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therapeutic drug monitoring, cerebrospinal fluid, central nervous system, infection, Infectious and parasitic diseases, and RC109-216

Jing Ren,1,* Qinhui Wang,1,* Linna Liu,1 Yunfeng Xiao,1 Peigang Ji,2 Hui Du,3 Shan Wang,4 Yao Zheng,1 Qi Yang1 1Department of Pharmacy, the Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Neurosurgery, the Second Affiliated Hospital of Air Force Medical University, Xi’an, Shaanxi, People’s Republic of China; 3Xi’an Institute for Food and Drug Control, Xi’an, Shaanxi, People’s Republic of China; 4Department of Pharmacy, NYU Langone Hospital – Long Island, Mineola, NY, USA*These authors contributed equally to this workCorrespondence: Qi Yang, Tel +86 15829673096, Fax +86-029-84777154, Email 376230719@qq.comAbstract: Post-neurosurgical infections caused by multidrug-resistant Enterobacterales are difficult to treat due to limited therapeutic options. Ceftazidime-avibactam (CAZ-AVI), a combination of cephalosporin and a novel β-lactamase inhibitor, has exhibited potential activity against multi/extensive drug-resistant (MDR/XDR) gram-negative bacilli. Several reports have described the successful treatment of central infections caused by MDR/XDR Pseudomonas aeruginosa or Enterobacterales. However, data on the efficacy and effective drug distribution of CAZ-AVI in the central nervous system (CNS), particularly in children, are lacking. We report a case of a 4-year-old girl with post-neurosurgical meningitis and abscess caused by extended-spectrum β-lactamase-producing Escherichia coli successfully treated with CAZ-AVI. CAZ-AVI therapeutic drug monitoring was performed to evaluate its efficacy and effective drug distribution in the CNS. We measured CAZ (15.6, 7.1, and 3.5 μg/mL) and AVI (4.0, 2.1, and 1.2 μg/mL) in cerebrospinal fluid (CSF) samples obtained 3, 5, and 7 h after the administration of the 15th CAZ-AVI dose (2.5 g, q8h, iv), respectively. We also measured CAZ (57.0 and 25.8 μg/mL) and AVI (11.3 and 4.5 μg/mL) in serum samples obtained 3 and 5 h after the administration, respectively. CAZ-AVI achieved an adequate CSF concentration throughout the drug interval. Our case provides evidence for using CAZ-AVI to treat CNS infections.Keywords: therapeutic drug monitoring, cerebrospinal fluid, central nervous system, infection

cerebral microbleeds, lipoprotein-associated phospholipase a2, cognitive impairment, risk factors, cerebral small vessel disease, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, and RC346-429

Lu Liu,1,* Xiaojiu Zhang,1,2,* Nan Jiang,3,* Yufeng Liu,1 Qing Wang,1 Guanghui Jiang,1 Xuejing Li,4 Liandong Zhao,1 Qijin Zhai1 1Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China; 2Department of Neurology, Hongze People’s Hospital, Huai’an, Jiangsu, People’s Republic of China; 3Department of Neurology, Lianshui PEople’s Hospital Affiliated to Kangda College of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China; 4Rehabilitation Centre, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liandong Zhao; Qijin Zhai, Email zld18796201519@163.com; qjzhai1983@163.comPurpose: The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs.Methods: In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2.Results: CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment (p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs (r =− 0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002– 1.026; p=0.025).Conclusion: A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.Keywords: cerebral microbleeds, lipoprotein-associated phospholipase A2, cognitive impairment, risk factors, cerebral small vessel disease

refractory metastatic colorectal cancer, chemotherapy, target therapy, angiogenesis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, and RC254-282

Xiu Liu,1 Xiaoting Ma,1 Kai Ou,1 Qi Wang,1,2 Lizhen Gao,1,3 Lin Yang1 1Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Medical Oncology, Beijing Chaoyang District Sanhuan Cancer Hospital, Beijing, People’s Republic of China; 3Department of Medical Oncology, Beijing Chaoyang Huanxing Cancer Hospital, Beijing, People’s Republic of ChinaCorrespondence: Lin Yang, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiyuanninli, Beijing, 10021, People’s Republic of China, Tel +86-10-87788118, Email linyangcicams@126.comPurpose: Treatment options for refractory metastatic colorectal cancer (CRC) are scarce. This retrospective study aimed to evaluate the efficacy and safety of raltitrexed combined with S-1 and bevacizumab in patients with heavily pretreated metastatic CRC in a clinical real-world setting.Patients and Methods: Records of patients with metastatic CRC refractory to standard therapies who initiated raltitrexed plus S-1 and bevacizumab from October 2017 to December 2021 were retrospectively reviewed at our institution. The study endpoints included median overall survival (OS), overall response rate (ORR), progression-free survival (PFS), disease control rate (DCR), and adverse events (AEs).Results: Forty-four patients with metastatic CRC, who had previously undergone standard chemotherapy received the regimen comprising raltitrexed plus S-1 and bevacizumab. As of March 2022, the median follow-up was 23.2 months (95% confidence interval 15.8− 30.6). The median OS and median PFS were 13.5 (95% CI 9.9– 17.1) and 4.7 months (95% CI 3.6– 5.8), respectively, with a 16-week PFS rate of 60.9%. Among 43 patients with measurable lesions, the ORR and DCR were 7.0% (3/43) and 65.1% (28/43), respectively. Patients without peritoneal metastases (P = 0.003, hazard ratio 0.160, 95% CI 0.048− 0.531), lower carcinoembryonic antigen level (≤ 42.8 ng/mL) (P = 0.039, HR 0.382, 95% CI 0.153− 0.952), and no previous treatment with both vascular endothelial growth factor inhibitors (VEGF) and S-1 (P = 0.020, HR 0.215, 95% CI 0.059− 0.785) had better OS. The incidence of any grade of treatment-related AEs was 88.6%, most of which were mild to moderate, and no treatment-related deaths occurred.Conclusion: Raltitrexed combined with S-1 and bevacizumab shows promising antitumor activity and safety and could be an alternative for patients with metastatic CRC who are refractory or intolerant to standard therapy.Keywords: refractory metastatic colorectal cancer, chemotherapy, target therapy, angiogenesis

bacterial pneumonia, covid-19, hypoproteinemia, lipids, Pathology, RB1-214, Therapeutics. Pharmacology, and RM1-950

