINICAL HAND JOINT INFLAMMATION: A COMPARATIVE STUDY BETWEEN EARLY RHEUMATOID AND PSORIATIC ARTHRITIS

Background

Ultrasound (US) detected subclinical inflammation can be present in early psoriatic arthritis (PsA) and rheumatoid arthritis (RA), and also in patients fulfilling clinical remission criteria[1-2]. Numerous evidences support that the persistence of subclinical synovitis detected by US is associated with a high risk of disease progression [2-3].

Objectives

To evaluate sub-clinical inflammation of PsA and RA at the level of small joints of the hand and wrist by B-mode and Power Doppler US.

Methods

30 patients of early PsA and 35 patients of early RA (no clinical evidence of hand joint involvement, PsA disease duration <2 years, and RA disease duration <1 year) were recruited. US [grey scale (GS) and power Doppler (PD)] was performed to assess synovitis, tenosynovitis, joint effusion, and bone erosion of bilateral wrists, metacarpophalangeal joints, proximal and distal interphalangeal joints, as well as the flexor tendons and extensor compartments.

Results

A total of 35 patients were included in the RA group, including 10 males and 25 females. A total of 30 patients were included in the PsA group, including 12 males and 18 females. There were no significant differences in gender composition, age, and duration of disease between the two groups (P>0.05) (Table 1). 19 (63.33%) PsA patients and 16 (45.71%) RA patients had sub-clinical hand joint synovitis. At the joint level, wrist joints were most commonly involved (23.08%), followed by MCP3 (15.38%) and DIP3 (13.46%) in PsA group. In RA group, wrist joints were most commonly involved (55.17%), followed by MCP3 (12.41%), and MCP2 (11.03%). Eight (26.67%) PsA patients and 16 (45.71%) RA patients were detected tenosynovitis. Tenosynovitis was most frequently presented at the extensor tendons in RA and at the flexor tendons in PsA patients (p<0.05). The two most commonly affected were the 4th and 1st extensor compartments in RA patients, and the flexor pollicis longus and flexor digitorum profundus in PsA patients. 81 (6.80%) joint recesses in the RA and 75 (7.35%) joint recesses in PsA were detected effusion. Joint effusion was most frequently detected at radiocarpal and midcarpal joints in RA (30.86%, 25.92%, respectively). Effusion in PsA was most commonly presented at the 3rd PIP joints (26.67%), followed by radiocarpal joints (24.00%). Bone erosions were uncommon, totally 2 (6.67%) PsA patients and 3 (8.57%) RA patients were detected bone erosions.

Table 1.

Demographic characteristics of RA and PsA patients

RA (n=35)PsA (n=30)PFemale, n(%)25 (71.43%)18 (60.00%)0.33Age, years, mean±SD53.20±14.5054.23±13.650.77Disease duration, years, mean±SD0.72±0.370.91±0.530.07

Conclusion

There are significant differences in the US findings of sub-clinical inflammation at the hand and wrist joints, such as the joint effusion and tenosynovitis, which may assist the identification between early RA and PsA. Simultaneously, it should be pointed out that there are some similarities in the joint involvement of sub-clinical synovitis between RA and PsA, physicians should take this into account in clinical work.

Figure 1.

Gray scale ultrasound sagittal view shows synovitis at the wrist joint in an RA patient (A) and at MCP3 in a PsA patient.

References

[1]Freeston JE, Coates LC, Nam JL, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis Care & Research, 2014,66:432-439.

[2]Kawashiri SY, Suzuki T, Nakashima Y, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford), 2014,53:562-569.

[3]Vreju FA, Filippucci E, Gutierrez M, et al. Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clin Exp Rheumatol, 2016,34:673-678.

Acknowledgements

This work was supported by National Natural Science Foundation of China (No. 82071930).

Disclosure of Interests

None declared

POS1163 PHARMACOKINETICS OF PEGLOTICASE AND METHOTREXATE POLYGLUTAMATE(S) IN PATIENTS WITH UNCONTROLLED GOUT RECEIVING PEGLOTICASE AND CO-TREATMENT WITH METHOTREXATE

Background

In a prior open-label, single-arm trial in adults with uncontrolled gout (MIRROR open-label [OL] trial), methotrexate (MTX) co-treatment with pegloticase suggested improved efficacy of pegloticase by reducing its immunogenicity.1,2 The current randomized, controlled trial (MIRROR RCT) confirmed that pegloticase-MTX co-therapy markedly increased pegloticase response rate (response defined as serum uric acid <6 mg/dL during ≥80% of Month 6) compared to pegloticase-placebo (PBO) co-therapy (71.0% vs. 38.5%) with a decreased infusion reaction rate and no new safety signals reported.

Objectives

To evaluate systemic exposures of pegloticase and its immunogenicity in uncontrolled gout patients receiving pegloticase with and without MTX as part of the MIRROR RCT; and to determine exposure of methotrexate polyglutamate(s) (MTX-PGs) in uncontrolled gout patients through Month 6 of treatment.

