[Efficacy analysis of 7 cases of mixed neuroendocrine-nonneuroendocrine neoplasm of the duodenal papilla]

The clinical data of 7 patients diagnosed with mixed neuroendocrine-nonneuroendocrine neoplasm were analyzed in the Department of Hepatobiliary Surgery of Hunan Provincial People's Hospital from January 2016 to December 2022. Among the 7 patients, 5 were male and 2 were female, with an average age of 59.3 years. Its clinical characteristics are similar to malignant ampulla tumors, and it is difficult to differentiate them. The preoperative puncture biopsy positivity rate is low, making it difficult to diagnose preoperatively, and the prognosis is worse.Comprehensive treatment including surgery, chemotherapy, and radiotherapy can be the preferred treatment option for this disease.

Effective stabilization of heavy metals in solid waste and sludge pyrolysis using intercalated-exfoliated modified vermiculite: Experiment and simulation study

Pyrolysis is effective in reducing the volume of solid waste and sludge, and produces less pollutants than incineration and landfill, but the process still suffers from heavy metal pollution. Four types of intercalated-exfoliated modified vermiculite (UIV, DIV, TIV and 3IV) were prepared using urea, dimethylsulfoxide, tributyl phosphate and 3-aminopropyltriethoxysilane as intercalators for the control of Cd, Cr, Cu, Pb and Zn in municipal sewage sludge (MSL), paper mill sludge (PML), municipal domestic waste (MWA) and aged refuse (AFE). The larger the interlayer spacing of the vermiculite, the more favorable the retention of heavy metals. 3IV was the most effective additive, with an average retention of more than 75 % of all heavy metals at 450 ℃ for the four raw materials. Cr, Cu, Pb and Zn were all at low potential ecological risk (Pr), while Cd was moderate or considerable Pr, and the addition of 3IV reduced the Pr. Distribution of intercalators between vermiculite interlayers was haphazard, and interlayer spacing results were close to those of the experiment (except for tributyl phosphate). The reactive electrons mainly flowed from the Highest Occupied Molecular Orbital (HOMO) of vermiculite flakes to the Lower Unoccupied Molecular Orbital (LUMO) of heavy metal chlorides. In contrast, the reactive electrons mostly flowed from the HOMO of heavy metal oxides to the LUMO of vermiculite flakes. Heavy metal oxides were more readily adsorbed on vermiculite flakes than heavy metal chlorides, and the adsorption capacity of Cr and Zn was stronger than that of Cd, Pb and Cu.

Stabilization of heavy metals in solid waste and sludge pyrolysis by intercalation-exfoliation modified vermiculite

Increasing amounts of solid waste and sludge have created many environmental management problems. Pyrolysis can effectively reduce the volume of solid waste and sludge, but there is still the problem of heavy metal contamination, which limits the application of pyrolysis in environmental management. The intercalated-exfoliated modified vermiculite (IEMV) by intercalators of sodium dodecylbenzene sulfonate, hexadecyltrimethylammonium bromide and octadecyltrimethylammonium bromide were used to control the release of Cd, Cr, Cu, Zn and Pb during pyrolysis process of sludge or solid waste. The retention of heavy metals in sludge was generally better than that in solid waste. The IEMV by octadecyltrimethylammonium bromide as the intercalator calcined 800 °C (STAB-800) was the best additive for heavy metal retention, and the retention of Cr, Cu and Zn was significantly better than that of Pb and Cd. Cr, Cu, Zn and Pb were at low risk, while Cd had considerable risk under certain circumstances. New models were proposed to comprehensively evaluate the results of the risk and forms of heavy metals, and the increasing temperature was beneficial in reducing the hazards of heavy metals by the addition of STAB-800. The reaction mechanism of heavy metals with vermiculite was revealed by simulation of reaction sites, Fukui Function and Frontier Molecular Orbital. Thermal activation-intercalated-exfoliated modified vermiculite (T-IEMV) is more reactive and had more active sites for heavy metals. Mg atoms and outermost O atoms are the main atoms for T-IEMV to react with heavy metals. The Cr, Cu and Zn have better adsorption capacity by T-IEMV than Pb and Cd. This study provides a new insight into managing solid waste and sludge and controlling heavy metal environmental pollution.

Epidemiology of healthcare-associated Pseudomonas aeruginosa in intensive care units: are sink drains to blame?

BACKGROUND

Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infection (PA-HAI) in the intensive care unit (ICU).

AIM

To describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and to identify episodes of sink-to-patient PA transmission.

METHODS

This was a prospective cohort study of patients in six ICUs from 2018 to 2019, with retrieval of PA clinical isolates, and PA-screening of antimicrobial-resistant organism surveillance rectal swabs, and of sink drain, air, and faucet samples. All PA isolates underwent whole-genome sequencing. PA-HAI was defined using US National Healthcare Safety Network criteria. ICU-acquired PA was defined as PA isolated from specimens obtained ≥48 h after ICU admission in those with prior negative rectal swabs. Sink-to-patient PA transmission was defined as ICU-acquired PA with close genomic relationship to isolate(s) previously recovered from sinks in a room/bedspace occupied 3-14 days prior to collection date of the relevant patient specimen.

FINDINGS

Over ten months, 72 PA-HAIs occurred among 60/4263 admissions. The rate of PA-HAI was 2.40 per 1000 patient-ICU-days; higher in patients who were PA-colonized on admission. PA-HAI was associated with longer stay (median: 26 vs 3 days uninfected; P < 0.001) and contributed to death in 22/60 cases (36.7%). Fifty-eight admissions with ICU-acquired PA were identified, contributing 35/72 (48.6%) PA-HAIs. Four patients with five PA-HAIs (6.9%) had closely related isolates previously recovered from their room/bedspace sinks.

CONCLUSION

Nearly half of PA causing HAI appeared to be acquired in ICUs, and 7% of PA-HAIs were associated with sink-to-patient transmission. Sinks may be an under-recognized reservoir for HAIs.

The utility of behavioral biometrics in user authentication and demographic characteristic detection: a scoping review

BACKGROUND

Objective measures of screen time are necessary to better understand the complex relationship between screen time and health outcomes. However, current objective measures of screen time (e.g., passive sensing applications) are limited in identifying the user of the mobile device, a critical limitation in children's screen time research where devices are often shared across a family. Behavioral biometrics, a technology that uses embedded sensors on modern mobile devices to continuously authenticate users, could be used to address this limitation.

OBJECTIVE

The purpose of this scoping review was to summarize the current state of behavioral biometric authentication and synthesize these findings within the scope of applying behavioral biometric technology to screen time measurement.

METHODS

We systematically searched five databases (Web of Science Core Collection, Inspec in Engineering Village, Applied Science & Technology Source, IEEE Xplore, PubMed), with the last search in September of 2022. Eligible studies were on the authentication of the user or the detection of demographic characteristics (age, gender) using built-in sensors on mobile devices (e.g., smartphone, tablet). Studies were required to use the following methods for authentication: motion behavior, touch, keystroke dynamics, and/or behavior profiling. We extracted study characteristics (sample size, age, gender), data collection methods, data stream, model evaluation metrics, and performance of models, and additionally performed a study quality assessment. Summary characteristics were tabulated and compiled in Excel. We synthesized the extracted information using a narrative approach.

RESULTS

Of the 14,179 articles screened, 122 were included in this scoping review. Of the 122 included studies, the most highly used biometric methods were touch gestures (n = 76) and movement (n = 63), with 30 studies using keystroke dynamics and 6 studies using behavior profiling. Of the studies that reported age (47), most were performed exclusively in adult populations (n = 34). The overall study quality was low, with an average score of 5.5/14.

CONCLUSION

The field of behavioral biometrics is limited by the low overall quality of studies. Behavioral biometric technology has the potential to be used in a public health context to address the limitations of current measures of screen time; however, more rigorous research must be performed in child populations first.

SYSTEMATIC REVIEW REGISTRATION

The protocol has been pre-registered in the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/92YCT ).

Experimental and theoretical study to control the heavy metals in solid waste and sludge during pyrolysis using modified expanded vermiculite

Na+/K+/Mg2+/Ca2+ expansion-modified vermiculite and calcination expansion (700 °C, 800 °C and 900 °C)-modified vermiculite (700-Mg-V, 800-Mg-V and 900-Mg-V) were prepared as additives to control the emission of five heavy metals (Zn, Cr, Cu, Pb, and Cd) during the pyrolysis of municipal sewage sludge, paper mill sludge, municipal domestic waste, and aged refuse. Mg2+-Modified vermiculite obtained via thermally activated calcination at 800 °C retained 65% of heavy metals from all raw materials at 450 °C. Zn, Cr, and Cu retained nearly 90%. Although modified vermiculite could reduce the ecological risk, Cd had an ecological risk level higher than Zn, Cr, Cu, and Pb. The fine textural properties, laminated morphology, and expansion capacity of modified vermiculite were positively correlated with its retention of heavy metals. Heavy metals interacted with the (002) surface of vermiculite, and the reactions were mainly concentrated near the 17-O and surrounding atoms. The heavy-metal monomers were less capable of binding to the (002) surface of vermiculite than the oxides and chlorides of heavy metals. The effect of heavy-metal oxides and chlorides binding to the (002) surface of vermiculite was related to heavy metals.

A simple and convenient model combining multiparametric MRI and clinical features to predict tumour-infiltrating lymphocytes in breast cancer

AIM

To develop a simple and convenient method based on multiparametric magnetic resonance imaging (MRI) and clinical features to non-invasively predict tumour-infiltrating lymphocytes (TILs) in breast cancer (BC) and to explore the relationship between TIL levels and disease-free survival (DFS).