Zheng Liu,1 Qian Wang,1 Hui Wang,1 Jing Li,1 Ying Yuan,2 Guo-zhen Yi1 1Department of Respiratory Medicine, the Petroleum Clinical Medical College of Hebei Medical University, Langfang, People’s Republic of China; 2Department of Respiratory Medicine, the Langfang Third Hospital, Langfang, People’s Republic of ChinaCorrespondence: Zheng Liu, Department of Respiratory Medicine, the Petroleum Clinical Medical, College of Hebei Medical University, No. 51 of Xinkai Road, Guangyang District, Langfang, Hebei, 065000, People’s Republic of China, Tel +863162077814, Email zhengl06drsun@163.comBackground: To look at the differences and similarities in albumin and lipid metabolism in non-severe COVID-19 infection, non-severe community-acquired pneumonia, and severe community pneumonia with underlying diseases, as well as the relationship between albumin and lipid metabolism and inflammatory mediators.Methods: This retrospective analysis comprised 253 individuals with bacterial pneumonia and COVID-19 infection (1 May 2021– 1 May 2022). Routine blood examination, blood lipid levels, albumin level, C-reactive protein (CRP) levels, coagulation function, cardiac enzymes, liver function, renal function, immunological function, and bacterial culture were also collected. Correlation analysis was performed using Spearman’s test for lipid parameter and Inflammatory factors in the blood. Furthermore, the multiple linear regression (MLR) analysis was employed to analyze the multicollinearity in lipidomics data. The statistical analysis was performed using SPSS statistic version 19.0.Results: There were 63 (24.90%) non-severe community-acquired pneumonia patients (NSCAP), 48 (18.97%) severe community-acquired pneumonia patients (SCAP), 112 (44.27%) non-severe COVID-19 infection patients (NSCOV), and 30 (11.86%) healthy volunteers (HV). In all, 45.59% (116/253) of the patients had underlying diseases. Patients with community-acquired pneumonia had lower albumin and cholesterol levels than those with non-severe COVID-19 infection and healthy controls (t = − 3.81, − 2.09, P = 0.00, 0.04). Albumin, triglyceride, cholesterol, and LDL-C levels in peripheral blood were considerably lower in the SCAP group than in the NSCAP group. Albumin, cholesterol, HDL-C, LDL-C, and aop-A were all inversely connected with CRP in the SCAP with underlying illness group, but cholesterol level was favorably correlated with lymphocyte count (R = 0.36, P = 0.01). Hypoproteinemia, hypotriglyceridemia, and an elevated neutrophil-to-lymphocyte count ratio are all risk factors for severe community-acquired pneumonia.Conclusion: Hypoalbuminemia and abnormal lipid metabolism are important indicators of bacterial infection, especially severe bacterial pneumonia.Keywords: bacterial pneumonia, COVID-19, hypoproteinemia, lipids

miru-vntr, spoligotyping, beijing genotype, drug resistance, genetic diversity, mycobacterium tuberculosis., Infectious and parasitic diseases, and RC109-216

Chunjie Yin,1,* Xiaokaiti Mijiti,2,* Haican Liu,3,* Quan Wang,2 Bin Cao,3,4 Aiketaguli Anwaierjiang,5 Machao Li,3 Mengwen Liu,1 Yi Jiang,3 Miao Xu,2 Kanglin Wan,3 Xiuqin Zhao,3 Guilian Li,3 Hui Xiao1 1School of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China; 2The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 3State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 4School of Public Health, University of South China, Hengyang, People’s Republic of China; 5College of Xinjiang Uyghur Medicine, Hetian, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guilian Li; Hui Xiao, Email liguilian@icdc.cn; xh20108262@sina.comBackground: In the last decades, the molecular epidemiological investigation of Mycobacterium tuberculosis has significantly increased our understanding of tuberculosis epidemiology. However, few such studies have been done in southern Xinjiang, China. We aimed to clarify the molecular epidemic characteristics and their association with drug resistance in the M. tuberculosis isolates circulating in this area.Methods: A total of 347 isolates obtained from southern Xinjiang, China between Sep, 2017 and Sep, 2019 were included to characterize using a 15-locus MIRU-VNTR (VNTR-15China) typing and spoligotyping, and test for drug susceptibility profiles. Then the lineages and clustering of the isolates were analyzed, as well as their association with drug resistance.Results: Spoligotyping results showed that 60 spoligotype international types (SITs) containing 35 predefined SITs and 25 Orphan or New patterns, and 12 definite genotypes were found, and the top three prevalent genotypes were Beijing genotype (207, 59.7%), followed by CAS1-Delhi (46, 13.6%), and Ural-2 (30, 8.6%). The prevalence of Beijing genotype infection in the younger age group (≤ 30) was more frequent than the two older groups (30~59 and ≥ 60 years old, both P values < 0.05). The Beijing genotype showed significantly higher prevalence of resistance to isoniazid, rifampicin, ethambutol, multi-drug or at least one drug than the non-Beijing genotype (All P values ≤ 0.05). The estimated proportion of tuberculosis cases due to transmission was 18.4% according to the cluster rate acquired by VNTR-15China typing, and the Beijing genotype was the risk factor for the clustering (OR 9.15, 95% CI: 4.18– 20.05).Conclusion: Our data demonstrated that the Beijing genotype is the dominant lineage, associated with drug resistance, and was more likely to infect young people and contributed to tuberculosis transmission in southern Xinjiang, China. These findings will contribute to a better understanding of tuberculosis epidemiology in this area.Keywords: MIRU-VNTR, spoligotyping, Beijing genotype, drug resistance, genetic diversity, Mycobacterium tuberculosis

systemic inflammation score, prostate cancer, progression-free survival, overall survival, Pathology, RB1-214, Therapeutics. Pharmacology, and RM1-950