Methods

In MIRROR RCT, MTX (15 mg/wk) or matching PBO was given orally 4 weeks prior to the first pegloticase dose and continued weekly, in combination with pegloticase 8 mg given intravenously every 2 weeks, over a 52-week treatment period. Pre-infusion blood samples were collected to measure MTX polyglutamates (MTX-PGs, including MTX-PG1-5) in red blood cells and pre- and post-infusion serum samples were obtained to measure trough (Cmin) and peak (Cmax) concentrations of pegloticase, respectively, at multiple visits. MTX-PG and pegloticase concentrations were summarized by visit and by treatment group. Pre-infusion serum samples for anti-polyethylene glycol (PEG) antibody (Ab) measurement were also collected at multiple pre-defined time points. Anti-PEG Ab incidence and titer were summarized by visit and by treatment group.

Results

Overall, higher Cmax and Cmin of pegloticase were observed in the pegloticase + MTX group than in the pegloticase + PBO group (Figure 1). At Week 14, median (first quartile [Q1], third quartile [Q3]) Cmin was 1.32 (0.73, 1.74) µg/mL and 0.63 (0.30, 1.28) µg/mL for the pegloticase + MTX and pegloticase + PBO groups, respectively. Median (Q1, Q3) Cmax was 3.01 (1.94, 3.94) µg/mL and 2.66 (1.45, 3.20) µg/mL for the pegloticase + MTX and pegloticase + PBO groups, respectively. Improved pegloticase response was associated with higher pegloticase concentrations. At Week 14, Cmin was below the quantitation limit (0.6 µg/mL) for 8 of 10 non-responders and 1.26 (0.72, 1.71) µg/mL for responders. MTX co-administration reduced the incidence of new anti-PEG antibody formation. The proportion of subjects with an increase from baseline in anti-PEG Ab titers or who were negative at baseline and developed an anti-PEG Ab response at ≥1 post-dose time point during pegloticase treatment was 29.5% and 51.0%, for the pegloticase + MTX and pegloticase + PBO groups, respectively. The pegloticase + MTX group had overall lower titer levels than those in the pegloticase + PBO group. Positive anti-PEG Ab status was associated with a lower pegloticase Cmin. Concentrations of MTX-PGs were maintained during the treatment course in the pegloticase + MTX group, suggesting compliance with MTX administration. There was no apparent difference in concentrations of MTX-PGs (including MTX-PG3, the predominant form of MTX-PGs4) between responders and non-responders. MTX-PG concentrations were in the same range as those reported for low-dose oral MTX use in patients with rheumatoid arthritis,3 suggesting no impact of pegloticase on MTX PK.

Conclusion

Pegloticase 8 mg IV every 2 weeks with MTX co-treatment (oral 15 mg weekly) reduced anti-PEG Ab incidence and resulted in higher pegloticase exposures compared to pegloticase administered with PBO, consistent with the increased clinical efficacy observed with pegloticase + MTX co-administration.

References

[1]Botson J, et al. J Rheumatol 2021;48:767-74

[2]Song Y, et al. Arthritis Rheum 2020;72(suppl 10)

[3]Dervieux T, et al. Ann Rheum Dis 2013;72:908-10

[4]Choi R. J Pharm Biomed Anal 2021;201:114124

Disclosure of Interests

Yan Xin Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Yang Song Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Michael E. Weinblatt Consultant of: Horizon Therapeutics, Jason Chamberlain Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Jennifer Zarzoso Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Katie Obermeyer Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephen Sainati Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Colleen Canavan Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Srini Ramanathan Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics

[Research Progress on Touch DNA on Cartridge Cases in Forensic Field]

Abstract

Cartridge cases are crucial physical evidence in gun-related crimes. The successful identification of the touch DNA on cartridge cases can help to screen the suspects and reconstruct the gun-related crime scene. With the improvement of DNA extraction methods and the sensitivity of amplification kit, forensic examiners are expected to obtain more valuable information by testing the touch DNA on cartridge cases. In practical cases, the touch DNA detection on cartridge cases often encounters with low DNA content degradation, mixing and the gunshot residual interference, which brings more challenges to DNA examination and identification. This article reviews forensic research of touch DNA on the cartridge cases from the aspects of factors affecting touch DNA on cartridge cases, advances in the extraction and amplification methods, and the practical applications in order to provide reference for forensic identification of touch DNA on the cartridge cases in real cases.

WITHDRAWN: Urban citizen health risk assessment for epidemic pneumonia and research on innovation on economic development

Ahead of Print article withdrawn by publisher.

Comparative Study on Temperature Response of Hydropower Development in the Dry-Hot Valley

Due to the specific hydrothermal conditions of dry-hot valleys, temperature changes caused by the development of large-scale hydropower projects may be more extreme than they are in other regions. In this study, we analyzed these temperature changes at four hydropower stations in both dry-hot and non-dry-hot valleys. Based on the calculated relative temperatures of the downstream river and the areas surrounding the reservoirs, we employed two indices to quantify the influence of the reservoirs on the temperatures of these two regions: the downstream river temperature change and the reservoir effect change intensity. Our results are as follows: (a) In the downstream rivers, the temperature regulation effect was more pronounced in the wet season; in the regions surrounding the reservoirs, the temperature regulation effect was more pronounced in the dry season. (b) The downstream river temperature in both the dry-hot and wet-hot valleys exhibited noticeable warming in both the wet and dry seasons, while the cold-dry valley was characterized by cooling in the dry season and warming in the wet season. With the exception of the Liyuan station (where the influence of the reservoir on the downstream temperatures only extended to a distance of 9 km from the dam) during the dry season, the existence of the hydropower stations affected the temperatures of the entire downstream region. (c) For the areas surrounding the reservoir, the presence of a hydropower station mainly caused the temperatures in the dry-hot valleys to rise and the temperatures in the non-dry-hot valleys to decrease.