MATERIALS AND METHODS

A total of 172 BC patients were enrolled between November 2017 and June 2021 in this retrospective study. The patients were divided into high (≥10%) and low (<10%) TIL groups. Clinicopathological data were collected. MRI features were reviewed by two radiologists. Predictors associated with TILs were determined by using multivariable logistic regression analyses. Kaplan-Meier survival curves based on TIL levels were used to estimate DFS.

RESULTS

A total of 102 patients with low TILs and 70 patients with high TILs were included in the study. Tumour size (odds ratio [OR], 1.040; 95% confidence interval [CI]: 1.006, 1.075; p=0.020), apparent diffusion coefficient (ADC; OR, 1.003; 95% CI: 1.001, 1.005; p=0.015), clinical axillary lymph node status (CALNS; OR, 3.222; 95% CI: 1.372,7.568; p=0.007), and enhancement pattern (OR, 0.284; 95% CI: 0.143, 0.563; p<0.001) were independently associated with TIL levels. These features were used in the ALSE model (where A is ADC, L is CALNS, S is size, and E is enhancement pattern). High TILs were associated with better DFS (p=0.016).

CONCLUSION

The ALSE model derived from multiparametric MRI and clinical features could non-invasively predict TIL levels in BC, and high TILs were associated with longer DFS, especially in human epidermal growth factor receptor 2 (HER2)-positive BC and triple-negative BC (TNBC).

Plant size, latitude, and phylogeny explain within-population variability in herbivory

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

Influence of silica-aluminum materials on heavy metals release during paper sludge pyrolysis: Experimental and theoretical studies

It is of great significance to reduce the secondary risk of heavy metals during the pyrolysis of paper sludge. This study used kaolin and alumina-silica-based xerogels to control heavy metals released during sludge pyrolysis. Pyrolyzing a mixture of sludge and 7% kaolin at 400 °C achieved high retention rates for Cu (95.85%), Zn (95.97%), Pb (97.15%), Cd (84.23%), and Cr (84.05%) when the pyrolysis tail gas was treated with 9 g of xerogel. The addition of kaolin facilitated the transformation of Cu, Zn, Pb, and Cr from the unstable fraction to the stable fraction in pyrolysis biochar, reducing their leachability. The xerogels also played a crucial role in adsorbing and stabilizing the heavy metals. The results of thermodynamic equilibrium calculations showed that Pb(g), PbS(g), PbCl2(g), PbCl(g), Zn(g), ZnCl2(g), and Cd(g) were the main gaseous products of Zn, Pb, and Cd during paper sludge pyrolysis. The Pb atoms in PbCl2 and PbS, and the Zn atoms in ZnCl2 bond with the oxygen atoms on the kaolin surface by covalent bonds, while the Cl atoms in PbCl and the Pb atoms of elemental lead form ionic bonds with H and O atoms on the kaolinite surface, respectively. These experimental and simulation results offer new ideas for controlling heavy metals during sludge pyrolysis.

Experiment and mechanism study on enrichment of heavy metals during MSW pyrolysis by modified kaolin

Experiment and mechanism studies on the enrichment of Pb, Cd, Zn, As, and Cr by modified kaolin were investigated during MSW (municipal solid waste) pyrolysis at 450 ~ 650 °C. The results showed that γAlOK(micro- and nano-γAl₂O₃ by hydrothermal method modified kaolin) was relatively selective for the solid phase enrichment of Cr and As, while CaHPK (CaHPO₄ impregnated modified kaolinite) was more advantageous for the adsorption of Pb and Zn, which might be related to the thermal stability of γAl₂O₃ and the thermal conversion of CaHPO₄. Compared with the original kaolin, the adsorption and retention capacity of γAlOK for As was improved by 20 ~ 30%. Moreover, the retention rate of modified kaolin for Cd decreased from 66.75 to 30.30% at 450 ~ 650 ℃, and the effect of temperature on the volatilization of Cd was always greater than the active components on the surface of modified kaolin. In the fluidized bed experiment, the physical mixing of different modified kaolin achieves complementary advantages on the retention capacity of heavy metals. In addition, the ∆E between Ca₂P₂O₇ and PbCl₂ is smaller than that of γAl₂O₃ at 500 ~ 650 °C, i.e., their electron transfer induction is stronger, and therefore more favorable for electron transfer and stable chemical bond formation.

Investigating the mechanism of interactive regulation of B-cell lymphoma-2/Beclin 1 through electroacupuncture intervention during reperfusion in myocardial ischemia-reperfusion injury in a rat model

To observe the regulation of B-cell lymphoma-2 (Bcl-2)/Beclin 1 interaction through electroacupuncture (EA) intervention during reperfusion and to investigate the EA mechanism of apoptosis-autophagy interactive regulation against myocardial ischemia-reperfusion injury (MIRI). A total of 48 adult Sprague Dawley (SD) rats were randomly divided into the sham-operated group (group Sham), the model group (group Model), the EA group (group EA), and the JNK inhibitor (SP600125) group (group JNK), with 12 rats in each group. Biospecimens were collected randomly from six rats in each group four hours after reperfusion. Evans Blue and triphenyl tetrazolium chloride double-staining were applied to observe each group's myocardial damage area and risk area. We collected 4 ml of blood by abdominal aortic method to detect serum troponin cTnI level by enzyme-linked immunosorbent assay (ELISA). For the remaining six in each group, a part of myocardial tissue below the ligation line was stored in 4% paraformaldehyde for immunohistochemistry and TUNEL staining; the other amount of myocardial tissue was detected by Western blotting to determine the expression levels of Bcl-2, Beclin1, and the phosphorylation levels of Thr69, Ser70, and Ser87 in Bcl-2. In results: electroacupuncture (EA) intervention during reperfusion significantly reduced the myocardial infarction area, cTnI level, and myocardial apoptosis, upregulated Bcl-2 expression, downregulated Beclin 1 expression and inhibited phosphorylation levels of Thr69, Ser70, and Ser87 in Bcl-2. We concluded that EA effectively inhibited apoptosis by upregulating Bcl-2 expression and inhibiting the phosphorylation of Thr69, Ser70, and Ser87 in Bcl-2. This reduced the separation of Bcl-2 and Beclin 1, restrains excessive autophagy, alleviates MIRI, and has a protective effect on myocardial tissue.

Environmental impact comparison of wheat straw fast pyrolysis systems with different hydrogen production processes based on life cycle assessment

This study aimed to evaluate the environmental impact of 1000 kg h^-1 wheat straw to produce biofuel via fast pyrolysis with three different hydrogen production processes by the life cycle assessment (LCA) based on Chinese Life Cycle Database (CLCD). The primary energy depletion (PED), global warming potential (GWP), abiotic depletion potential (ADP) and respiratory inorganics (RI) impact categories of 1 MJ biofuel produced were employed for comparison. In case 1, the hydrogen was derived from natural gas steam reforming, and all the bio-oil was hydrotreated to produce the biofuel. In case 2, a part of the aqueous phase was reformed to produce hydrogen, whereas the remaining bio-oil was hydrotreated to produce biofuel. In case 3, all the aqueous phase of bio-oil was reformed to produce hydrogen, a part of hydrogen generated by reforming was used to oil phase hydrotreated and the excess hydrogen was considered as a co-product. Our results show that the PED, GWP, ADP and RI of case 3 are 0.1355 MJ, -17.96 g CO_2eq., 0.0338 g antimony_eq and 0.0461 g PM2.5_eq.. Compared with conventional diesel, the PED, GWP, ADP and RI of case 3 were reduced by 89.81, 117.44, 1.74 and 85.03%, respectively. The results of sub-process contribution analysis and sensitivity analysis suggested that the electricity consumption for the bio-oil production has the maximal effect on the total PED, GWP and RI of case 3, whereas the amount of fertilizers in the biomass production sub-process has the maximal effect on the total ADP.

Efficient with low-cost removal and adsorption mechanisms of norfloxacin, ciprofloxacin and ofloxacin on modified thermal kaolin: experimental and theoretical studies

Quinolone antibiotics (QNs) can be potential hazard to environment and human. Combination of experimental and theoretical studies was used to analyze the adsorption properties of norfloxacin, ciprofloxacin and ofloxacin on modified thermally activated kaolin (KL). Main factors (calcination temperature, dose, pH, cations and regeneration) affecting the adsorption were discussed. Adsorption processes fit the pseudo-second order kinetic and Langmuir model well. The adsorption removal of norfloxacin, ciprofloxacin and ofloxacin can reach 88.53%, 89.43% and 91.46%, respectively. Cations inhibited adsorption, and AlS-KLB can maintain 80% efficiency in five cycles under optimal conditions. Simulations showed that the materials had good adsorption capacity for QNs, and the "①" of KL had the best capacity. Simulations explain the adsorption mechanism: F, H, O atoms of QNs are covalently bonded to O atoms from KL, Al₂O₃ and Al (OH)₃, C atoms from amorphous carbon and H atoms from C-H and Al (OH)₃. The Al atoms of Al₂O₃ and Al, Si atoms of KL are ionically bonded to F, H, O atoms of QNs. This study shed new light on the removal of QNs by providing low-cost and efficient modified KL and elucidating the adsorption mechanism in conjunction with DFT simulations.

Comparison of Laminoplasty vs. Laminectomy for Cervical Spondylotic Myelopathy: A Systematic Review and Meta-Analysis

OBJECTIVES

Laminoplasty (LP) and laminectomy (LC) with or without fusion are recommended as treatment procedures for cervical spondylotic myelopathy (CSM). The purpose of this study is to conduct a meta-analysis to analyze the results of CSM patients undergoing LP or LC surgery.

METHODS

We systematically and comprehensively searched Web of Science, Cochrane Library, PubMed, EMBASE, OVID, VIP database, Google Scholar, Chinese Bio-medicine Literature database, and China Scientific Journal Full-text database to July 2021 for randomized controlled trials (RCTs) and observational case series that compared LP and LC in patients with CSM. The main endpoints were the surgical process, radiographic outcomes, clinical outcomes, and surgical complications.