Jie Xie,* Xu Xiao,* Zhenjia Dong, Qiangdong Wang Department of Urology, the Fifth People’s Hospital of Huai’an, Huai’an City, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiangdong Wang, Email fhhywm@163.comBackground: The systemic inflammation score (SIS) based on the albumin (Alb) level and lymphocyte-to-monocyte ratio (LMR), has been associated with survival in some cancers. However, its prognostic role in prostate cancer (PCa) remains unclear.Methods: The associations between the SIS and the clinicopathological features of PCa were evaluated. The correlations between the SIS and overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analysis and the Log rank test. Univariate and multivariate Cox analyses were conducted to determine the prognostic factors for PCa. Hazard ratios and 95% confidence intervals were calculated.Results: A total of 253 patients with PCa were included in this study. The Kaplan-Meier analysis and Log rank test suggested that patients with a higher Alb level, higher LMR, or a lower SIS had better 5-year OS and PFS compared with patients with a lower Alb level or lower LMR or higher SIS. Univariate and multivariate Cox analyses showed that drinking, prostate-specific antigen level > 100 ng/mL, and neutrophil-to-lymphocyte ratio > 2.09 were significant prognostic factors for OS and PFS in patients with PCa. Nomograms for 5-year OS and PFS were established with concordance index values of 0.888 and 0.824, respectively. The calibration curve was consistent between the actual observations and the prediction nomogram for OS and PFS probability at 5 years.Conclusion: A high SIS is associated with unfavorable survival in patients with PCa. The SIS serves as a novel independent prognostic factor for OS in patients with PCa.Keywords: systemic inflammation score, prostate cancer, progression-free survival, overall survival

abo blood group, lymphoma, survival, disease susceptibility, race, Pathology, RB1-214, Therapeutics. Pharmacology, and RM1-950

Ling Qin,1 Dongli Gao,1 Qian Wang,1 Xuewei Zheng,2 Jingjing Wang,2 Xingang Chen,2 Dongliao Fu,2 Haodi Ma,2 Junjia Tan,3 Qinan Yin2 1The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, People’s Republic of China; 2Laboratory for Precision Medicine, School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, People’s Republic of China; 3Section for Statistical Analysis and Data Collection, Luoyang Branch, Bank of China, Luoyang, People’s Republic of ChinaCorrespondence: Qinan Yin, School of Medical Technology and Engineering, Henan University of Science and Technology, No. 263 Kaiyuan Avenue, Luoyang, 471000, People’s Republic of China, Tel +86-13939928711, Email qinanyin@haust.edu.cnAbstract: ABO blood group antigens exhibit alternative phenotypes and genetically derived structures that are located on the red cell surface. The role of ABO blood group in cancer biology has been intensely reported by several studies, and it is now widely recognized that ABO antigens are associated with the risk and prognosis of several types of tumors, namely gastric cancer and pancreatic cancer. However, there have been contentious limited issues with the association between the ABO blood group and lymphoma. In this narrative review, based on literature data, we discuss the role of ABO blood group in the risk and prognosis of lymphoma and summarize the current knowledge of the underlying pathogenic mechanisms of the association. The possible association of ABO blood group with racial disparities and pathological classification in lymphoma patients is also discussed.Keywords: ABO blood group, lymphoma, survival, disease susceptibility, race

carbon dots, chemoresistance, co-delivery, sirna, Medicine (General), and R5-920

Hailing Yu,1,* Kexin Tang,1,* Zeyu Cai,2,* Xi Lin,1 Yongquan Huang,3 Ting Yu,1 Qianqian Zhang,1 Qiang Wang,4 Lili Wu,5 Lei Yang,6 Hong Shan,1 Hui Luo1 1Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, Guangdong, People’s Republic of China; 2Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China; 3Department of Ultrasound, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China; 4The Green Aerotechnics Research Institute of Chongqing Jiaotong University, Chongqing, People’s Republic of China; 5Key Laboratory for Photonic and Electronic Bandgap Materials, Ministry of Education, School of Physics and Electronic Engineering, Harbin Normal University, Harbin, Heilongjiang, People’s Republic of China; 6Center for Composite Materials and Structures, Harbin Institute of Technology, Harbin, Heilongjiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hui Luo; Hong Shan, Email luoh53@mail.sysu.edu.cn; shanhong@mail.sysu.edu.cnBackground: Nanomaterials exhibited intrinsic enzyme-like properties due to the unique properties compared with natural enzyme. Carbon dots (CDs) are an important kind of quantum-sized nanomaterials, which have enormous application potential in bio-imaging, drug carrier, and nanosystems. Carbon dots possess intrinsic enzyme-like properties, such as glutathione (GSH) oxidase or peroxidase activities.Methods: A co-delivery nanosystem that could carry siRNA and doxorubucin (DOX) simultaneously has been studied in this work. The co-delivery based on carbon dots was surface-modified with poly-ethylenimine (PEI) and loaded the siMRP1 with chemotherapeutics on the surface with pH-triggered drug release. The CD-PEI was synthesized by one-step microwave assisted method; the PEI was raw materials and passivator during the reaction process that makes CDs exhibit excellent optical property.Results: The CD-PEI was capable of loading and delivering siMRP1 and DOX to tumors and releasing them synchronously in cells in an acid-triggered manner. The particles exhibited GSH oxidase-like catalytic property, oxidizing GSH to oxidized glutathione with concomitant increase of reactive oxygen species (ROS). We found that silencing of MRP1 by co-delivery system antagonized chemoresistance by increasing DOX accumulation and significantly enhancing the inhibitory effect of cell viability induced by CD-PEI-DOX. The co-delivery system dramatically inhibited tumor growth in xenograft model, and CDs counteracted MRP1 function by siRNA-mediated knockdown of MRP1.Conclusion: Taken together, we uncover the potential role of CDs with a combination of siRNA and chemotherapeutics in overcoming chemoresistance of lung cancer by suppressing MRP1 and oxidation of GSH. Our findings imply its potential of antagonizing chemoresistance to enhance therapeutic efficiency of doxorubicin in clinical practices of lung cancer treatment.Keywords: carbon dots, chemoresistance, co-delivery, siRNA

maintenance hemodialysis, group exercise, aerobic exercise, resistance exercise nutrition, quality of life, Medicine (General), and R5-920