POS1136 PHARMACOKINETICS OF PEGLOTICASE AND METHOTREXATE POLYGLUTAMATE(S) IN PATIENTS WITH UNCONTROLLED GOUT RECEIVING PEGLOTICASE AND CO-TREATMENT OF METHOTREXATE

Background:

In an open-label, single-arm trial in adult patients with uncontrolled gout (MIRROR open-label [OL] trial) evaluating pegloticase co-treatment with methotrexate (MTX); 78.6% patients were responders, defined as maintenance of serum uric acid <6 mg/dL for at least 80% of the time during month 6 [weeks 20, 22, and 24]. In comparison, 42% patients achieved a response during month 3 and 6 in historical Phase 3 monotherapy trials of pegloticase (C0405 and C0406)1. MTX co-treatment is shown to improve the pharmacokinetics (PK) of biologics by attenuating the formation of anti-drug antibodies2.

Objectives:

To determine the systemic exposures of pegloticase and methotrexate polyglutamate(s) (MTX-PGs) in uncontrolled gout patients receiving pegloticase and MTX; to evaluate the effect of MTX on the PK of pegloticase in comparison to historical pegloticase monotherapy trials (C0405 and C0406)3, 4; and to evaluate the immunogenicity of pegloticase in co-treatment with MTX.

Methods:

In the MIRROR OL trial, MTX (15 mg/week) was given orally 4 weeks prior to the first pegloticase dose and continued weekly, in combination with pegloticase 8 mg given intravenously every 2 weeks, for a treatment duration of up to 52 weeks. Pre-infusion samples were collected to measure MTX-PGs in red blood cells. Pre- and post-infusion blood samples were obtained to measure the peak (Cmax) and trough (Cmin) concentrations of pegloticase at multiple visits. Anti-drug antibody blood samples were collected at multiple visits. The impact of MTX on pegloticase PK was evaluated by comparing pegloticase exposures with MTX from this trial to historical monotherapy data (C0405 and C0406)3, 4. The observed pegloticase concentrations with MTX were also overlaid with the 90% prediction interval based on the population PK model5 from C0405 and C0406.

Results:

Pegloticase and MTX-PG levels were determined in 14 patients. The 11 responders were generally associated with higher pegloticase exposures than the non-responders, especially Cmin (Figure 1). Concomitant treatment of MTX resulted in fewer patients with Cmin below quantitation limit (BQL) (5/14 [36%] with MTX vs 63/82 [77%] without MTX), and higher overall Cmin (median: 1.03 µg/ml with MTX vs BQL without MTX); Cmax was slightly higher (median [Q1, Q3]: 2.11 [1.65, 2.59] µg/mL with MTX vs 1.51 [BQL, 2.48] µg/mL without MTX). Pegloticase co-treatment with MTX resulted in more concentrations above the predicted median value of pegloticase, compared to monotherapy. ADA data is consistent with pegloticase PK and efficacy. Significant increase in ADA titers were only observed in 2 subjects (both were non-responders) at time corresponding to the loss of pegloticase exposure and increases in sUA levels. Concentrations of MTX-PGs were maintained during the treatment course, suggesting compliance of MTX administration. There was no apparent difference in concentrations of MTX-PGs between responders and non-responders.

Conclusion:

Pegloticase 8 mg IV every 2 weeks co-treatment with MTX 15 mg weekly resulted in fewer patients with pegloticase Cmin below the quantification limit (BQL) and gave higher overall trough concentrations (Cmin) compared to pegloticase monotherapy in the phase 3 studies.

Pegloticase 8 mg IV every 2 weeks co-treatment with MTX 15 mg weekly was associated with an improved response rate for pegloticase in association with improved drug levels in these patients with uncontrolled gout compared to pegloticase monotherapy in the phase 3 studies.

References:

[1]Botson J., et al. J Rheumatol. 2020; doi: 10.3899/jrheum.200460

[2]Goss S. L., et al. Clin Ther;2018, 40 (2).

[3]Lipsky P. E., et al. Arthritis Res Ther;2014, 16 (2).

[4]Sundy J. S., et al. JAMA;2011, 306 (7).

[5]Yue C. S., et al. ASCPT, Atlanta, 2010.

Disclosure of Interests:

Yang Song Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Yan Xin Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Michael E. Weinblatt Shareholder of: Canfite, Inmedix, Lycera, Vorso, Scipher, Grant/research support from: Crescendo Bioscience, Bristol Myers Squibb, Sanofi, Eli Lilly, Amgen, Jason Chamberlain Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Katie Obermeyer Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Lin Zhao Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Colleen Canavan Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Paul M. Peloso Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Srini Ramanathan Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc.

POS1062 ULTRASOUND ASSESSMENT OF SUB-CLINICAL HAND JOINT SYNOVITIS: A COMPARATIVE STUDY BETWEEN PSORIATIC AND RHEUMATOID ARTHRITIS

Background:

Ultrasound (US) detected subclinical synovitis can be present in early psoriatic arthritis (PsA) and rheumatoid arthritis (RA), and also in patients fulfilling clinical remission criteria[1-2]. Numerous evidences support that the persistence of subclinical synovitis detected by US is associated with a high risk of disease progression [2-3].