RESULTS

A total of 19 were included the inclusion criteria in this meta-analysis (n = 4,348 patients). There was no significant difference in range of motion (ROM), sagittal vertical axis (SVA), Japanese Orthopedic Association (JOA), Cobb angle, visual analog scale (VAS), cervical curvature index (CCI), Nurick score, Neck Dysfunction Index (NDI), and complications. LP was found to be superior than LC in terms of complications of C5 radiculopathy and surperficial infection.

CONCLUSION

Our results indicate that LP can achieve better results in C5 radiculopathy and superficial infection in surgical treatment of CSM compared with LC. Further high-quality research is warranted to further verify our findings.

SYSTEMATIC REVIEW REGISTRATION

PRISMA: CRD42018107070.

Comparative study on intercalation-exfoliation and thermal activation modified kaolin for heavy metals immobilization during high-organic solid waste pyrolysis

With the new municipal solid waste classification policy implemented in China, attention on achieving the waste-to-energy disposal of "dry waste" has been growing. Pyrolysis conversion of organic waste into value-added chemicals is a promising method to treat solid waste. However, after removing the non-combustible components of "dry waste", the obtained high-organic solid waste (HSW) contains various heavy metals, which requires urgent attention during thermochemical conversion. To mitigate heavy metals risk, kaolin was employed as additive during HSW pyrolysis, and intercalation-exfoliation and thermal activation modifications were performed on the kaolin to further immobilize and stabilize heavy metals in the derived chars. The characterization results illustrated that the interlayer spacing, pore volume and diameter of kaolin were expanded after intercalation-exfoliation modification, providing more opportunities for the adsorption of metals. The thermal activation method favored the transformation of kaolin into metakaolin via dehydroxylation to enhance its nonhexacoordinated Al proportion and chemisorption. During 450-650 °C, kaolin exhibited an effective solid enrichment performance for targeting heavy metals, and the intercalation-exfoliation and thermal activation modification further enhanced the adsorption capacity of the kaolin for Cd, Cr, Pb and Cr, Cu, Pb, Zn, respectively. Compared with Cu and Zn, additives demonstrated better stabilization effects for Cd, Pb, and Cr, transforming more bioavailable fractions to the residual speciation. Overall, a higher pyrolytic temperature (650 °C) and the addition of effective additives could simultaneously increase the residual fraction and decrease the bioavailable fraction of heavy metals in HSW-derived chars, reducing the potential ecological risk.

The adsorption mechanism of heavy metals from coal combustion by modified kaolin: Experimental and theoretical studies

Experimental and theoretical studies are combined to analyze the adsorption properties of modified kaolin for heavy metal (Pb, Cd, Zn and Cr) from coal combustion. The results indicate that the retention effect of kaolin for Pb, Cd, Zn and Cr has been significantly enhanced after intercalation-exfoliation combined with acid/alkali modification, which is mainly attributed to more active sites for adsorption, richer porosity and more effective in retarding coking of coal ash. The higher oxygen concentration is positive to the enrichment of heavy metals at 900-1200 ℃, while the coking of coal ash and the thermal conversion of additives become the main factors affecting the absorption at 1200-1300 ℃. The acid/alkali modification effectively promotes the inductive effect of electron transfer between modified kaolin and heavy metals to form stable chemical adsorption. The electron transfer induction of modified kaolin for Pb, Cd is higher than Zn, Cr at 900-1000 ℃, while the adsorption activity of mullite and cristobalite for Zn, Cr is stronger than Pb, Cd at 1200-1300 ℃. In addition, Pb, Cd and Zn are more readily adsorbed as oxides by additives at 900-1300 °C. The results shed new light on strengthening the adsorption activity of kaolin to Pb, Cd, Zn and Cr in high temperature.

Characterization of serum adiponectin and leptin in healthy perinatal dairy cows or cows with ketosis, and their effectson ketosis involved indices

We investigated changes in concentrations of ADP (adiponectin), LEP (leptin), BHBA (beta-hydroxybutyric acid), NEFA (non-esterified fatty acid), Glucose (Glu) and INS (insulin) in serum of healthy perinatal dairy cows and cows with ketosis. Twenty-one healthy cows and seventeen cows with ketosis from a herd of a total 60 Holstein cows (near dry period i.e. 56 days antepartum) were selected. Blood was collected through the tail vein every 7 days, from 56 day antepartum to 56 day postpartum. Serum ADP, LEP, BHBA, NEFA, Glu, and INS concentrations were determined, and ketosis was diagnosed through serum BHBA (≥1.2 mmol/L). We showed the concentration of serum adipokines and energy balancing indices were stable during antepar- tum period. However, ADP concentration increased while LEP decreased, and there were a significant increase in cows with ketosis compared to that of in healthy cows. Serum BHBA and NEFA concentrations increased significantly at first, and then gradually decreased in both healthy cows and cows with ketosis. However, cows with ketosis showed higher concentrations of BHBA and NEFA which restored later. The serum concentration of Glu in both healthy dairy cows and cows with ketosis showed a decreasing trend. INS concentration in healthy cows was decreased while it was increased in cows with ketosis. The results reflect the extent of hypo- glycemia and lipid mobilization postpartum, suggest IR exists in cows with ketosis while serum ADP and LEP might play roles in the development of ketosis.

Mutations of the c-Kit and PDGFRA gene in gastrointestinal stromal tumors among hakka population of Southern China

Aims

The aim of the present study was to investigate mutation status of the cKit and PDGFRA genes in patients with a gastrointestinal stromal tumor (GIST).

Methods

In total, 96 patients with a GIST were included in the study, in which polymerase chain reaction amplification and gene sequencing were used to detect the sequences of exons 9, 11, 12, 13, 14, 17, and 18 in KIT and exons 12, 14, and 18 in PDGFRA.

Results

KIT mutations were detected in 65 cases (67.71%), of which 81.54% (53/65) were located on exon 11, 12.31% (8/65) were located on exon 9, 4.61% (3/65) were located on exon 17, which included a concomitant mutation of exon 9 and 11, and 4.08% (2/65) were located on exon 13, which included a concomitant mutation on exon 11. The most common mutation in exon 11 was deletion, which accounted for 77.36% (41/53) of the cases, followed by a point mutation observed in 22.64% (12/53) of the cases. Among the 31 GIST cases without a KIT mutation, a mutation in PDGFRA was detected in 5 cases (5.21%, 5/96; 16.13%, 5/31). With respect to gender, age, tumor max diameter, tumor position, and mitotic index, there were no significant differences between KIT/PDGFRA mutations and non-mutations.

Conclusions

GIST mainly occurs in the stomach, and the cytological morphology is mainly spindle cells, and the mutations mainly occur in KIT genes. We need a large sample size to analyze the regularity of GIST gene mutations in Hakka population and understand the independent prognostic correlation of all KIT/PDGFRA genotypes.

AB0791 THE DIAGNOSIS VALUE OF SYNOVIAL FLUID LYMPHOCYTE IN GOUT PATIENTS

Background:

Synovial fluid cell counts have long been recognised to have utility in the diagnosis and management of arthritis. Few studies have explained the diagnosis value of synovial fluid cell counts in gout patients.

Objectives:

The study aims to investigate the diagnosis value of synovial fluid cell counts in gout patients.

Methods:

A total of 185 gout, 64 rheumatoid arthritis(RA), 26 axial spondyloarthritis(axSpA) and 24 osteoarthritis(OA) patients were included into the study. According to serum uric acid(sUA) level on attack, gout patients were divided into normal sUA gout patients and high sUA gout patients. The laboratory data was recorded and ROC curve was performed.

Results:

The synovial fluid WBC, PBMC, monocyte, PMN and neutrophil in gout patients were higher than OA patients (P<0.05). The synovial fluid PBMC and lymphocyte in gout patients were lower than RA and axSpA patients (P<0.05). Compared with RA, axSpA and OA patients, ROC curve showed that the AUC value of lymphocyte and sUA for gout were 0.728 and 0.881, which were higher than other variables. The optimal cut off value of lymphocyte for gout was 1.362, with sensitivity of 83.3% and specificity of 60.6%. The AUC value of lymphocyte and sUA for normal sUA gout patients were 0.694 and 0.643, which were higher than other variables. The optimal cut off value of lymphocyte for normal sUA gout patients was 1.362, with sensitivity of 81.6% and specificity of 60.6%.

Conclusion:

Synovial fluid cell counts of gout patients were different from RA, axSpA, and OA patients. Synovial fluid lymphocyte had a higher diagnosis value for gout.

References:

[1]Scanu A, Oliviero F, Ramonda R, et al. Cytokine levels in human synovial fluid during the different stages of acute gout: role of transforming growth factor β1 in the resolution phase. Ann Rheum Dis. 2012, 71(4): 621-4.

Table 1.