Lijuan Zhou,1,2,* Dan Shi,2 Liyuan Zhang,2,* Qian Wang,2 Li Chen,2 Honglin Chen3 1Medical School, Nantong University, Nantong, People’s Republic of China; 2Nursing Department, Taizhou People’s Hospital, Taizhou, People’s Republic of China; 3School of Public Health, Nantong University, Nantong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Honglin Chen, Email honglinyjs@126.comBackground: Maintenance hemodialysis(MHD) patients often suffer from fatigue and are recommended to undertake physical activities. The optimal format of exercise rehabilitation for MHD patients remains uncertain despite demonstrated health benefits. This study aimed to evaluate the effectiveness of an intradialytic group exercise programme for MHD patients.Methods: This was a single-centre, single-group repeated-measures design study. The 12-week, three times per-week intradialytic group exercise programme was conducted for around 30 min during the first 2 hours of each dialysis session. Patient-reported outcomes including fatigue, anxiety, depression and health-related quality of life, laboratory parameters including haemoglobin, albumin, pre-albumin and hypersensitive C-reactive protein, and anthropometric parameters including triceps skinfold thickness, mid-upper arm circumference, mid-arm muscle circumference and handgrip strength, were measured at baseline, immediately post-intervention and 12-weeks post-intervention. The repeated-measures analysis of variance and Friedman test were used to compare the parametric and non‐parametric data across time points, respectively.Results: Ninety patients were enrolled and 75 completed. Participants reported significant improvements across time points in fatigue (F = 10.19, p < 0.01), depression (F = 19.20, p < 0.001), health-related quality of life (F = 5.36, p = 0.006), haemoglobin (F = 3.43, p = 0.047), albumin (F = 4.42, p = 0.032), hypersensitive C-reactive protein (χ2 = 50.39, p < 0.001), pre-albumin (χ2 = 11.85, p = 0.003), triceps skinfold thickness (F = 25.03, p < 0.001), mid-upper arm circumference (F = 6.32, p = 0.005), mid-arm muscle circumference (F = 4.89, p = 0.02), and handgrip strength (F = 13.59, p < 0.001). Although the mean anxiety score tended to reduce, the difference across time points was nonsignificant (F = 1.33, p = 0.27).Conclusion: The findings suggested that the intradialytic group exercise programme could improve MHD patients’ fatigue, depression, health-related quality of life, nutritional status, and inflammation.Trial Registration: Chinese Clinical Trial Registry ChiCTR2000034394 (04/07/2020).Keywords: maintenance hemodialysis, group exercise, aerobic exercise, resistance exercise nutrition, quality of life

ventricular tachycardia, ventricular flutter and fibrillation, risk stratification, scoring system, acute myocardial infarction, Geriatrics, and RC952-954.6

Ling Sun,1,* Bing Han,2,* Yu Wang,1,* Wenwu Zhu,2 Jianguang Jiang,1 Ailin Zou,1 Boyu Chi,1,3 Lipeng Mao,1,3 Yuan Ji,1 Qingjie Wang,1 Liming Tang4 1Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, People’s Republic of China; 2Department of Cardiology, Xuzhou Central Hospital, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, 221009, People’s Republic of China; 3Dalian Medical University, Dalian, Liaoning, 116000, People’s Republic of China; 4Department of Gastrointestinal Disease, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liming Tang, Center of Gastrointestinal Disease, Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, 29 Xinglong Alley, Changzhou, Jiangsu, 213003, People’s Republic of China, Email drtangliming@163.com Yuan Ji, Department of Cardiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, People’s Republic of China, Email jiyuan1213@aliyun.comObjective: In this study, a risk score for ventricular arrhythmias (VA) were evaluated for predicting the risk of ventricular arrhythmia (VA) of acute myocardial infarction (AMI) patients.Methods: Patients with AMI were divided into two sets according to whether VA occurred during hospitalization. Another cohort was enrolled for external validation. The area under the curve (AUC) of receiver operating characteristic (ROC) was calculated to evaluate the accuracy of the model.Results: A total of 1493 eligible patients with AMI were enrolled as the training set, of whom 70 (4.7%) developed VA during hospitalization. In-hospital mortality was significantly higher in the VA set than in the non-VA set (31.4% vs 2.7%, P=0.001). The independent predictors of VA in patients with AMI including Killip grade ≥ 3, STEMI patients, LVEF < 50%, frequent premature ventricular beats, serum potassium < 3.5 mmol/L, type 2 diabetes, and creatinine level. The AUC of the model for predicting VT/VF in the training set was 0.815 (95% CI: 0.763– 0.866). A total of 1149 cases were enrolled from Xuzhou Center Hospital as the external validation set. The AUC of the model in the external validation set for predicting VT/VF was 0.755 (95% CI: 0.687– 0.823). Calibration curves indicated a good consistency between the predicted and the observed probabilities of VA in both sets.Conclusion: We have established a clinical prediction risk score for predicting the occurrence of VA in AMI patients. The prediction score is easy to use, performs well and can be used to guide clinical practice.Keywords: ventricular tachycardia, ventricular flutter and fibrillation, risk stratification, scoring system, acute myocardial infarction

oral and maxillofacial surgery, postoperative sore throat, female gender, cough during extubation, predictors., Therapeutics. Pharmacology, and RM1-950

