Role of soluble guanylyl cyclase in renal afferent and efferent arterioles

Renal arteriolar tone depends considerably on the dilatory action of nitric oxide (NO) via activation of soluble guanylyl cyclase (sGC) and cGMP action. NO deficiency and hypoxia/reoxygenation are important pathophysiological factors in the development of acute kidney injury. It was hypothesized that the NO-sGC-cGMP system functions differently in renal afferent arterioles (AA) compared with efferent arterioles (EA) and that the sGC activator cinaciguat differentially dilates these arterioles. Experiments were performed in isolated, perfused mouse glomerular arterioles. Hypoxia (0.1% oxygen) was achieved by using a hypoxia chamber. Phosphodiesterase 5 (PDE5) and sGC subunits were considerably expressed on the mRNA level in AA. PDE5 inhibition with sildenafil, which blocks cGMP degradation, diminished the responses to ANG II bolus application in AA, but not significantly in EA. Vasodilation induced by sildenafil in ANG II-preconstricted vessels was stronger in EA than AA. Cinaciguat, an NO- and heme-independent sGC activator, dilated EA more strongly than AA after N^G-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) treatment and preconstriction with ANG II. Cinaciguat-induced dilatation of l-NAME-pretreated and ANG II-preconstricted arterioles was similar to controls without l-NAME treatment. Cinaciguat also induced dilatation in iodinated contrast medium treated AA. Furthermore, it dilated EA, but not AA, after hypoxia/reoxygenation. The results reveal an important role of the NO-sGC-cGMP system for renal dilatation and that EA have a more potent sGC activated dilatory system. Furthermore, AA seem to be more sensitive to hypoxia/reoxygenation than EA under these experimental conditions.

[Therapy-related myeloid neoplasms after successful treatment for acute promyelocytic leukemia: a report of four cases and literature review]

目的

探讨急性早幼粒细胞白血病（APL）患者继发治疗相关性髓系肿瘤（t-MN）的临床特点、诊断、治疗及预后。

方法

回顾性分析中国医学科学院血液病医院2012年10月至2019年1月收治的4例APL继发t-MN患者的临床资料，并进行相关文献复习。

结果

4例APL继发t-MN患者均为女性，中位年龄42（40~53）岁，3例接受了以维甲酸（ATRA）+亚砷酸（ATO）为基础联合蒽环/蒽醌类药物±阿糖胞苷的前期诱导缓解及巩固治疗方案，1例采用了ATRA联合蒽环/蒽醌类药物±阿糖胞苷的治疗方案，均没有使用烷化剂。在APL获得完全缓解（CR）后40~43个月出现t-MN，其中治疗相关性骨髓增生异常综合征（t-MDS）1例，治疗相关性急性髓系白血病（t-AML）3例，出现t-MN时PML-RARα融合基因均为阴性。3例t-AML患者接受了2~4个疗程再诱导治疗，其中有1例t-AML患者在获得CR后行异基因造血干细胞移植（allo-HSCT），1例t-MDS患者接受了去甲基化治疗。中位随访54.5（48~62）个月，2例t-AML患者死亡，出现t-MN后中位生存期为12（5~18）个月。1989至2018年文献共报道63例APL继发t-MN病例，与本次报道的4例汇总分析，67例患者中男27例，女40例；中位年龄为52.5（15~76）岁；中位潜伏期39（12~168）个月，确诊t-MN后中位生存时间为10（1~39）个月。

结论

APL继发t-MN较为少见，目前缺乏有效的防治措施，预后不佳，在随访过程中（尤其是获得CR后39个月左右）若出现病情变化，应警惕t-MN的发生，对此类患者应尽快明确疾病的变化，给予合理的治疗。

[Treatment of central nervous system leukemia with CD19-chimeric antigen receptor T-cell immunotherapy: two cases report and literature review]

目的

探讨CAR-T细胞治疗中枢神经系统白血病（CNSL）的有效性和安全性。

方法

报道两例合并CNSL白血病患者抗CD19 CAR-T细胞治疗的过程及结果，并对相关文献进行复习。

结果

两例患者骨髓细胞形态学特征分别为伴B淋系表达的急性髓系白血病（AML）-M₂和急性B淋巴细胞白血病（B-ALL），免疫分型符合AML-M₂和B-ALL的异常表现，临床和实验室检查符合CNSL诊断标准，诊断明确后予以抗CD19 CAR-T细胞治疗，输注总量均为5.0×10⁶/kg。回输后两例患者中枢神经系统症状缓解。例1影像学异常消失，治疗过程中出现细胞因子释放综合征（CRS），药物干预后好转；例2脑脊液微小残留病转阴，未出现明显CRS反应。