Objectives:

To evaluate sub-clinical synovitis of PsA and RA at the level of small joints of the hand and wrist by B-mode and Power Doppler US.

Methods:

21 patients of early PsA and 25 patients of early RA (no clinical evidence of hand joint involvement, PsA disease duration <2 years, and RA disease duration <1 year) were recruited. DAS28 and DAPSA score used for assessment of articular disease activity for RA and PsA, respectively. US [grey scale (GS) and power Doppler (PD)] was performed to assess synovitis of bilateral wrists, metacarpophalangeal joints, proximal and distal interphalangeal joints, altogether 30 joints. A GS score ≥2 and/or a PD score ≥1 were used to identify US detected synovitis.

Results:

A total of 25 patients were included in the RA group, including 5 males and 20 females. A total of 21 patients were included in the PsA group, including 7 males and 14 females. There were no significant differences in gender composition, age, and duration of disease between the two groups (P>0.05) (Table 1). 14 (66.67%) PsA patients and 12 (48%) RA patients had sub-clinical hand joint synovitis. Among 630 hand joints scanned in PsA group, 49 (7.78%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (24.49%), followed by MCP3 (14.29%), MCP1 (12.24%) and DIP3 (10.20%). Among 750 hand joints scanned in RA group, 110 (14.67%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (60.00%), followed by MCP3 (8.24%), MCP1 (8.24%) and MCP2 (7.06%). No correlation noted between numbers of joints with subclinical synovitis with DAPSA and DAS28 score. There was no correlation between number of joints with sub-clinical synovitis and disease activity indices.

Conclusion:

Almost two-thirds patients with PsA and half patients with RA had US evidence of sub-clinical synovitis in wrist and hand joints, most commonly in wrist. There are some similarities in the joint involvement of sub-clinical synovitis between RA and PsA, physicians should take this into account in clinical work.

Table 1.

Demographic characteristics of RA and PsA patients

RA (n=25)PsA (n=21)PFemale, n(%)20 (80.00%)14 (66.67%)0.305Age, years, mean±SD56.32±12.1854.31±15.820.637Disease duration, years, mean±SD1.06±0.590.90±0.580.363

References:

[1]Freeston JE, Coates LC, Nam JL, Moverley AR, Hensor EM, Wakefield RJ, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis care & research 2014, 66:432-439.

[2]Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Iwamoto N, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: Power doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford), 2014, 53:562-569.

[3]Vreju FA, Filippucci E, Gutierrez M, Di Geso L, Ciapetti A, Ciurea ME, et al. Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clinical and experimental rheumatology, 2016, 34:673-678.

Acknowledgements:

This work was supported by National Natural Science Foundation of China (No. 82071930 and 81571684).

Disclosure of Interests:

None declared.

Expression of lncRNA TUG1 in hypertensive patients and its relationship with change state of an illness

OBJECTIVE

To investigate the expression of LncRNA TUG1 in hypertensive patients and its relationship with the change state of illness.

PATIENTS AND METHODS

A prospective analysis was carried out. Eighty-two patients with hypertension admitted to our hospital from March 2016 to February 2019 were regarded as a research group, and 79 healthy people admitted to our hospital during the same period were regarded as a control group. The serum LncRNA TUG1, platelet activating factor (PAF), endothelin-1 (ET-1), serum tumor necrosis factor-α (TNF-α), high sensitive C-reactive protein (hsCRP), and the relationship between the expression of LncRNA TUG1 and the clinicopathological characteristics of patients with hypertension in the two groups were detected, and finally, the risk factors of hypertension were analyzed.

RESULTS

The expression levels of LncRNA TUG1, PAF, ET-1, TNF-α, and hsCRP in the serum of patients in research group were significantly higher than those in control group (p<0.05). LncRNA TUG1 has a positive correlation with the severity of an illness of hypertensive patients (r=0.881, p<0.001), and also has a positive correlation with the expression levels of PAF, ET-1, TNF-α, and hsCRP (r=0.735, p<0.001; r=0.756, p<0.001; r=0.712, p<0.05; r=0.723, p<0.05). The expression of LncRNA TUG1 in the serum of patients with hypertension was related to hypertension mode, severity of disease, hyperlipidemia, and obesity (p<0.05). Obesity (OR: 3.469, 95% CI: 2.175-4.095), drinking (OR: 3.677, 95% CI: 1.695-4.892), hyperlipidemia (OR: 3.374, 95% CI: 1.759-6.988), and the high expression of TUG1 (OR: 2.693, 95% CI: 1.679-7.472) are independent risk factors for the attack of hypertension.

CONCLUSIONS

LncRNA TUG1 is highly expressed in the serum of hypertensive patients and it is closely related to the progression of hypertension. Also, it may be one of the independent risk factors for hypertension and a new molecular target for hypertension treatment.