Zhou-peng Zheng,1– 4 Su-lin Tang,1– 4 Shao-lan Fu,1– 4 Qian Wang,1– 4 Li-wei Jin,1– 4 Yan-li Zhang,1– 4 Rong-rong Huang1– 4 1Department of Anesthesiology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, 310,000 People’s Republic of China; 2Zhejiang Provincial Clinical Research Center for Oral Diseases, Hangzhou, 310,000 People’s Republic of China; 3Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310,000 People’s Republic of China; 4Cancer Center of Zhejiang University, Hangzhou, 310,000 People’s Republic of ChinaCorrespondence: Rong-rong Huang, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, No. 166, Qiutao North Road, Shangcheng District, Hangzhou, People’s Republic of China, Email hrr8310@zju.edu.cnObjective: To identify risk factors for postoperative sore throat (POST) after general anesthesia in oral and maxillOfacial surgery.Material and Methods: This study is a retrospective cohort design study. We enrolled patients with oral and maxillofacial surgery who underwent endotracheal intubation under general anesthesia in the Stomatology Hospital, Zhejiang University School Of Medicine between April 2020 and April 2021. They were divided into the POST group and the without POST group. The distribution Of various characteristics in the two groups was firstly analyzed. Then, logistic regression analysis was performed to explore the independent predictors for POST occurrence. Following this, logistic regression and random forest models were constructed and their performance was evaluated to predict POST occurrence.Results: A total of 891 participants were enrolled in the study. Female gender and cough during extubation were significantly associated with increased POST occurrence in multivariate analysis (all P < 0.05). Stratified logistic regression analysis results showed that the female gender was an independent predictor for POST occurrence in the 4≤age≤ 14 and 14 60 group after adjusting American Society of Anesthesiologists status and throat and lung disease (all P < 0.05). The logistic regression model had a similar effect to the random forest model in predicting POST occurrence. Interestingly, the female gender had a higher important weight compared to the cough during extubation.Conclusion: This research reveals female gender and cough during extubation as potential risk factors for POST occurrence, which may provide guidance for the effective prevention of POST in oral and maxillofacial surgery.Keywords: oral and maxillofacial surgery, postoperative sore throat, female gender, cough during extubation, predictors

nanoparticles；dox；fenton；ros, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, and RC254-282

Mengqi Zhang,1,* Shengxian Bao,2,* Guanhua Qiu,2,* Jingchen Liang,2 Qin Wang,2 Xiaoqi Zhu,2 Guchun Qin,1 Junjie Liu,2 Chang Zhao1 1Department of Interventional Therapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Ultrasound and Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junjie Liu; Chang Zhao, Email liujunjie197806@163.com; 710519137@qq.comPurpose: In this experiment, we constructed a magnetic targeting nano-diagnosis and treatment platform of doxorubicin (DOX) combined with iron nanoparticles, and explored their application value and mechanism in the treatment of Triple Negative Breast Cancer (TNBC), as well as its new diagnosis and treatment mode in Magnetic Resonance Imaging (MRI).Patients and Methods: Hollow mesoporous nanoparticles (HFON) were synthesized by solvothermal method, and loaded the drug DOX (DOX@HFON) to treat TNBC. The experiments in vivo and in vitro were carried out according to the characteristics of the materials. In vitro experiments, the killing effect of the drug on cells was verified by cell viability CCK8, ROS generation level, LPO evaluation and flow cytometry; the MRI effect and targeted anti-tumor therapy effect were studied by in vivo experiments; then the tumor tissue sections were detected by Ki-67, CD31, ROS, LPO and TUNEL immunofluorescence detection; H&E staining and blood biochemical tests were used to evaluate the biosafety of the materials.Results: Through a series of characterization tests, it is confirmed that the nano-materials prepared in this experiment have positive drug loading properties. MDA-MB-231 cells had great phagocytic ability to DOX@HFON under Confocal Laser Scanning Microscope (CLSM). Experiments in vitro confirmed that DOX and Fe were released and concentrated in cells, and a large number of ROS production and induction of LPO were detected by DCFH-DA and C11-BODIPY probes in cells. Apoptosis experiments further confirmed that DOX@HFON induced apoptosis, autophagy and ferroptosis. In the vivo experiment, the anti-tumor therapy effect of MAGNET@DOX@HFON group was the most significant, and in MRI also proved that the drug had great tendency and imaging ability in tumor tissue.Conclusion: The new magnetic targeting nano-diagnosis and treatment platform prepared in this experiment is expected to become a new treatment model for TNBC.Keywords: nanoparticles, DOX, Fenton, ROS

bronchopulmonary dysplasia, endothelial glycocalyx, inflammation, protectin dx, Pathology, RB1-214, Therapeutics. Pharmacology, and RM1-950

Zhongjie Liang,1,2 Huilin Yue,1 Congcong Xu,1 Qian Wang,3 Shengwei Jin2,3 1Department of Neonatology, The Second Affiliated Hospital, Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang, People’s Republic of China; 2Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang, People’s Republic of China; 3Key Laboratory of Anesthesiology of Zhejiang Province, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang, People’s Republic of ChinaCorrespondence: Qian Wang; Shengwei Jin, Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang Province, 325027, People’s Republic of China, Tel +86 577-88002806, Fax +86 577-88832693, Email wqian84@163.com; jinshengwei69@163.comBackground: Bronchopulmonary dysplasia (BPD) is a common chronic lung disease in premature infants with limited treatments and poor prognosis. Damaged endothelial glycocalyx leads to vascular permeability, lung edema and inflammation. However, whether hyperoxia increases neonatal pulmonary microvascular permeability by degrading the endothelial glycocalyx remains unknown.Methods: Newborn mice were maintained in 60– 70% O2 for 7 days. Protectin DX (PDX), an endogenous lipid mediator, was injected intraperitoneally on postnatal d 0, 2, 4 and 6. Lung samples and bronchoalveolar lavage fluid were taken at the end of the study. Primary human umbilical vein endothelial cells (HUVECs) were cultured in 80%O2.Results: Hyperoxia exposure for 7 days led to neonatal mice alveolar simplification with less radial alveolar count (RAC), mean linear intercept (MLI) and mean alveolar diameter (MAD) compared to the control group. Hyperoxia exposure increased lung vascular permeability with more fluid and proteins and inflammatory factors, including TNF-α and IL-1β, in bronchoalveolar lavage fluid while reducing the heparan sulfate (HS), the most abundant component of the endothelial glycocalyx, in the pulmonary endothelial cells. PDX relieve these changes. PDX attenuated hyperoxia-induced high expression of heparanase (HPA), the endoglycosidase that shed endothelial glycocalyx, p‐P65, P65, and low expression of SIRT1. BOC‐2 and EX527 abolished the affection of PDX both in vivo and intro.Conclusion: In summary, our findings indicate that PDX treatment relieves hyperoxia‐induced alveolar simplification, vascular leakage and lung inflammation by attenuating pulmonary endothelial glycocalyx injury via the SIRT1/NF‐κB/ HPA pathway.Keywords: bronchopulmonary dysplasia, endothelial glycocalyx, inflammation, protectin DX

hyaluronic acid, 35kda hyaluronic acid fragment, b-ha/ha35, molecular weight, inflammation, inflammatory cells, reactive oxygen species, injection safety., Pathology, RB1-214, Therapeutics. Pharmacology, and RM1-950