Basic characteristics of the participants

Gout(n=185)RA(n=64)axSpA (n=26)OA(n=24)P valueAge (years)48.58±15.5856.19±12.39*32.96±15.19*#69.63±12.43*#&<0.001Gender (male/female)176/911/5321/58/16<0.001WBC(×109/L)18.58±22.9422.24±20.8715.52±15.033.03±5.59*#&0.002PBMC(×109/L)1.85±1.993.68±2.43*3.85±3.34*0.74±1.01*#&<0.001Monocyte(×109/L)1.02±1.591.24±1.111.34±1.520.29±0.37*#&0.030PMN(×109/L)16.77±21.5118.57±19.3215.75±24.172.30±5.00*#&0.008Lymphocyte (×109/L)0.80±0.832.43±1.76*2.50±2.04*0.45±0.80#&<0.001Eosinophil (×109/L)1.32±3.750.56±0.930.11±0.170.49±1.850.098Neutrophil (×109/L)16.42±21.1618.82±20.8911.13±14.232.23±4.87*#0.003UA(μM)497.92±132.24299.31±97.91*351.81±118.93*333.38±75.19*<0.001ESR(mm/h)61.02±37.6882.42±32.87*68.12±36.2542.34±35.91*#&<0.001CRP(mg/L)56.52±45.6444.01±35.27*65.49±39.85#22.11±40.65*#&<0.001

*P<0.05 vs gout group, #P<0.05 vs RA group, &P<0.05 vs axSpA group

Disclosure of Interests:

None declared

POS1144 SERUM URIC ACID TO CREATININE RATIO IS ASSOCIATED WITH URINARY URIC ACID EXCRETION IN PATIENTS WITH GOUT

Background:

Underexcretion of uric acid is the dominant mechanism leading to hyperuricemia [1] and the 24-hour urinary uric acid excretion is an important measurement. However, it is inconvenient due to accurate timing and complete collection of the specimen.

Objectives:

The aim of this study was to investigate the relationship between serum uric acid to creatinine ratio (sUACR) and 24-hour urinary uric acid excretion in gout patients.

Methods:

A total of 110 gout patients fulfilling 2015 ACR/EULAR classification criteria from Guangdong Second Provincial General Hospital from January 2019 to January 2021 were retrospectively enrolled in this study. Patients were divided into underexcretion group (<3600 μmol/24h) and non-underexcretion group (≥3600 μmol/24h). The correlation between sUACR and 24-hour urinary uric acid excretion was analyzed by the Pearson’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to assess the utility of sUACR for discriminating between underexcretion group and non-underexcretion group. Furthermore, the risk factors of uric acid underexcretion were evaluated using binary logistic regression analysis.

Results:

sUACR in the underexcretion group was significantly lower than the non-underexcretion group (p=0.0001). Besides, sUACR was positively correlated with 24-hour urinary uric acid excretion (r=0.4833, p<0.0001). Furthermore, ROC suggested that the area under the curve (AUC) of sUACR was 0.728, which was higher that of serum uric acid and creatinine. The optimal cutoff point of sUACR was 5.2312, with a sensitivity and specificity of 71.9% and 67.9%. Logistic analysis results revealed that decreased sUACR (<5.2312) was an independent risk factor of underexcretion of uric acid (OR =5.510, 95% CI: 1.952-15.550, P=0.001).

Conclusion:

sUACR is lower in gout patients with underexcretion of uric acid and may serve as a useful and convenient marker of assessing underexcretion of uric acid in gout patients.

References:

[1]Perez-Ruiz F, Calabozo M, Erauskin GG, Ruibal A, Herrero-Beites AM. Renal underexcretion of uric acid is present in patients with apparent high urinary uric acid output. Arthritis Rheum 2002; 47: 610–13.

Figure 1.

A. Comparison of serum uric acid to creatinine ratio between underexcretion group and non-underexcretion group. B. Correlation between serum uric acid to creatinine ratio and 24h uric acid excretion.

Disclosure of Interests:

None declared.

AB0645 CLINCAL CHARACTERISTICS OF GOUT PATIENTS WITH RENAL CYSTS

Background:

Gout is a crystal-related arthropathy caused by monosodium urate deposition, which is a common and treatable form of inflammatory arthritis and becoming more prevalent[1]. A few studies have found that gout patients have an increased prevalence of simple renal cysts[2, 3]. The relationship between gout and renal cysts is still insufficient.

Objectives:

Compare the difference between gout with renal cyst and without renal cyst.

Methods:

We retrospectively collected data on 200 gout patients. The data includes age, gender, uric acid, creatinine, glomerular filtration rate, 24-hour urine collection, and whether they have kidney stones, renal cysts, coronary heart disease, hypertension, and diabetes. Chi-square and exact Fisher’s tests were utilized, while continuous variables were assessed by Student’s t-test. A P value of less than 0.05 was considered statistically significant.

Results:

Of the 200 gout patients, 56 have kidney cysts(28%). In gout patients who had a renal cyst, were significantly older than patients without renal cysts (59.14 vs. 46.87, P = 0.000), more number of people suffering from coronary heart disease (7 vs. 5, P = 0.016). The glomerular filtration rate was lower (58.5 vs. 71.6, P = 0.000), with lower urinary creatinine, uric acid, and urinary potassium.

Conclusion:

Gout patients with and without simple renal cysts have significant differences in age, hypertension, cardiovascular disease, GFR, serum creatinine, urine creatinine, and urine potassium.

References:

[1]N. Dalbeth, T.R. Merriman, L.K. Stamp, Gout, Lancet 388(10055) (2016) 2039-2052.

[2]E.M. Hasegawa, R. Fuller, M.C. Chammas, F.M. de Mello, C. Goldenstein-Schainberg, Increased prevalence of simple renal cysts in patients with gout, Rheumatol Int 33(2) (2013) 413-6.

[3]Y. Han, M. Zhang, J. Lu, L. Zhang, J. Han, F. Zhao, H. Chen, Y. Bao, W. Jia, Hyperuricemia and overexcretion of uric acid increase the risk of simple renal cysts in type 2 diabetes, Sci Rep 7(1) (2017) 3802.

Table 1.

Clinical characteristics of gout patients

Renal cyst(n=56)Without Renal cyst(n=144)PDisease duration, (month)98.7(±64.1)91.2(±67.0)0.468Age, (year)59.14(±14.3)46.78(±15.9)0.000Gender, n(F/M)7/4911/1330.281Smoking history, n(%)18(32.1%)47(32.6%)0.946Drinking history, n(%)10(17.9%)32(22.2%)0.496Hypertension, n(%)31(55.3%)49(34.0%)0.006Diabetes, n(%)9(16.1%)15(10.4%)0.269CVDs, n(%)7(12.5%)5(3.4%)0.016Nephrolithiasis, n(%)14(25%)43(29.9%)0.494UA, (μmol/L)494.8(±158.0)544.3(±121.0)0.037Serum creatinine, (μmol/L)139.4(±57.2)116.5(±35.45)0.007GFR, (ml/L)58.5(±22.5)71.6(±22.3)0.000FEUA, (%)7.0(±3.2)6.0(±3.2)0.052Urine creatinine, (μmol/L)4687.09(±1832.9)5565.2(±2599.8)0.008Urine Uric acid, (μmol/L)1204.9(±772.0)1542.1(±1048.5)0.030Urine sodium, (mmol)132.1(±68.7)131.2(±76.6)0.939Urine potassium, (mmol)25.6(±12.5)31.8(±14.2)0.005

Disclosure of Interests:

None declared.

Theoretical study on the adsorption mechanism of PbCl2/CdCl2 by kaolinite during municipal solid waste pyrolysis

In the process of municipal solid waste (MSW) pyrolysis, kaolinite possesses an outstanding trapping effect on semi-volatile metal vapors (Pb, Cd) through physical and chemical adsorption. In this paper, the microscopic mechanism of PbCl₂ and CdCl₂ adsorption on the surface of Al rings and Si rings of kaolinite was investigated by combining Monte Carlo method with density functional theory (DFT). The calculations indicate that the continuously enriched pore structure in the process of dehydroxylation indirectly influences the adsorption of PbCl₂/CdCl₂ by kaolinite. Under the non-bond interaction and electron transfer induction, PbCl₂ molecules are more conveniently adsorbed on the Al-(001) surface than CdCl₂, while the adsorption sites of CdCl₂ molecules are more widely distributed on the Si-(001) surface. Moreover, the transform in the Al-coordination and the exposed active oxygen atoms significantly affect the adsorption activity of kaolinite (the capability to gain and lose electrons). Considering the energy barrier and electrophilic nucleophilic sensitivity, it is more feasible for PbCl₂/CdCl₂ to be adsorbed near IV/V-coordinated Al and active O under Van der Waals action. Subsequently, IV/V-coordinated Al will act as an electron acceptor, and the active oxygen atoms after dehydrogenation will serve as an electron donor. Under the induction of the energy difference of frontier orbitals, the electrons transfer will encourage the formation of more stable adsorption states. The results shed new light on strengthening the adsorption activity of kaolinite to PbCl₂/CdCl₂ in the process of MSW pyrolysis.

Microwave-assisted catalytic fast pyrolysis of rice husk over a hierarchical HZSM-5/MCM-41 catalyst prepared by organic base alkaline solutions

This paper reports the results obtained for microwave-assisted catalytic fast pyrolysis (MACFP) of rice husk. The MACFP process employed a hierarchical catalyst prepared via a combination of organic alkali treatment (TPAOH) and the generation of an external layer of MCM-41-type mesoporous channels. We propose this catalyst which is used for the first time for pyrolysis of lignocellulosic biomass, as a tool to reduce coke agglomeration and increase hydrocarbon yields. Our results indicate that during catalyst preparation the mass fraction of cetyltrimethylammonium bromide (CTAB) has a direct effect on the content of MCM-41 formed on top of the HZSM-5 core. For MACFP, we hypothesize that the small molecules generated from thermal decomposition of rice husk react further to form aromatic and aliphatic hydrocarbons by decarbonylation, decarboxylation, oligomerization and aromatization. The highest hydrocarbon yield (60.5%) was obtained for a catalyst modified by a 2.0 mol/L TPAOH solution, with 10 wt% of CTAB (template for producing MCM-41), as well as with digestion and crystallization at 110 °C for 24 h. In addition, the highest liquid yield (47.6 wt%) was obtained at 550 °C. The relative content of hydrocarbons goes through a maximum of 60.5% with CTAB mass fraction which was higher than values obtained with MCM-41 (3.2%) and HZSM-5 (36.0%). Characterization and catalytic testing results suggest that the digestion temperature plays a more important role in the catalyst synthesis than the crystallization temperature. High digestion temperature (120 °C) decreases the overall hydrocarbon selectivity from 60.5% (110 °C) to 39.2%. The relative content of oxygenates reached the lowest value of 35.9% at the digestion and crystallization temperature of 110 °C. The synergistic effect of the MCM-41 shell and the HZSM-5 core promotes the catalytic activity, leading to outstanding deoxygenation capabilities and excellent selectivity to BTEX (52.7%).