[The study of the protection function of the sphingosine kinase 1 in the nerve cell damage caused by acrylamide]

Objective: To study the protective effect and effect of SphK1 overexpression on the injury of nerve cells induced by acrylamide. Methods: ACR with 99% purity was prepared into 1.25 mmol/L and 2.5 mmol/L solutions. SH-SY5Y cells were divided into control group (NC group) , experimental group and SphK1 activator group. The experimental group was given ACR solution with final concentration of 1.25 mmol/L and 2.5 mmol/L respectively for 24 h. In the SphK1 activator group, on the basis of the exposure concentration of the experimental group, the SphK1 specific activator (12-) phorbol tetradecanoate (-13-) acetate (PMA) solution[prepared by dimethyl sulfoxide (DMSO) , the final concentration was 100 nmol/l], and other treatments were the same as the experimental group. Control group (NC group) added PMA solution into normal cells. Western blot was used to detect the expression of SphK1 protein; CCK-8 was used to detect the proliferation of SH-SY5Y cells; hoechst33342 method was used to observe the morphological changes of nerve cells; flow cytometry was used to analyze the apoptosis of cells. Results: Compared with NC group, the expression of SphK1 protein in the experimental group and the SphK1 activator group was significantly lower (P<0.05) . Compared with the experimental group, the expression of SphK1 protein in each concentration of SphK1 activator group was increased, and the difference was statistically significant (P<0.05) . In addition to 1.25 mmol/L SphK1 activator group, compared with NC group, the relative growth survival rate of experimental group and 2.5 mmol/L SphK1 activator group were lower, the difference was statistically significant (P<0.05) . Compared with the experimental group, the relative survival rate of cells in the SphK1 activator group was higher, and the difference was statistically significant (P<0.05) . With the increase of exposure concentration, the cells in the experimental group showed the morphological characteristics of early apoptosis at ACR 1.25 mmol/L and late apoptosis at ACR 2.5 mmol/L. Compared with NC group, the apoptosis rate of experimental group and SphK1 activator group at ACR 2.5 mmol/L was significantly different (P<0.05) ; compared with experimental group, the apoptosis rate of SphK1 activator group at ACR 2.5 mmol/L was lower, the difference was statistically significant (P<0.05) . Conclusion: The SphK1 excessive expression plays the protective function to the nerve cell damage caused by acrylamide.

Cationic Liposome/DNA Complexes Mediate Antitumor Immunotherapy by Promoting Immunogenic Tumor Cell Death and Dendritic Cell Activation

Immunotherapy has been successfully used in the treatment of multiple malignancies, but clinical studies revealed low response rates. Thus, the development of new effective immunotherapeutic modalities is urgently needed. Successfully inducing tumor cell death with enhanced antigenicity is important for the expansion and differentiation of tumor-specific CD8⁺ cytotoxic T lymphocytes. Cationic liposome/DNA complexes (CLN/DNA), which usually have obvious cytotoxic effects, may improve the antitumor immunity through enhancing the immunogenicity of dying tumor cells. Herein, we report that a plasmid DNA-encapsulated cationic lipid nanoparticle formulated with cholesterol, DOTAP, and DSPE-mPEG₂₀₀₀ significantly increases the tumor cell death with high antigenicity in vitro. Furthermore, the cationic liposome/DNA complex (CLN/DNA) treatment promotes the activation of dendritic cells (DCs). We also find that the intratumorally injected CLN/DNA successfully promoted the activation of DCs in the tumor-draining lymph node. Importantly, both local tumor growth and distant tumor formation were significantly inhibited by T cell-dependent antitumor immune responses after intratumoral injection of CLN/DNA. This study presents a simple and effective strategy for improving the cancer immunotherapy.

Effects of early nutritional intervention on oral mucositis in patients with radiotherapy for head and neck cancer

BACKGROUND

To observe the effect of early nutritional intervention on radiation-induced oral mucositis and nutritional status in patients with head and neck cancer (HNC).

METHODS

A total of 54 HNC patients were divided into early (28 cases) and late (26 cases) nutritional intervention groups. The early group received enteral nutrition at the beginning of radiotherapy (RT), while the late group received enteral nutrition after restricted feeding. Operators reported and assessed the timing and extent of oral mucositis and nutritional status during treatment. The nutritional status assessment indicators included body weight; body mass index (BMI); Patient-Generated-Subjective Global Assessment (PG-SGA) score; levels of albumin, hemoglobin and pre-albumin and total lymphocyte count.

RESULTS

The incidence of high-grade oral mucositis was significantly lower in the early group than that in the late group (P < 0.05). Nutritional status assessments showed more significant weight and BMI losses in the late group than in the early group at weeks 4 and 7 after RT (P < 0.01). The albumin decreased in the late group at week 7 after RT was more significant than that in the early group (P < 0.05). Albumin, hemoglobin and pre-albumin levels and total lymphocyte count decreased significantly in both groups (P > 0.05). During therapy, more patients in the early group were well-nourished and fewer were malnourished according to PG-SGA scores (P < 0.05).

CONCLUSION

Early nutritional intervention can reduce the incidence of high-grade oral mucositis during RT in patients with HNC and improve the nutritional status during treatment, which has important clinical significance.