XiaoXiao Jia,1,2,* Ming Shi,3,* Qifei Wang,1,2 Jessica Hui,4 Joshua Hui Shofaro,1,2 Ryenchindorj Erkhembayar,5 Mizhou Hui,1,2 Chenzhe Gao,1 Munkh-Amgalan Gantumur1 1College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China; 2College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China; 3School of Life Science and Technology, Harbin Institute of Technology, Harbin, People’s Republic of China; 4Center for Cancer Cell Therapy, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA; 5Department of International Cyber Education, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia*These authors contributed equally to this workCorrespondence: Mizhou Hui; Munkh-Amgalan Gantumur, Email huimizhou@163.com; mnkh.calm@gmail.comBackground: Hyaluronic acid (HA) and HA fragments interact with a variety of human body receptors and are involved in the regulation of various physiological functions and leukocyte trafficking in the body. Accordingly, the development of an injectable HA fragment with good tissue permeability, the identification of its indications, and molecular mechanisms are of great significance for its clinical application. The previous studies showed that the clinical effects of injectable 35kDa B-HA result from B-HA binding to multiple receptors in different cells, tissues, and organs. This study lays the foundation for further studies on the comprehensive clinical effects of injectable B-HA.Methods: We elaborated on the production process, bioactivity assay, efficacy analyses, and safety evaluation of an injectable novel HA fragment with an average molecular weight of 35 kDa (35 kDa B-HA), produced by recombinant human hyaluronidase PH20 digestion.Results: The results showed that 35 kDa B-HA induced human erythrocyte aggregation (rouleaux formation) and accelerated erythrocyte sedimentation rates through the CD44 receptor. B-HA application and injection treatment significantly promoted the removal of mononuclear cells from the site of inflammation and into the lymphatic circulation. At a low concentration, 35 kDa B-HA inhibited production of reactive oxygen species and tumor necrosis factor by neutrophils; at a higher concentration, 35 kDa B-HA promoted the migration of monocytes. Furthermore, 35 kDa B-HA significantly inhibited the migration of neutrophils with or without lipopolysaccharide treatment, suggesting that in local tissues, higher concentrations of 35 kDa B-HA have antiinflammatory effects. After 99mTc radiolabeled 35 kDa B-HA was intravenously injected into mice, it quickly entered into the spleen, liver, lungs, kidneys and other organs through the blood circulation.Conclusion: This study demonstrated that the HA fragment B-HA has good tissue permeability and antiinflammatory effects, laying a theoretical foundation for further clinical studies.Keywords: hyaluronic acid, 35kDa hyaluronic acid fragment, B-HA/HA35, molecular weight, inflammation, inflammatory cells, reactive oxygen species, injection safety

benign prostatic hyperplasia, lower urinary tract symptoms, renal function, elderly men, drug therapy, Geriatrics, and RC952-954.6

Qian Wang,1,* Bin Zhang,1,* Bing Li,1 Shengnan Yang,1 Zhifang Wang,2 Chao Han,3 Jie Wu,4 Rui Tian1 1The Second Division of General Geriatrics, Department of Geriatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Division of Endocrinology, Department of Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 4Division of Ultrasound, Department of Medical Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qian Wang; Rui Tian, The Second Division of General Geriatrics, Department of Geriatrics, the First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Erqi District, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +8615838328873, Fax +8637166295183, Email qiansmile320@163.com; tianruiyfy@sina.comPurpose: To investigate the relationship between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and renal function in elderly men aged 80 years and older.Patients and Methods: We selected 389 elderly men aged 80– 97 years with BPH/LUTS hospitalized at The Second Division of General Geriatrics, The First Affiliated Hospital of Zhengzhou University, between July 2018 and July 2020. In the cross-sectional study, patients were divided into the treatment (233 patients) and non-treatment (156 patients) groups based on whether they received treatment for BPH/LUTS. In the prospective self-case-control study, we included 129 of the non-treatment group patients who received oral BPH/LUTS medication and completed the 6-month outpatient follow-up. We compared prostate indicators and renal function in the cross-sectional study and baseline and after-treatment data in the prospective self-case-control study. Multiple linear regression analysis was performed for risk factors affecting renal function before and after BPH/LUTS treatment.Results: In the cross-sectional study, renal function was significantly better in the treatment group than in the non-treatment group. In the subgroup analysis of the prospective self-case-control study, renal function significantly improved after treatment among patients with hypertension and those with chronic kidney disease (CKD) 3a, but not in the entire cohort. Multivariable linear regression analysis showed that hypertension (β=2.06, 95% CI 0.40 to 3.71) and CKD 3a (β=17.16, 95% CI 15.53 to 18.79) were independent risk factors for creatinine differences before and after treatment, whereas hypertension (β=− 2.27, 95% CI − 3.65 to − 0.89), CKD 3a (β=− 11.93, 95% CI − 13.29 to − 10.58), and baseline prostate volume (β=− 0.11, 95% CI − 0.20 to − 0.02) were independent risk factors for estimated glomerular filtration rate differences before and after treatment.Conclusion: Treatment for moderate and severe BPH/LUTS can improve renal function in elderly patients with hypertension or CKD 3a.Keywords: benign prostatic hyperplasia, lower urinary tract symptoms, renal function, elderly men, drug therapy

global burden of disease, colorectal cancer, disability-adjusted life year, estimated annual percentage change, age-standardized incidence rate, bapc: bayesian age-period-cohort, Infectious and parasitic diseases, and RC109-216