结论

CAR-T细胞治疗有望缓解CNSL，改善患者预后。

[Screening of adult Ph-like acute lymphoblastic leukemia by multiplex real-time quantitative PCR]

目的

探讨多重实时荧光定量PCR法早期、快速筛查Ph样急性淋巴细胞白血病（ALL）的可行性，了解Ph样ALL的临床特征及预后。

方法

2010年10月至2016年3月收治的118例初诊成人B-ALL患者纳入研究，利用多重实时荧光定量PCR法检测其中58例BCR-ABL融合基因和MLL重排均阴性患者Ph样相关融合基因及细胞因子受体样因子2（CRLF2）表达情况。比较分析Ph样融合基因阳性和（或）CRLF2高表达患者的临床特征、疗效和预后。

结果

检出Ph样融合基因阳性患者9例（9/58，15.5%），CRLF2高表达患者10例（10/58，17.2%）。Ph样融合基因阳性和（或）CRLF2高表达组、Ph阳性组、MLL重排阳性组以及其他患者组在年龄、WBC、免疫分型、细胞遗传学、危险度分组方面差异有统计学意义（P值均<0.01）。四组患者的2年总生存率分别为65%、47%、64%、74%（P=0.043），2年无复发生存率分别为51%、39%、62%、70%（P=0.010）。

结论

采用多重实时荧光定量PCR法筛查Ph样ALL患者可行，Ph样ALL患者预后较差。

Myoglobin facilitates angiotensin II-induced constriction of renal afferent arterioles

Vasoconstriction plays an important role in the development of acute kidney injury in rhabdomyolysis. We hypothesized that myoglobin enhances the angiotensin II (ANG II) response in afferent arterioles by increasing superoxide and reducing nitric oxide (NO) bioavailability. Afferent arterioles of C57Bl6 mice were isolated perfused, and vasoreactivity was analyzed using video microscopy. NO bioavailability, superoxide concentration in the vessel wall, and changes in cytosolic calcium were measured using fluorescence techniques. Myoglobin treatment (10−5 M) did not change the basal arteriolar diameter during a 20-min period compared with control conditions. NG-nitro-l-arginine methyl ester (l-NAME, 10−4 M) and l-NAME + myoglobin reduced diameters to 94.7 and 97.9% of the initial diameter, respectively. Myoglobin or l-NAME enhanced the ANG II-induced constriction of arterioles compared with control (36.6 and 34.2%, respectively, vs. 65.9%). Norepinephrine responses were not influenced by myoglobin. Combined application of myoglobin and l-NAME further facilitated the ANG II response (7.0%). Myoglobin or l-NAME decreased the NO-related fluorescence in arterioles similarly. Myoglobin enhanced the superoxide-related fluorescence, and tempol prevented this enhancement. Tempol also partly prevented the myoglobin effect on the ANG II response. Myoglobin increased the fura 2 fluorescence ratio (cytosolic calcium) during ANG II application (10−12 to 10−6 M). The results suggest that the enhanced afferent arteriolar reactivity to ANG II is mainly due to a myoglobin-induced increase in superoxide and associated reduction in the NO bioavailability. Signaling pathways for the augmented ANG II response include enhanced cytosolic calcium transients. In conclusion, myoglobin may contribute to the afferent arteriolar vasoconstriction in this rhabdomyolysis model.

[Value of R2(*) in evaluating the biological behavior of primary hepatocellular carcinoma]

OBJECTIVE

To investigate the correlation between R2(*) value of enhanced T2 star-weighted angiography (ESWAN) sequence and primary hepatocellular carcinoma infiltration and tumor thrombus, and investigate the biological behavior of HCC.

METHODS

A total of 221 cases of patients' imaging data with MRI examination(including ESWAN sequence) diagnosed as primary HCC were retrospectively analyzed.All the patients were collected from January 2014 to September 2015 in the First Affiliated Hospital of Dalian Medical University.The differences of R2(*) values in different MR types of HCC were analyzed.All patients were divided into infiltration group and non-infiltration group, tumor thrombus group and non-tumor thrombus group, the R2(*) values of the paired groups were compared.The diagnostic efficiency of R2(*) in HCC infiltration and tumor thrombus were evaluated by ROC curve, and to find out the threshold values.