Development and validation of a nomogram to predict the risk of occult cervical lymph node metastases in cN0 squamous cell carcinoma of the tongue

We have explored the relations between clinicopathological features and cervical lymph node metastases (LNM) in patients with cN0 squamous cell carcinoma (SCC) of the tongue, and developed and validated a nomogram for predicting the risk of their development. Clinical data on 230 patients with cN0 SCC of the tongue who had had primary extended excision and lymph node dissection of the neck were collected retrospectively. They were divided into a development cohort and a validation cohort in a 4:1 ratio. Logistic regression analysis was used to assess the risk factors of cervical LNM in patients in the development cohort, and a nomogram was established to predict the risk of such nodes. In the validation cohort, the predictive performance and compliance of the model were evaluated using the consistency index (C-index) and calibration curve, and the clinical value was evaluated by decision curve analysis. Of the 230 patients, 60 had cervical LNM, of which 60 were invaded (26%). Analysis of the development cohort showed that the site of the primary lesion, depth of invasion, size of the tumour, and histopathological grade were included in the prediction model, which was validated in the validation cohort. Consistency was high (C-index=0.846), calibration good, and it was clinically valuable. The nomogram could be used to predict the probability of occult cervical LNM before operation in patients with stage cN0 SCC of the tongue. It could also be used as a reference tool for dissection of cervical nodes and a communication tool between the doctor and the patient.

Type 2 diabetes remission: economic evaluation of the DiRECT/Counterweight-Plus weight management programme within a primary care randomized controlled trial

AIM

The Counterweight-Plus weight management programme achieved 46% remission of Type 2 diabetes at 1 year in the DiRECT trial. We estimated the implementation costs of the Counterweight-Plus programme and its 1-year cost-effectiveness in terms of diabetes remission, compared with usual care, from the UK National Health Service (NHS) perspective.

METHODS

Within-trial total costs included programme set-up and running costs (practitioner appointment visits, low-energy formula diet sachets and training), oral anti-diabetes and anti-hypertensive medications, and healthcare contacts. Total costs were calculated for aggregated resource use for each participant and 95% confidence intervals (CI) were based on 1000 non-parametric bootstrap iterations.

RESULTS

One-year programme costs under trial conditions were estimated at £1137 per participant (95% CI £1071, £1205). The intervention led to a significant cost-saving of £120 (95% CI £78, £163) for the oral anti-diabetes drugs and £14 (95% CI £7.9, £22) for anti-hypertensive medications compared with the control. Deducting the cost-savings of all healthcare contacts from the intervention cost resulted an incremental cost of £982 (95% CI £732, £1258). Cost per 1 year of diabetes remission was £2359 (95% CI £1668, £3250).

CONCLUSIONS

Remission of Type 2 diabetes within 1-year can be achieved at a cost below the annual cost of diabetes (including complications). Providing a reasonable proportion of remissions can be maintained over time, with multiple medical gains expected, as well as immediate social benefits, there is a case for shifting resources within diabetes care budgets to offer support for people with Type 2 diabetes to attempt remission. (Clinical Trial Registry No.: ISRCTN03267836).

The relationship between plasma homocysteine levels and MTHFR gene variation, age, and sex in Northeast China

Background

Hyperhomocysteinemia (HHcy) is the risk factor for cardiovascular disease and stroke. However, the impacts on the genetic variation of methylene tetrahydrofolate reductase (MTHFR) on plasma homocysteine levels in the Northeast Chinese population have not been studied. Therefore, this study was carried out to determine the relationship between HHcy and MTHFR gene variation, and whether it was influenced by age and sex of the population in Northeast China.

Materials and Methods

A total of 466 subjects were randomly enrolled in this study. According to the homocysteine levels (Hcy ≥ 15 μmol/L) of the subjects, they were divided into hyperhomocysteine (HHcy = 206) and normal homocysteine (Hcy = 260). Polymerase chain reaction/high-resolution dissolution curve and homocysteine determination kit methods were used for genotype testing and homocysteine detection, respectively.

Results

High plasma homocysteine levels are associated with MTHFR 677T and 1298A [P < 0.00, odds ratio (confidence interval) = 1.842 (1.418-2.394) >1], which is related to increasing age (P_range = 0.0005-0.0161), with the homocysteine levels of males higher than females (P < 0.0001).

Conclusion

High plasma homocysteine levels were linked to the MTHFR gene mutation. In addition, plasma homocysteine levels increased significantly with age with male's homocysteine levels higher than that of females.

[The analysis of pathogens distribution and drug resistance of bacteria in sputum samples of pneumoconiosis patients combined with lower respiratory tract infection.]

Objective: To guide the rational use of antibiotic drugs in clinical practice for doctors by the analysis of pathogens distribution, transition and drug resistance of bacteria in sputum samples of pneumoconiosis patients combined with lower respiratory tract infection. Methods: 2 199 qualified sputum samples from 214 pneumoconiosis patients collected from January 2008 to December 2012 were examined by bacterium or fungus education. BioMerieux API and Eastern Cowin application software were used to do bacterial identification, and K-B method recommended by the NCCLS was used to take drug sensitivity tests. Results: 508 pathogens were isolated from sputum specimens and the positive rate among them was 23.1%. The majority of pathogens were fungus and Gram-negative bacteria, with the detection rates 50.0%, 40.7% respectively. Bacterial identification results show that the majority of pathogens of sputum samples were candida albicans, pseudomonas aeruginosa and acinetobacter baumannii. Susceptibility results show that P. aeruginosa was 100% sensitive to ceftriaxone (non-meningitis) and acinetobacter baumannii was 100% sensitivite to ampicillin/sulbactam, cefoperazone/sul-bactam and imipenem. These two bacteria were resistant to many kinds of antibiotic drugs, and the sensitive rates to cephalothin and clindamycin were 0%. Conclusion: The infections of pneumoconiosis patients combined with lower respiratory tract infection were fungi, pseudomonas aeruginosa and acinetobacter baumannii, which have a significant drug resistance. Doctors should consider the results of laboratory detection of pathogens and sensitivity test to select the antibiotic drugs in order to reduce the generation of resistant strains.