Yang Liu,1 Chao Zhang,2 Qianwen Wang,1 Kangze Wu,3 Zhouyi Sun,1 Zhe Tang,1 Bo Zhang3 1The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China; 2Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China; 3The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, People’s Republic of ChinaCorrespondence: Bo Zhang, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310000, People’s Republic of China, Tel/Fax +86-0571-87783563, Email jjs10@zju.edu.cnBackground: This study aimed to evaluate the global colorectal cancer(CRC) trend and the relevant risk factors from 1990 to 2019 and for better policymaking and resource allocation.Methods: Data on CRC, including incidence, mortality and disability adjusted life year (DALY) rates, were extracted from the 2019 Global Burden of Disease (GBD) study. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trend of incidence, mortality and DALYs. The Bayesian age-period-cohort model(BAPC) was used to predict the future burden of CRC.Results: In 2019, a total of 2.17 million CRC cases were reported worldwide, a 157% increase from 1990. In high-social demographic index (SDI) regions, the trend of age-standardized incidence rate(ASIR) tended to decrease, while the proportion of people under 50 years of age tended to increase. Although the number of deaths and DALYs increased, the age-standardized death rate (ASDR) and age-standardized DALY rate decreased. The CRC burden was growing fastest in middle-SDI regions, especially in East Asia, followed by low SDI regions. In addition, the milk intake, High-BMI and high fasting plasma glucose play a more important role in on CRC. The predicted cases and deaths in global continued to increase to 2044. And there is an upward trend in ASIR for both men and women.Conclusion: In developed regions, the CRC burden continues to decrease, while the CRC burden become more and more severe in developing regions. Overall, the burden of CRC will rising in the near future. Therefore, reasonable resource allocation and prevention policies should be implemented. Developing countries needs more attention.Keywords: global burden of disease, colorectal cancer, disability-adjusted life year, estimated annual percentage change, age-standardized incidence rate, Bayesian age-period-cohort

ferroptosis, hepatocellular carcinoma, immunotherapy, overall survival, signature, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, and RC254-282

Qingbin Wang,1,2,* Bingkun Wang,1,2,* Xiaowu Ma,1,2 Hongkai Zhuang,1,2 Zhiqin Xie,1,2 Chenwei Tang,1,2 Wenliang Tan,1,2 Lei Yang,1,2 Changzhen Shang,1,2 Yajin Chen1,2 1Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Changzhen Shang; Yajin Chen, Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China, Tel +86 13711279678, Email shangcz_sysu@163.com; chenyaj@mail.sysu.edu.cnPurpose: Ferroptosis has been reported to regulate multiple biological behaviors. However, the prognostic and oncologic values of ferroptosis-related genes (FRGs) have not been comprehensively elucidated in hepatocellular carcinoma (HCC). Here, we aimed to construct FRGs-associated signature for stratification of the prognosis of HCC patients.Methods: A list of FRGs was generated from FerrDb. Public databases were used to extract expression matrices and clinical information. TCGA cohort was randomly divided into a training set and a validation set. Prognostic signature for Overall Survival (OS) was established in training set and validated in internal cohorts (TCGA validation set and entire set) and external cohort (ICGC cohort). Additionally, the role of signature in HCC was well investigated by analysis of mutations, gene set enrichment analysis (GSEA), analysis of immune infiltrates, and analysis of response to immune checkpoint blockade (ICB) treatment. The oncogenic effects of ZFP69B on HCC were also investigated in vitro.Results: We identified 12 FRGs-based signature for OS with LASSO regression. Patients were partitioned into different risk groups based on the signature. Overall, patients in different groups had different prognosis. The signature independently predicted OS in multivariate Cox regression analyses. Anti-tumor immune cells including activated CD8 T cells, cytolytic activity, and Th1 cells were negatively correlated with risk score in both TCGC and ICGC cohorts. Furthermore, low-risk patients responded better to ICB than high-risk patients. In addition, knockdown of ZFP69B reduced proliferation, migration, and invasion, and promoted erastin-induced ferroptosis of HCC cells.Conclusion: We developed a prognostic signature based on FRGs to predict OS of HCC patients. And the signature may facilitate clinicians in identifying those who are likely to benefit from ICIs. The results also indicated that ZFP69B might regulate the process of ferroptosis and could be used as a novel potential target for HCC.Keywords: ferroptosis, hepatocellular carcinoma, immunotherapy, overall survival, signature

epilepsy, relapse, antiepileptic drugs, drug withdrawal, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, and RC346-429

Xiaoli Zhang,1,* Jiao Zeng,1,* Xin Gu,1 Fan Zhang,1 Yongkai Han,1 Ping Zhang,1 Qun Wang,2,3 Renjun Gu1 1Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, People’s Republic of China; 2Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 3China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Renjun Gu, Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Qianjin Road, No. 207, Xinxiang, Henan, People’s Republic of China, Tel +86 0373-3373704, Email gurenjun1961@163.com Qun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Nansihuanxi Road, No. 119, Beijing, People’s Republic of China, Tel +86 010-59975052, Email wangq@ccmu.edu.cnBackground and Study Aims: Antiepileptic drugs are the first choice of treatment for patients with epilepsy. However, the withdrawal of antiepileptic drugs after seizure-free remains a significant focus for the majority of patients with epilepsy and their families. In this study, we evaluated the risk factors associated with relapse after drug withdrawal in patients with seizure free for 2 years. We aimed to guide patients in seizure-free to assess the risk of drug withdrawal.Patients and Methods: Through screening, 452 patients with epilepsy were included in the study.Patients were followed up for at least 2 years or more. Analyzed their clinical data by applying the χ 2-test, Kaplan-Meier survival analysis and multivariate Cox regression analysis.Results: 423 patients completed follow-up, of which 304 cases recurred (71.9%).Related recurrence factors include age of onset, type of seizure, number of AEDs, seizure-free time before withdrawal, and electroencephalogram (EEG) results before drug withdrawal (P< 0.05). The results of correlation analysis showed that age of onset, seizure frequency, seizure type, number of AEDs, the period from AEDs treatment to a seizure-free status, EEG results before drug withdrawal, and pre-medication course, were all significantly related to the recurrence of seizures after drug reduction and withdrawal (P< 0.05). We identified a range of independent risk factors, including onset age, seizure frequency, Multiple AEDs and the period from AEDs treatment to a seizure-free status.Conclusion: The overall recurrence rate of epilepsy in our patient cohort was high, and the peak recurrence period was within one-year of drug withdrawal. Patients with partial seizures, a short seizure-free time before withdrawal, severe EEG abnormalities before drug reduction, and a long course of the disease, are prone to relapse. Patients with an older age at onset and a high frequency of attack, those taking multi-drug combination therapy, and those that take a long time to gain control, should be managed carefully to AEDs withdrawal.Keywords: epilepsy, relapse, antiepileptic drugs, drug withdrawal