A new generation of direct X-ray detectors for medical and synchrotron imaging applications

Large-area X-ray imaging is one of the most widely used imaging modalities that spans several scientific and technological fields. Currently, the direct X-ray conversion materials that are being commercially used for large-area (> 8 cm × 4 cm without tiling) flat panel applications, such as amorphous selenium (a-Se), have usable sensitivities of up to only 30 keV. Although there have been many promising candidates (such as polycrystalline HgI2 and CdTe), none of the semiconductors were able to assuage the requirement for high energy (> 40 keV) large-area X-ray imaging applications due to inadequate cost, manufacturability, and long-term performance metrics. In this study, we successfully demonstrate the potential of the hybrid Methylammonium lead iodide (MAPbI3) perovskite-based semiconductor detectors in satisfying all the requirements for its successful commercialization in synchrotron and medical imaging. This new generation of hybrid detectors demonstrates low dark current under electric fields needed for high sensitivity X-ray imaging applications. The detectors have a linear response to X-ray energy and applied bias, no polarization effects at a moderate bias, and signal stability over long usage durations. Also, these detectors have demonstrated a stable detection response under BNL's National Synchrotron Light Source II (NSLS-II) 70 keV monochromatic synchrotron beamline.

Experimental study on enrichment of heavy metals by intercalation-exfoliation modified kaolin during coal combustion

An intercalation-exfoliation method is applied to modify the natural kaolin mineral, so that to improve the enrichment effects on heavy metals (Zn, Pb, Cr & Cd) during coal combustion. The modified kaolin is scanned by electron microscope (SEM), X-ray diffraction (XRD), Fourier Transform infrared spectroscopy (FTIR) and Brunner-Emmett-Teller (BET), which indicate that the natural kaolin is peeled off to form fine flakes and the interlayer spacing is significantly increased. The coal-kaolin combustion tests were performed in a tube furnace from 900°C to 1300°C. It is found that the enrichment of heavy metals is enhanced obviously during the coal combustion, especially when the raw kaolin has high activity. Besides, the adsorption effects on the above four heavy metals are different. To be specific, the kaolin modified by potassium acetate has a better performance for Zn and Pb, but that intercalated by dimethyl sulfoxide shows better influences on Cd and Cr. The modified kaolin can provide more active sites for the adsorption of heavy metals, enhance chemical adsorption, and fix heavy metals in the form of aluminosilicates, silicates and aluminates. These founding could reduce the pollutant emissions of coal combustion in industrial applications.

2D shear wave elastography combined with age and serum biomarkers prior to kasai surgery predicts native liver survival of biliary atresia infants

BACKGROUND

The prognosis of patients with biliary atresia (BA) after Kasai portoenterostomy (KPE) varies, and precisely predicting the outcomes of KPE before surgery is still challenging.

METHODS

A total of 158 patients who underwent KPE in our hospital were included in this study. The patients in the training cohort were recruited from January 2012 to October 2017 (n = 118), and then, those in the validation cohort were recruited from November 2017 to April 2019 (n = 40). Combined nomogram models were developed based on two-dimensional shear wave elastography (2D SWE) values and other biomarkers. The utility of the proposed models was evaluated by C-index.

RESULTS

2D SWE played a potentially important role in predicting native liver survival (NLS) of BA patients with a C-index of 0.69 (0.63 to 0.75) in the training cohort and 0.76 (0.67 to 0.85) in the validation cohort. The nomogram A based on 2D SWE values, age, gamma-glutamyl transferase (GGT) and aspartate aminotransferase-to-platelet ratio (APRI) had a better C-index in the training cohort [0.74 (0.68-0.80) vs. 0.66 (0.60-0.73), P = 0.017] and in the validation cohort [0.78 (0.70-0.86) vs. 0.60 (0.49-0.71), P = 0.002] than the nomogram B (without 2D SWE). Using risk score developed from nomogram A, we successfully predicted 88.0% (22/25) of patients in the training cohort and 75.0% (9/12) in the validation cohort to have survival time of less than 12 months after KPE.

CONCLUSION

The combined nomogram model based on 2D SWE values, age, GGT and APRI prior to KPE can effectively predict NLS in BA infants.

Comparative study on pyrolysis of bamboo in microwave pyrolysis-reforming reaction by binary compound impregnation and chemical liquid deposition modified HZSM-5

The deactivation of catalyst is a significant reason for its limited application during the catalytic fast pyrolysis (CFP) process. To reduce the coke formation, binary compound impregnation (BCI) and chemical liquid deposition (CLD) were used to modify HZSM-5 catalysts. At the same time, the self-designed microwave reactor separated the pyrolysis of bamboo and catalytic upgrading of primary vapor, which made the catalytic effect more thorough. Experimental results indicated that CLD used TiO₂ deposition to cover external acid sites, while BCI by phosphorus-nickel could cover and partly destroy superficial acid sites through two different ways. Within the scope of the loaded amount studied, the yield of aromatic hydrocarbons in the oil phase increased at first and then decreased, while the coke formation reduced continuously. BTX (benzene, toluene and xylene), the most valuable product in bio-oil, drastically increased by 39.1% and 22.6% respectively over the CLD and BCI modified catalysts. Considering the catalytic performance as well as cost, CLD over HZSM-5 has more advantages in the CFP process to upgrade bio-oil.

Promoting Aromatic Hydrocarbon Formation via Catalytic Pyrolysis of Polycarbonate Wastes over Fe- and Ce-Loaded Aluminum Oxide Catalysts

Converting polycarbonate (PC) plastic waste into value-added chemicals and/or fuel additives by catalytic pyrolysis is a promising approach to dispose of solid wastes. In this study, a series of Fe-Ce@Al₂O₃ metal oxides were prepared by coprecipitation, impregnation, and a direct mixing method. The synthesized catalysts were then employed to investigate the catalytic conversion of PC wastes to produce aromatic hydrocarbons. Experimental results indicated that Fe-Ce@Al₂O₃ prepared by coprecipitation possessed superior catalytic activity because of its high content of weak acid sites, large pore volume, high surface area, and well dispersion of Fe and Ce active species, leading to an ∼3-fold increase in targeted monocyclic aromatic hydrocarbons compared to that achieved noncatalytically. Moreover, an increase in the catalyst to feedstock (C/F) mass ratio was beneficial to the production of aromatic hydrocarbons at the expense of phenolic products, and elevating the C/F ratio from 1:1 to 3:1 considerably increased the benzene formation as the enhancement factor was increased from 2.3 to 8.8.

THU0405 SERUM METABOLIC PROFILING ANALYSIS OF GOUT PATIENTS BASED ON UHPLC-Q-TOF/MS

Background:

Gout is a common kind of inflammatory arthritis with metabolic disorders. The detailed pathogenesis of gout remains largely unknown. Metabolomics has become an important tool in detecting the new pathogenesis and biomarkers. However, few studies have focused on the serum metabolic profiling of gout.

Objectives:

The study aims to investigate the metabolic profiling of gout patients with ultra-performance liquid chromatograph quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and explore the potential pathological mechanisms and biomarkers.

Methods:

Serum samples from 31 gout patients and 31 healthy controls were analyzed by UPLC-Q-TOF-MS. Principal components analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA) and Hierarchical clustering analysis were performed to detect different compounds between the two groups. Receiver operating characteristic (ROC) curve analysis and pathway analysis of the different metabolites were conducted.

Results:

A total of 9192 compounds were detected, of which 138 significantly different compounds were selected, according to the criteria of (Variable importance in projection (VIP)>3,P<0.05). Eventually, 96 reliable metabolites matched the HMDB database were confirmed. ROC curve results showed that the area under the curve (AUC) value of 4-hydroxytriazolam for gout was 0.933 (CI95%: 0.875-0.992), yielding a highest AUC value, with the sensitivity of 83.9% and specificity of 93.5%. The pathway analysis results indicated that the significantly different metabolites were mainly involved in “primary bile acid biosynthesis”, “purine metabolism” and “glycerophospholipid metabolism”.

Conclusion:

The serum metabolic profiling in gout patients were significantly different from healthy subjects. 4-hydroxytriazolam was the potential biomarkers. Primary bile acid biosynthesis may be a novel metabolic pathway of gout.

References:

[1]Banoei MM, et al. Metabolomics and Biomarker Discovery in Traumatic Brain Injury. J Neurotrauma, 2018. 35(16): p. 1831-1848.

Disclosure of Interests: :

None declared

AB0931 THE QUALITY OF LIFE IN GOUT PATIENTS WITH ULCERATION OVER TOPHI

Background:

The prevalence of gouty patients with ulcerations over tophi are increasing over time and it has been reported that gouty patients have significantly poor quality of life (QoL) compared to those healthy controls. [1, 2] there is no study on comparison of the QoL in patients with or without ulceration over tophi.

Objectives:

To compare the QoL in gout patients with or without ulcerations over tophi.

Methods:

A total of 79 inpatients with gout who were admitted to Guangdong Second Provincial General Hospital from January 2019 to January 2020 were included. Among them, ulcerations were identified in 28 patients. Short Form-36 Scales (SF-36) were chosen to assess patients. Differences between the groups were tested with Student’s t test or Mann-Whitney U test for continuous variables, and Chi-square tests for categorical variables.