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries

AIMS

To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries.

METHODS

People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected.

RESULTS

A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%).

CONCLUSIONS

Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.

The effect of aspirin on circulating tumor cells in metastatic colorectal and breast cancer patients: a phase II trial study

PURPOSE

Aspirin could reduce the risk of cancer metastasis. Circulating tumor cells (CTCs) are a key factor of cancer metastasis, but no evidence has revealed how aspirin affects CTCs and its epithelial-mesenchymal transition (EMT). Here, we conducted a clinical trial to investigate how aspirin affects CTCs in metastatic colorectal cancer (MCC) and breast cancer patients (MBC).

METHODS

The trial is retrospective registered at clinicaltrials.gov (NCT02602938). The eligible patients are given 100 mg aspirin q.d. for 8 weeks, and CTCs are evaluated at baseline, 4 and 8 weeks for absolute number, phenotype (epithelial type, E+, mesenchymal type, M+, and biophenotypic type, B+), and vimentin expression.

RESULTS

Data on 21 MCC and 19 MBC patients are analyzed, and it revealed that the CTC numbers decreased with aspirin treatment in MCC (p < 0.001) but not MBC (p = 0.0532); besides, ratio of E+ CTCs increased (p = 0.037) and M+ CTCs decreased at 2 months in MCC (p = 0.013), but neither the ratio of E+ or M+ CTCs changes significantly in MBC; vimentin expression of M+ CTCs is higher than E+ and B+ CTCs either in MBC or MCC patients at baseline (p < 0.01); and aspirin suppresses the vimentin expression in M+ (p = 0.002)and B+ (p = 0.006) CTCs of MCC and M+ CTCs of MBC (p = 0.004); besides it find vimentin expression in B+ (p = 0.004) or M+ (p < 0.001), CTCs are markedly decreased in patients with total CTC numbers declined.

CONCLUSION

Aspirin could decrease CTCs numbers and block EMT transition in MCC patients and part of MBC patients.

Measurements of the associated production of a Z boson and b jets in pp collisions at s = 8 TeV

Measurements of the associated production of a Z boson with at least one jet originating from a b quark in proton-proton collisions ats = 8 TeV are presented. Differential cross sections are measured with data collected by the CMS experiment corresponding to an integrated luminosity of 19.8fb - 1 . Z bosons are reconstructed through their decays to electrons and muons. Cross sections are measured as a function of observables characterizing the kinematics of the b jet and the Z boson. Ratios of differential cross sections for the associated production with at least one b jet to the associated production with any jet are also presented. The production of a Z boson with at least two b jets is investigated, and differential cross sections are measured for the dijet system. Results are compared to theoretical predictions, testing two different flavour schemes for the choice of initial-state partons.

Study of Jet Quenching with Z+jet Correlations in Pb-Pb and pp Collisions at sqrt[s]_{NN}=5.02 TeV

The production of jets in association with Z bosons, reconstructed via the μ^{+}μ^{-} and e^{+}e^{-} decay channels, is studied in pp and, for the first time, in Pb-Pb collisions. Both data samples were collected by the CMS experiment at the LHC, at a nucleon-nucleon center-of-mass energy of 5.02 TeV. The Pb-Pb collisions were analyzed in the 0%-30% centrality range. The back-to-back azimuthal alignment was studied in both pp and Pb-Pb collisions for Z bosons with transverse momentum p_{T}^{Z}>60  GeV/c and a recoiling jet with p_{T}^{jet}>30  GeV/c. The p_{T} imbalance x_{jZ}=p_{T}^{jet}/p_{T}^{Z}, as well as the average number of jet partners per Z, R_{jZ}, was studied in intervals of p_{T}^{Z}. The R_{jZ} is found to be smaller in Pb-Pb than in pp collisions, which suggests that in Pb-Pb collisions a larger fraction of partons associated with the Z bosons fall below the 30  GeV/c p_{T}^{jet} threshold because they lose energy.

[Bone conduction in tympanosclerosis patients and its changes after surgery for tympanosclerosis]

Objective:To investigate the bone conduction (BC) in tympanosclerosis patients and its changes after surgery for tympanosclerosis, as well as its possible causes.Method:Retrospectively analyzed 30 cases of tympanosclerosis patients.Result:Before surgery, the average BC of the operated ear was (21.06±8.88) dBHL, the average BC of the healthy side was (16.78±8.97) dBHL, the difference had a statistical significance (t= 3.072, P< 0.01). The BC threshold, air conduction (AC) and ABG were significantly lower after operation. Preoperative BC at 2 000 Hz was the highest threshold (25.17±10.95) dBHL, and the postoperative decrease of BC thresholds at 500 Hz, 1 000 Hz and 2 000 Hz were statistically significant (P< 0.05 or P< 0.01). Tympanoplasty with mastoidectomy for BC threshold improvement was better than only tympanoplasty (P< 0.05)Conclusion:Tympanosclerosis leads to elevated BC threshold. Removal of tympanosclerosis lesions together with the removal of the lesions in antrum and mastoid and the reconstruction of sound conduction structures not only improve AC hearing and shorten ABG, but also improve postoperative BC hearing significantly.