autism spectrum disorders, children, age, influencing factors, multicenter, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, and RC346-429

Dan Long,1 Ting Yang,1 Jie Chen,1 Ying Dai,1 Li Chen,1 Feiyong Jia,2 Lijie Wu,3 Yan Hao,4 Ling Li,5 Jie Zhang,6 Xiaoyan Ke,7 Mingji Yi,8 Qi Hong,9 Jinjin Chen,10 Shuanfeng Fang,11 Yichao Wang,12 Qi Wang,13 Chunhua Jin,14 Tingyu Li1 1Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, People’s Republic of China; 3Research Center for Child Development and Behavior, Harbin Medical University, Harbin, People’s Republic of China; 4Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 5Department of Children Rehabilitation, Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China; 6Children Health Care Center, Xi’an Children’s Hospital, Xi’an, People’s Republic of China; 7The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 8Department of Child Health Care, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 9Maternal and Child Health Hospital of Baoan, Shenzhen, People’s Republic of China; 10Department of Child Health Care, Shanghai Children’s Hospital, Shanghai, People’s Republic of China; 11Department of Child Health Care, Children’s Hospital Affiliated of Zhengzhou University, Zhengzhou, People’s Republic of China; 12National Health Commission Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Hospital, Changsha, People’s Republic of China; 13Deyang Maternal and Child Health Hospital, Deyang, People’s Republic of China; 14Department of Children Health Care, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Tingyu Li, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, People’s Republic of China, Tel +86 23 63630913, Fax +86 23 63622754, Email tyli@vip.sina.comPurpose: The present study investigated the age of diagnosis, treatment and demographic factors of Chinese children with autism spectrum disorders (ASD), to provide a scientific basis for the early detection, diagnosis, and intervention of ASD.Patients and Methods: A total of 1500 ASD children aged 2– 7 years old from 13 cities in China were administered questionnaires to examine their diagnosis, treatment, and basic family information. The Childhood Autism Rating Scale (CARS) was used to measure the symptoms and severity of ASD children, and the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was utilized to measure neurodevelopmental levels of ASD children.Results: We found that for children with ASD, the median (p25, p75) age for the initial detection of social behavioral developmental delay was 24 (18, 30) months, while the age for the initial diagnosis was 29 (24, 36) months and the age for the beginning of intervention was 33 (27, 42) months. Multiple linear regression (MLR) analysis suggested that in children with ASD whose parents were divorced, separated, or widowed, or whose mothers were engaged in physical work, the initial detection of social behavioral developmental delay happened later. For the children with ASD who lived in urban areas, had higher levels of ASD symptom severity or whose parents were not divorced or separated, the age for the initial diagnosis was earlier. For the children with ASD who lived in urban areas or whose mothers had received higher level of education, the earlier age for the beginning of intervention was observed, while for those with ASD whose mothers were engaged in physical work, the age for the beginning of training was later.Conclusion: It is recommended to actively carry out health education of ASD and strengthen the support for ASD families to enhance their rehabilitation level.Keywords: autism spectrum disorders, children, age, influencing factors, multicenter

ketamine, asthma, inflammation, apoptosis, oxidative stress, nf-e2-related factor 2, Therapeutics. Pharmacology, and RM1-950

Shilin Xiao, Ying Zhou, Qianyu Wang, Dong Yang Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Dong Yang, Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan, Beijing, 100144, People’s Republic of China, Tel +86-13661267522, Email yangdongpsh@163.comPurpose: The use of ketamine, an anesthetic, as a treatment for asthma has been investigated in numerous studies. However, how ketamine affects asthma is unclear. The present study examined the effects of ketamine on a murine model of mixed-granulocytic asthma, and the role of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway.Methods: The murine model of mixed-granulocytic asthma was established using ovalbumin (OVA) for sensitization and the combination of OVA and lipopolysaccharides (LPS) for challenge. The main characteristics of asthma, oxidative stress biomarkers, and the expression of the Nrf2 pathway were examined. ML385 was administered to verify the role of the Nrf2 pathway.Results: Mice in the OVA +LPS group developed asthmatic characteristics, including airway hyperresponsiveness, mixed-granulocytic airway inflammation, mucus overproduction, as well as increased levels of oxidative stress and impaired apoptosis of inflammatory cells. Among the three concentrations, ketamine at 75mg/kg effectively attenuated these asthmatic symptoms, activated the Nrf2 pathway, decreased oxidative stress, and induced apoptosis of eosinophils and neutrophils in bronchoalveolar lavage fluid (BALF) with a reducing level of myeloid cell leukemia 1(Mcl-1). ML385 (an Nrf2 inhibitor) eliminated the protective effects of ketamine on the mixed-granulocytic asthma model.Conclusion: The study concluded that ketamine reduced oxidative stress and attenuated asthmatic symptoms (neutrophilic airway inflammation) by activating the Nrf2-Keap1 pathway, with 75 mg/kg ketamine showing the best results. Ketamine administration also increased neutrophil and eosinophil apoptosis in BALF, which may contribute to the resolution of inflammation. The use of ketamine as a treatment for asthma may therefore be beneficial.Keywords: ketamine, asthma, inflammation, apoptosis, oxidative stress, NF-E2-related factor 2