Results:

Of 79 subjects, 74 were male, mean age was 54.23±14.3 years, disease duration was 10.94±7.06 years. Gouty patients had moderate- to high-quality levels in general health, vitality, social functioning, role emotional, and mental health (median: 65, 75, 75, 88, and88, respectively), while had low levels of quality in role physical, and bodily pain (median: 0, and 22, respectively). Patients presenting with ulcerations over tophi had worse scores on five SF-36 domains, the mental component summary (MCS) and the physical component summary (PCS) than gout patients without ulcerations [mean (SD); P < 0.05 for all]: Bodily pain, 30.86(31.59) vs 35.17(33.40); General health, 49.46(27.01) vs 64.17(23.69); Vitality, 57.14(32.53) vs 72.84(26.38); Mental health, 75.4(22.43) vs 83.05(20.96); Reported health transition, 3.58(0.89) vs 3.78(1.42); MCS, 52.62(21.82) vs 66.65(21.44); PCS, 35.85(21.17) vs 46.67(23.86).

Conclusion:

Patients with ulcerations over tophi present much worse QoL compared those without ulcerations. Our study suggests that the presence of ulceration over tophi further deteriorates the QoL in gout patients.

References:

[1]Z. Huang, X. Liu, Y. Liu, et al., Clinical characteristics and risk factors of ulceration over tophi in patients with gout, Int J Rheum Dis, 22 (2019) 1052-1057.

[2]T. Fu, H. Cao, R. Yin, et al., Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study, BMC Musculoskelet Disord, 18 (2017) 429.

Table 1.

Clinical characteristics

VariableTotal (n=79)Non-ulcerations (n=51)Ulcerations (n=28)PvalueMale, n (%)74(93.7)47(92.1)27(96.4)0.462Agea, mean, y54.23±14.3053.96±12.2454.71±17.690.842Body mass indexa, kg/m224.87±3.9725.13±4.0224.40±3.910.444Gout durationa,y10.96±7.0610.04±6.7512.63±7.410.119Maximum Serum uric acid, mg/dL625.5±133.86630.9±124.23614.3±166.430.639Smoking, n (%)38(48.1)23(45.1)15(53.5)0.477Alcohol, n (%)26(32.9)13(25.5)13(46.4)0.072Hypertension, n (%)34(43.0)18(35.3)16(57.1)0.062Diabetes mellitus, n (%)13(16.5)10(19.6)3(10.7)0.281Regular treatment, n(%)3(3.8)3(5.9)0(0)0.971Glucocorticoid abuse, n (%)18(22.8)11(21.5)7(25.0)0.173

aMean (SD).

Table 2.

QoL scores

Median (IQR)Non-ulcerations (n=51), mean (SD)Ulcerations (n=28), mean (SD)PvaluePhysical functionb50(20-80)58.62(32.17)40.89(35.97)0.095Role physicalb0 (0-100)33.03(46.91)17.85(37.17)0.119Bodily painb22(0-62)35.17(33.40)30.86(31.59)0.007General healthb65 (40-80)64.17(23.69)49.46(27.01)0.014Vitalityb75 (50-95)72.84(26.38)57.14(32.53)0.023Social functionb75(38-100)72.55(3.02)60.27(33.85)0.107Role emotionalb88 (68-96)33.98(47.37)15.43(34.45)0.135Mental healthb88 (68-96)83.05(20.96)75.4(22.43)0.007Reported health transition3.78(1.42)3.58(0.89)0.007PCS46.67(23.86)35.85(21.17)0.048MCS66.65(21.44)52.62(21.82)0.007

b(range = 0-100)

Disclosure of Interests:

None declared

THU0450 OPTIMISTIC STATUS ASSOCIATES WITH COMPLIANCE TO URATE-LOWERING THERAPY IN GOUT PATIENTS

Background:

Compliance to urate-lowering therapy (ULT) is poor in gout patients, which contributes to increased frequency of acute gout attacks, deposition of tophi and urate nephropathy [1]. Optimistic status is probably a potential and considerable factor affecting compliance to ULT in gout patients.

Objectives:

To compare optimistic status between gout patients and healthy controls, and also between gout patients with good and poor compliance. Relationship between optimistic status and compliance to ULT, sUA target achievement of gout patients were assessed as well.

Methods:

This was a monocentric and observational study which was performed from August 2018 to December 2019. Adult patients who met the 2015 gout classification criteria were included in this study. The healthy controls were individuals who were free of gout, hyperuricemia and other rheumatic diseases from the physical examination center of our hospital. Demographic data, including age, gender and education were collected from all individuals. Serum uric acid (sUA) were collected from gout patients at enrollment and again after 3 months. Disease duration of gout, visual analogue scale (VAS) of pain were also assessed for gout patients at enrollment. Compliance to ULT was measured using the medication possession ratio (MPR) in the following 3 months. Poor compliance was defined as MPR<0.8 and good compliance was defined as MPR≥0.8. All subjects completed the life orientation test-revised (LOT-R) for optimistic status assessment.

Results:

Five hundred and thirty gout patients and 307 healthy controls matched by age (41.4±12.3 vs. 42.1±9.3 years), gender (male 97.1% vs. 95.1%) and education (college graduated 54.2% vs. 58.0%) were included in this study. Of the 530 gout patients, the mean disease duration was 5.7±4.9 years, and 292 (55.1%) patients’ MPR were lower than 0.8. There was no statistic difference in LOT-R between gout patients and healthy controls (19.0±2.4 vs. 19.2±2.5, P>0.05) (Table 1). Gout patients with poor compliance (MPR<0.8) had higher level of sUA (525.5±138.0 vs. 471.2±152.5 μmol/L, P<0.05), followup sUA (450.1±154.5 vs. 361.6±120.0 μmol/L, P<0.05) and higher LOT-R (19.6±2.6 vs. 17.8±1.7, P<0.05) than those with good compliance (MPR≥0.8). Of the 292 gout patients with poor compliance, there were only 83 (28.4%) patients achieved sUA target after 3 months, and their LOT-R were significantly lower than those did not achieve sUA target (18.8±2.1 vs. 19.6±2.4, P<0.05). Finally, LOT-R correlated positively with sUA (r=0.131, P<0.05) and followup sUA (r=0.09, P<0.05), but negatively with MPR (r=-0.473, P<0.05) of gout patients (Table 2).

Table 1

Demographic and optimistic status of gout patients and healthy controls

VariablesGout patients(n=530)Controls(n=307)PAge (years)41.4±12.342.1±9.30.116Male gender, n (%)511 (96.4)292 (95.1)0.368College graduated, n (%)287 (54.2)178 (58.0)0.312LOT-R19.0±2.419.2±2.50.189

LOT-R:life orientation test-revised

Table 2

Correlation analysis between LOT-R and clinical variables in gout patients

VariablesLOT-RrPAge00.994Disease duration-0.0580.182VAS0.0340.432sUA0.1310.003*Followup sUA0.1260.016*MPR-0.393<0.001*

LOT-R: life orientation test-revised,VAS:visual analogue scale,sUA:serum uric acid,MPR:medication possession ratio

*P<0.05

Conclusion:

Gout patients share similar optimistic status to healthy controls. However, optimistic status relates to compliance to ULT and sUA target achievement of gout patients.

References:

[1]Harrold L R, Andrade S E, Briesacher B A, et al. Adherence with urate-lowering therapies for the treatment of gout. Arthritis research & therapy 2009, 11(2):R46.

Disclosure of Interests: :

None declared

Converting polycarbonate and polystyrene plastic wastes intoaromatic hydrocarbons via catalytic fast co-pyrolysis

Thermochemical conversion of plastic wastes is a promising approach to produce alternative energy-based fuels. Herein, we conducted catalytic fast co-pyrolysis of polycarbonate (PC) and polystyrene (PS) to generate aromatic hydrocarbons using HZSM-5 (Zeolite Socony Mobil-5, hydrogen, Aluminosilicate) as a catalyst. The results indicated that employing HZSM-5 in the catalytic conversion of PC facilitated the synthesis of aromatic hydrocarbons in comparison to the non-catalytic run. A competitive reaction between aromatic hydrocarbons and aromatic oxygenates was observed within the studied temperature region, and catalytic degradation temperature of 700 °C maximized the competing reaction towards the formation of targeted aromatic hydrocarbons at the expense of phenolic products. Catalyst type also played a vital role in the catalytic decomposition of PC wastes, and HZSM-5 with different Si/Al molar ratios produced more aromatic hydrocarbons than HY (Zeolite Y, hydrogen, Faujasite). Regarding the effect of Si/Al molar ration in HZSM-5 on the distribution of monocyclic aromatic hydrocarbons (MAHs), a Si/Al molar ratio of 38 maximized benzene formation with an advanced factor of 5.1. Catalytic fast co-pyrolysis of PC with hydrogen-rich plastic wastes including polypropylene (PP), polyethylene (PE), and polystyrene (PS) favored the production of MAHs, and PS was the most effective hydrogen donor with a ∼2.5-fold increase. The additive effect of MAHs increased at first and then decreased when the PC percentage was elevated from 30 % to 90 %, achieving the maximum value of 32.4 % at 70 % PC.