[A case report: Ramsay Hunt syndrome with throat as starting place merger ipsilateral cranial nerver involvement]

The clinical data of a case of Ramsay Hunt syndrome concurrent with ipsilateral Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ cranial nerves paralysis with throat as starting place was retrospectively analyzed, and the relevant literatures were also reviewed. The case is rare, so the relevant clinical reports are less. It is important to take the objective data as well as subjective symptoms of the patients into consideration to make a definite diagnosis, so that we can treat it as soon as possible to achieve better curative effect.

Searches for pair production of third-generation squarks in [Formula: see text][Formula: see text] pp collisions

Searches are presented for direct production of top or bottom squark pairs in proton-proton collisions at the CERN LHC. Two searches, based on complementary techniques, are performed in all-jet final states that are characterized by a significant imbalance in transverse momentum. An additional search requires the presence of a charged lepton isolated from other activity in the event. The data were collected in 2015 at a centre-of-mass energy of 13[Formula: see text] with the CMS detector and correspond to an integrated luminosity of 2.3[Formula: see text]. No statistically significant excess of events is found beyond the expected contribution from standard model processes. Exclusion limits are set in the context of simplified models of top or bottom squark pair production. Models with top and bottom squark masses up to 830 and 890[Formula: see text], respectively, are probed for light neutralinos. For models with top squark masses of 675[Formula: see text], neutralino masses up to 260[Formula: see text] are excluded at 95% confidence level.

A search for new phenomena in pp collisions at [Formula: see text] in final states with missing transverse momentum and at least one jet using the [Formula: see text] variable

A search for new phenomena is performed in final states containing one or more jets and an imbalance in transverse momentum in pp collisions at a centre-of-mass energy of 13[Formula: see text]. The analysed data sample, recorded with the CMS detector at the CERN LHC, corresponds to an integrated luminosity of 2.3[Formula: see text]. Several kinematic variables are employed to suppress the dominant background, multijet production, as well as to discriminate between other standard model and new physics processes. The search provides sensitivity to a broad range of new-physics models that yield a stable weakly interacting massive particle. The number of observed candidate events is found to agree with the expected contributions from standard model processes, and the result is interpreted in the mass parameter space of fourteen simplified supersymmetric models that assume the pair production of gluinos or squarks and a range of decay modes. For models that assume gluino pair production, masses up to 1575 and 975[Formula: see text] are excluded for gluinos and neutralinos, respectively. For models involving the pair production of top squarks and compressed mass spectra, top squark masses up to 400[Formula: see text] are excluded.

[Clinical characteristics in gout patients with different body mass index]

Objective: Obesity is one of the risk factors for gout. The aim of the present study was to evaluate clinical characteristics of gout patients with different BMI. Methods: A total of 5 104 patients with gout were enrolled and divided into three groups according to the BMI. The clinical information was collected and relevant biochemical indices were detected. SPSS software was applied for the statistical analyses. Results: There were significant differences in the ratios of gender, regular exercise, hypertension, tophus, renal insufficiency, hyperlipidemia, impaired glucose metabolism, liver dysfunction among the three groups (all P<0.01). The onset age in overweight [45(36, 55) years] and obese subjects [40(31, 50) years] were earlier than that of the normal weight subjects [50(38, 61) years]. Moreover, waist circumstances [103(99, 108) cm and 94 (90, 98) cm vs 87 (82, 91) cm], systolic pressure [130 (120, 145) mmHg (1 mmHg=0.133 kPa)and 130(120, 140)mmHg vs 128(115, 140) mmHg], diastolic pressure [90 (80, 100) mmHg and 85 (80, 92) mmHg vs 80 (79, 90) mmHg], fasting blood glucose [5.77 (5.30, 6.44) mmol/L and 5.65 (5.19, 6.26) mmol/L vs 5.55 (5.10, 6.15) mmol/L], TG [2.10 (1.46, 3.04) mmol/L and 1.88 (1.35, 2.78) mmol/L vs 1.52 (1.07, 2.39) mmol/L], TC [5.20 (4.55, 5.93) mmol/L and 5.07 (4.46, 5.75) mmol/L vs 4.95 (4.27, 5.65) mmol/L], serum uric acid [483(418, 552) μmol/L and 461(395, 524) μmol/L vs 440 (368, 517) μmol/L], ALT [30 (21, 46) U/L and 25 (18, 36) U/L vs 21 (14, 29) U/L], AST [21(17, 28) U/L and 20 (17, 26) U/L vs 20 (6, 25) U/L], the number of joints involved [2(1, 3)joints and 2(1, 2) joints vs 1(1, 2) joints] in the overweight and obese groups were higher than those in the normal weight group ( all P<0.01). There were no statistical differences in family history, involvement of upper limb joints, kidney stones and coronary heart disease among the three groups (all P>0.05). Conclusions: Obesity is associated with an earlier age of gout onset.With the increase of BMI, the blood pressures, glucose, lipid, serum uric acid, liver transaminase levels and the number of involved joints increased gradually. Cautions should be taken in treating patients with different BMI.