Relationship of adiponectin, leptin, visfatin and IGF-1 in cow's venous blood and venous cord blood with calf birth weight

The Intrauterine fetal development process is complicated and affected by many regulating factors such as maternal nutritional status, transcription factors and adipokines. Adipokines are kinds of active substances secreted by adipose tissue, including more than 50 kinds of molecules. To explore the correlation between calf birth weights and adipokines including adiponectin, leptin, visfatin, and IGF-1 in cows venous and venous cord blood. Fifty-four healthy multiparous Chinese Holstein cows were used; in which, cows with a calf weight less than 40 kg were included in group A (n=9); those with a calf weight between 40 kg~45 kg were included in group B (n=25) and ≥45 kg were included in group C (n=20), venous blood and cord venous blood was collected. An ELISA kit was used to evaluate the concentration of adiponectin, leptin, visfatin, and IGF-1, correlations between index-index and index-calf birth weight were analysed. In both cows venous and cord venous blood, adiponectin, leptin, visfatin, and IGF-1 levels were significantly correlated with each other (p⟨0.01), and levels of these adipokines in venous blood were significantly higher than cord venous blood (p⟨0.01). Adiponectin, leptin, visfatin, and IGF-1 in venous cord blood were positively correlated with calf birth weights, and significantly correlated with calf birth weights respectively (p⟨0.01). Our study showed that adiponectin, leptin, and IGF-1 were found in venous blood and cord venous blood, and adiponectin, leptin, and IGF-1 in venous and cord venous blood potentially inter-regulated each other; adiponectin, leptin, and IGF-1 in venous blood were not significantly correlated with calf birth weights, while adiponectin, leptin, visfatin, and IGF-1 in venous cord blood were significantly correlated with calf birth weights, respectively.

Effect of alkali-treated HZSM-5 zeolite on the production of aromatic hydrocarbons from microwave assisted catalytic fast pyrolysis (MACFP) of rice husk

We performed microwave-assisted catalytic fast pyrolysis (MACFP) of rice husk (RH) over an alkali-treated HZSM-5 zeolite, for production of hydrocarbons. The treatment consisted in the modification of the HZSM-5 by the organic base tetrapropylammonium hydroxide (TPAOH) solution at several concentrations. We characterized the resulting catalysts by powder X-ray diffraction (XRD), transmission electron microscopy (TEM), N₂ adsorption-desorption, and temperature-programmed sorption of ammonia (NH₃-TPD). The results suggest that the TPAOH treatment generated mesoporous structures in the HZSM-5, while preserving its microporous structure and crystallinity. We obtained the highest yield (45.9%) of hydrocarbons from MACFP of rice husk (RH) at 550 °C. As the TPAOH concentration increases, the relative content of BTEX hydrocarbons (benzene, toluene, ethylbenzene, and xylene) reaches a maximum value of 22.9% at 2.0 mol/L. A comparison of results obtained over the organic base TPAOH (HZSM-5 modified by 2.0 mol/L TPAOH solution) with those obtained over an inorganic base (HZSM-5 modified by 2.0 mol/L NaOH solution) shows a 4.3% increase in the relative content of monocyclic aromatic hydrocarbons for the TPAOH. In addition, the TPAOH-treated catalyst shows excellent selectivity of BTEX (58.5%), which is higher than the selectivity obtained with the parent HZSM-5 (51.2%) and NaOH-treated HZSM-5 (53.9%). The TPAOH-modified HZSM-5 catalyst effectively reduced coke formation by 4.6% compared to MACFP over the parent HZSM-5, most likely because TPAOH decreases the concentration of strong acidic sites on the outer surface of the catalyst, creating a mesoporous structure while retaining the weak acidic sites on the HZSM-5 inner surface. The new catalyst generated in this work contains a moderate amount of mesopores structures, which allows for effective upgrading of pyrolysis vapors while simultaneously reducing coke formation, thereby addressing a significant problem in the development of the catalytic fast pyrolysis process.

Catalytic fast co-pyrolysis of waste greenhouse plastic films and rice husk using hierarchical micro-mesoporous composite molecular sieve

Catalytic fast co-pyrolysis of waste greenhouse plastic films and rice husk over a hierarchical HZSM-5/MCM-41 catalyst was performed in an analytical Py-GC/MS. We evaluated the effect of pyrolysis temperature and the ratio of rice husk to waste greenhouse plastic films on the total peak area of condensable organic products and CO₂. In order to evaluate synergy possibilities among the two feedstocks, we performed non-catalytic pyrolysis and catalytic fast pyrolysis of rice husk and waste greenhouse plastic films separately. In addition, we report results for the catalytic fast co-pyrolysis of the mixture rice husk and waste greenhouse plastic films. The maximum relative content of hydrocarbons from catalytic fast co-pyrolysis of rice husk and waste greenhouse plastic films is obtained at 600 °C. When the mass ratio of rice husk to waste greenhouse plastic films is 1:1.5, the relative content of hydrocarbons reaches a maximum (71.1%). The hierarchical micro-mesoporous composite molecular sieve used in this work has outstanding catalytic activity and increases the relative content of hydrocarbons.

Investigation on gaseous pollutants emissions during co-combustion of coal and wheat straw in a fluidized bed combustor

Co-combustion of coal and wheat straw (WS) was conducted in a lab-scale BFB combustor. Fuel composition (coal, 70%coal+30%WS), temperature (750, 800, 850, 900, 950 °C), secondary air ratio (0, 10%, 20%, 30%) were varied to on the release of gaseous pollutant was studied. CO, NO_x and SO₂ concentration in flue gas (FG) were measured on-line by a flue gas analyzer. Fly ash (FA), bottom slag (BS) and bed material (BM) were collected, digested and analyzed by ICP-OES to determine the distribution of heavy metals (e.g. Pb, Zn, Cr and Cd). Results indicated that co-combustion could improve the combustion of coal alone by reducing CO, NO_x and SO₂ emission and carbon content in fly ash effectively. In co-combustion the increasing secondary air could reduce CO emission and SO₂ by enhancing disturbance and promoting sulfation respectively while the minimum NO emission was reached at the ratio of 20%. Co-combustion restrained the release of Zn, Cd and Pb compared with coal combustion alone. In co-combustion, high temperature increased their portion in the flue gas. For Zn, Pb and Cd, their content in the bottom solids increased while the portion of Cr decreased. Secondary air decreased their content in fly ash and transferred into flue gas significantly and in bottom solids content of Zn and Pb decreased while Cd increased.

Phase-space matching between bent Laue and flat Bragg crystals

Through phase-space analysis of Dumond diagrams for a flat Bragg crystal, a single bent Laue crystal and a monochromator consisting of double-bent Laue crystals, this work shows that it is possible to match the flat Bragg crystal to both the single-crystal and double-crystal Laue monochromators. The matched system has the advantage that the phase space of the bent crystal's output beam is much larger than that of the flat crystal, making the combined system stable. Here it is suggested that such a matched system can be used at synchrotron facilities to realize X-ray dark-field imaging, analyzer-based imaging and diffraction-enhanced imaging at beamlines using double-Laue monochromators.

Research on catalytic pyrolysis of algae based on Py-GC/MS

In order to improve the quality of catalysis products of algae, composite molecular sieve catalyst was prepared by digestion and crystallization of HZSM-5 to reduce the oxygen content of the catalytic products. According to the analysis of the pyrolysis products, the best preparation conditions were chosen of tetra propylammonium hydroxide (TPAOH) solution 2.0 mol l-1, cetyltrimethylammonium bromide (CTAB) solution 10 wt%, crystallization temperature 110°C, digestion-crystallization time: 24-24 h. The results indicate that the main function of catalysts is to promote the conversion of alcohols into hydrocarbons by reducing energy barriers. Catalysed by the composite molecular sieve, the content of alcohols in the pyrolysis products decreased from more than 30% to less than 10%, the content of hydrocarbons increased from 20% to nearly 60%, while all the adverse components remained at a low level, which indicates that the catalytic pyrolysis products are of high quality. The great deoxidation effect of composite molecular sieves is not only due to the expansion of the range of organic matter during re-pyrolysis, but also the increasing of the residence time of pyrolysis products inside the structure for the external mesoporous structure.

Mutation Analysis of Pre-mRNA Splicing Genes PRPF31, PRPF8, and SNRNP200 in Chinese Families with Autosomal Dominant Retinitis Pigmentosa

BACKGROUND

To screen variants in pre-mRNA Splicing genes in 95 Chinese autosomal dominant retinitis pigmentosa (adRP) families.

METHODS

Clinical examination and pedigree analysis were performed. Targeted exome sequencing (TES) and / or Sanger sequencing were performed to detect the variants in genes of Splicing factors and conduct intra-familiar segregation analysis with DNA available. In silico analysis was performed to predict pathogenicity of variants in protein level and in vitro splicing assays were performed to compare splicing variants with their corresponding wildtype about their splicing effect.

RESULTS

In this study, total nine different variants were identified in PRPF31, SNRNP200, and PRPF8 respectively, including six PRPF31 variants [five novel variants 322+1G>A, c.527+2T>G, c.590T>C(p.Leu197Pro), c.1035_1036insGC (p.Pro346Argfs X18), and c.1224dupG (p.Gln409AlafsX66) plus one reported variant c.1060C>T (p.Arg354X)], a recurrent PRPF8 variant c.6930G>T (p.Arg2310Ser), two SNRNP200 variants [one heterozygous and homozygous SNRNP200 recurrent variant c.3260G>A (p.Ser1087Leu), and a reported heterozygous c.2042G>A(p.Arg681His)]. In family 20009, incomplete penetrance was observed. A novel PRPF31 missense variant c.590T>C (p.Leu197Pro) was predicted to be pathogenic in protein level via in silico analysis and in vitro splicing assay demonstrated that two novel splicing PRPF31 variants c.322+1G>A and c.527+2T>G affect splicing compared with the wildtype.

CONCLUSIONS

In our studies, RP-causing variants of pre-mRNA Splicing genes (PRPF31, PRPF8 and SNRNP200) were identified in nine of the ninety-five adRP families respectively, which extend the spectra of RP variant and phenotype. And we provide the first example that SNRNP200-related RP can be caused by both heterozygous and homozygous variants of this gene.

Comparison of microRNAs in adipose and muscle tissue from seven indigenous Chinese breeds and Yorkshire pigs

Elucidation of the pig microRNAome is essential for interpreting functional elements of the genome and understanding the genetic architecture of complex traits. Here, we extracted small RNAs from skeletal muscle and adipose tissue, and we compared their expression levels between one Western breed (Yorkshire) and seven indigenous Chinese breeds. We detected the expression of 172 known porcine microRNAs (miRNAs) and 181 novel miRNAs. Differential expression analysis found 92 and 12 differentially expressed miRNAs in adipose and muscle tissue respectively. We found that different Chinese breeds shared common directional miRNA expression changes compared to Yorkshire pigs. Some miRNAs differentially expressed across multiple Chinese breeds, including ssc-miR-129-5p, ssc-miR-30 and ssc-miR-150, are involved in adipose tissue function. Functional enrichment analysis revealed that the target genes of the differentially expressed miRNAs are associated mainly with signaling pathways rather than metabolic and biosynthetic processes. The miRNA-target gene and miRNA-phenotypic traits networks identified many hub miRNAs that regulate a large number of target genes or phenotypic traits. Specifically, we found that intramuscular fat content is regulated by the greatest number of miRNAs in muscle tissue. This study provides valuable new candidate miRNAs that will aid in the improvement of meat quality and production.

Serum IgG Antibodies against Periodontal Microbes and Cancer Mortality

INTRODUCTION

Periodontitis is a chronic inflammatory condition initiated by microorganisms and is positively linked to systemic conditions such as cancer, cardiovascular disease, and diabetes mellitus.

OBJECTIVES

To prospectively investigate associations between empirically derived clusters of IgG antibodies against 19 selected periodontal microorganisms and cancer mortality in a representative sample of the US population.

METHODS

We evaluated 6,491 participants aged ≥40 y from the Third National Health and Nutrition Examination Survey (1988 to 1994), who had complete data on IgG antibody titers against 19 selected periodontal microorganisms and were free of cardiovascular disease and cancer. In a prior study, antibodies were categorized into 4 mutually exclusive groups via cluster analysis: red-green, orange-red, yellow-orange, and orange-blue. Cluster scores were estimated by summing z scores of the antibody titers making up each cluster. Participants were followed up to death until December 31, 2011. Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% CIs for all-cancer mortality by tertiles of cluster scores.

RESULTS

During follow-up for a median of 15.9 y, there were 2,702 deaths (31.3%), including 631 cancer-related deaths (8.1%). After adjusting for multiple confounders, the orange-blue cluster was inversely associated with cancer mortality (tertile 2 vs. tertile 1: HR = 0.67, 95% CI = 0.54 to 0.84; tertile 3 vs tertile 1: HR = 0.62, 95% CI = 0.46 to 0.84). The association between the yellow-orange cluster and all-cancer mortality was also inverse but not significant, and the orange-red cluster and the red-green cluster were not associated with all-cancer mortality.

CONCLUSIONS

Antibodies against Eubacterium nodatum and Actinomyces naeslundii may be novel predictors of cancer mortality. If further studies establish a causal relationship between these antibodies and cancer mortality, they could be targets to prevent possible systemic effects of periodontal disease with potential interventions to raise their levels.

KNOWLEDGE TRANSFER STATEMENT

Periodontal antibodies against Eubacterium nodatum and Actinomyces naeslundii were inversely associated with cancer mortality among adults followed up for an average of 16 y. Periodontal antibodies may predict cancer mortality.

Syngas production and trace element emissions from microwave-assisted chemical looping gasification of heavy metal hyperaccumulators

Phytoremediation is one of the most encouraging options for the elimination of heavy metals from contaminated soil. However, the treatment and exploitation of hazardous harvested hyperaccumulator biomass is a challenge recently. In this investigation, we propose a novel microwave-assisted chemical looping gasification (MACLG) process for the disposal of hyperaccumulator biomass, and syngas fuel production and trace element emissions from MACLG over hematite is evaluated. Experimental results show that the addition of hematite as oxygen carrier (OC) favors the production of H₂ and CO. The elevated operation temperature induces a decay in CO₂ yield and an increase in H₂, CO and CH₄ yields. Meanwhile, a higher temperature causes an increased heavy metal percentage in syngas. On the other hand, the augmentation of steam flow and hematite content stimulates an uptrend for CO₂ and H₂ production and downtrend for CO generation. The percentage of each trace element in char after MACLG reduces with increasing steam flow, and its change in syngas presents the opposite trend. In addition, the proportions of trace elements in spent hematite and syngas tend to increase with an augmented hematite content whereas their portions in char reduce gradually. Moreover, our results suggest that activated carbon is capable of effective adsorption removal of heavy metals in syngas.

RNA-seq of circular RNAs identified circPTPN22 as a potential new activity indicator in systemic lupus erythematosus

Background

Circular RNAs (circRNAs) are possible biomarkers for many diseases, but the knowledge of circRNAs in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE) remains limited. This study aimed to assess the expression of circRNAs in PBMCs from patients with SLE and healthy individuals by RNA sequencing (RNA-seq).

Methods

In total, 128 circRNAs were significantly differentially expressed including 39 upregulated and 89 downregulated circRNAs in four new-onset SLE patients compared with three healthy controls. After verification of the four candidate circRNAs in 49 patients with SLE and 37 controls using quantitative real-time polymerase chain reaction (qRT-PCR) assays, a previously undescribed circRNA with potential translation activity, circPTPN22, was selected to confirm its clinical significance.

Results

Bioinformatics analysis demonstrated that the parent gene of circPTPN22 was protein tyrosine phosphatase non-receptor type 22 (PTPN22), a potent regulator of T cell activation. The downregulation of circPTPN22 in patients with SLE was strongly negatively correlated with their Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. circRNA-miRNA-mRNA co-expression network analysis indicated a correlation between circPTPN22 and the miRNAs and mRNAs related to immunological regulation including the development of SLE. Patients with higher SLEDAI scores had lower circPTPN22 expression levels, and long-term hormone treatment significantly increased circPTPN22 levels. Receiver operating characteristic curve analysis indicated that circPTPN22 has good diagnostic value for SLE.

Conclusion

Our data demonstrated the aberrant expression of circRNAs in patients with SLE compared with healthy controls; circPTPN22 might function as a diagnostic and disease severity indicator in SLE.

Abstract P6-03-01: Development of patient-derived xenograft tumor model with organ-specific metastatic potential for evaluation of new therapeutics for hormone receptor-positive advanced breast cancer

Background: Breast cancer (BC) is a heterogeneous disease with most common metastatic sites of liver, lung, brain, and bone. Endocrine resistance in hormone receptor-positive (HR+) advanced BC (ABC) cancer is a clinical challenge. ESR1 mutations are a key mechanism in acquired resistance, primarily occurs after exposure to endocrine therapy such as aromatase inhibitors but also selective estrogen modulators and degraders (i.e. Tamoxifen and Fulvestrant). Circulating tumor cells (CTCs) enumeration is a prognostic biomarker in ABC but the relation between the onset of ESR1 mutations and CTCs status is still unclear. Aim of this project is to define the clinical behavior of ESR1 mutated ABC in terms of metastasizing potential, through CTC enumeration and pattern; and to establish ESR1 mutated HR+ ABC PDX models able to recapitulate these characteristics.

Methods: CTCs and circulating tumor DNA (ctDNA) were characterized in 55 HR+ ABC patients. ESR1 mutations status from 55 patient plasma cell-free DNA were generated using Guardant Next Generation Sequencing. Samples were also examined for numbers of CTCs by CellSearch. Association of ESR1 mutations with sites of distant organ metastasis and with CTC enumeration was analyzed by Chi square test and Kruskal–Wallis test, respectively. In preclinical model development, six samples of pleural effusion-derived tumor cells from Stage IV HR+ ABC patients were collected to establish HR+ ABC with ESR1 mutation PDX tumor model and its derived 3D organoid/spheroid cultures

Results: ESR1 mutations were identified in 10 out of 55 patients (4 Y537S variant and 3 D538G variant, 4 other variants, 1 patient with both variants). In 55 patients, 72 visceral vs 27 bone metastatic incidences were observed; the data indicated 9 observed vs 4.5 expected in ESR1 mutated and 16 observed vs 20.5 expected in wild type (WT) (P=0.003) for liver metastasis; 10 observed vs 7.1 expected in ESR1 mutated and 29 observed vs 31.9 expected in WT (P=0.026) for bone metastasis. Further liver metastasis analysis of individual hot spot mutation site indicated 4 observed vs 1.8 expected in Y537S and 21 observed vs 23.2 expected in WT (P=0.037); and 3 observed vs 1.4 expected in D538G and 22 observed vs 23.6 expected in wild type (P=0.088). The analysis of correlation/distribution between CTCs numbers and ESR1 mutated suggested CTCs median of 13 (IQR 7-49) in ESR1 mutated and 0 (IQR 0-4) in WT HR+ patients (P=0.0044). Four ABC PDX tumor models were developed in immunodeficient NSG female mice demonstrated by pathology to have highly heterogeneous characteristics and metastatic features of the origin patient tumor, in particular, breast fat pad xenografted PDX tumor can result in metastasis to liver and lung tissue. In addition, two patient 3D tumor organoid/spheroid cultures were successfully established.

Conclusions: ESR1 mutated ABC is associated with more aggressive (Stage IV) clinical behavior demonstrated by association with visceral metastases and CTCs detection. ESR1-mutated PDX models recapitulate aggressive features of the disease and can be used for preclinical testing of novel agents in endocrine resistant disease.

Citation Format: Qiang W, Zhong Z, Gerratana L, Zhang Y, Zhang Q, Gursel D, Wei J-J, Bleher R, James C, O'Halloran T, Cristofanilli M. Development of patient-derived xenograft tumor model with organ-specific metastatic potential for evaluation of new therapeutics for hormone receptor-positive advanced breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-03-01.