RESULTS

The MR types of 221 patients included 90 cases of nodular type, 62 cases of massive type, 69 cases of diffuse type.70 patients had tumor thrombus.The R2(*) values of different MR types were (21.82±8.52), (24.17±8.84)and (34.45±11.73) Hz, respectively.There was no statistically significant difference between the nodular and the massive types (P=0.144), while the difference between the nodular and diffuse type, the massive and diffuse types were statistically significant(P=0.000). The R2(*) values of infiltration group and non-infiltration group were (34.45±11.73) and (22.78±8.70) Hz , the R2(*) values of tumor thrombus group and non-tumor thrombus group were (31.20±12.17) and (24.21±9.90) Hz, the difference also had statistically significant(t=7.397 and 4.534, P=0.000 and 0.000). The AUC of R2(*) values for infiltration and tumor thrombus were 0.804, 0.681. R2(*) ≥24.68 Hz was the threshold value to diagnose the infiltration and tumor thrombus.

CONCLUSION

R2(*) value can be used as a MR non-enhancement quantitative index to evaluate the biological behavior of HCC.

Health risk assessment of organochlorine contaminants in fish from a major lake (Baiyangdian Lake) in North China

Organochlorine contaminants (OCs) in fish were determined to evaluate the potential risk to humans consuming fish originating in Baiyangdian Lake, North China. Relatively low levels of PCBs, HCHs and DDTs were observed, with mean concentrations ranging from 0.28 to 3.28 ng/g, wet weight. Among various fish species tested, the highest burden of OCs was recorded in northern snakehead (7.39 ng/g, wet weight) and the lowest was in grass carp (2.04 ng/g, wet weight). The hazard ratios (HRs), based on noncancer risk were all less than 1.0, while the HRs based on cancer risk exceeded 1.0 only for PCBs based on the 90th percentile concentration.

Modelling the depuration rates of polychlorinated biphenyls in Oncorhynchus mykiss with quantum chemical descriptors

Using quantum chemical descriptors and partial least squares regression, a quantitative structure-activity relationship (QSAR) model is developed for the depuration rate constants (log k(d)) of 62 polychlorinated biphenyls (PCBs) in juvenile rainbow trout (Oncorhynchus mykiss). The values of the cross-validated regression coefficient (Qcum(2)) and standard deviation (SD) are 0.655 and 0.05, respectively. The high cross-validated coefficient and low standard deviation indicate that the QSAR model is well predictive. In the QSAR model, the following six descriptors are highly significant: QH(+) (the most positive charge of a hydrogen atom), HOF (standard heat of formation), CCR (core-core repulsion), EE (electronic energy), alpha(2) (squared average molecular polarisability), and S (molecular surface area). The significant descriptors show that the depuration of PCBs in rainbow trout may be mainly attributed to the biota-water partitioning process, and the reactive activity of PCB molecules may play a subordinate role.

[The development of an all-purpose medical electronic teaching instrument]

This paper introduces a kind of all-purpose medical electronic teaching instrument. According to the modularization design rule, a medical electronic teaching instrument integrated with information transfer, signal processing, keyboard monitoring and signal sampling, etc, can be realized. On the other hand, A/D, D/A, self-detecting of computer, collecting and testing of biological potentials, driving electromotor and generating functional signals, etc can also be realized by the related software based on the system. It has been proved that, by using single-chip processor and computer, the system can implement full-scale test and processing of biomedical signals so that operators can understand the principles and the construction of medical instruments more easily and deeply. Therefore, it is valuable in application of medical electronic coursesteaching, research and etc.

Regulation of transcription of immunoglobulin germ-line gamma 1 RNA: analysis of the promoter/enhancer

Antibody class switching is achieved by recombinations between switch (S) regions which consist of tandemly repeated sequences located 5' to Ig heavy chain constant (CH) region genes. RNA transcripts from specific unrearranged or germ-line Ig CH genes are induced in IgM+ B cells prior to their undergoing class switch recombination to the same CH genes. Thus, the antibody class switch appears to be directed by induction of accessibility, as assayed by transcription of germ line CH genes. For example, IL-4 induces transcripts from the mouse germ-line C gamma 1 and C epsilon genes to which it also directs switch recombination. We report here that the 150 bp region upstream of the first initiation site of RNA transcribed from the murine germ-line C gamma 1 gene, contains promoter and enhancer elements responsible for basal level transcription and inducibility by anti-Ig phorbol myristate acetate (PMA) and for synergy of these inducers with IL-4 in a surface IgM+ B cell line, L10A6.2 and a surface IgG2a+ B cell line, A20.3. Linker-scanning mutations demonstrated that multiple interdependent elements are required for inducibility by PMA and also for synergy with IL-4. Within the 150 bp region are several consensus sequences that bind known or putative transcription factors, including a C/EBP binding site--IL-4 responsive element, four CACCC boxes, a PU box, a TGF beta inhibitory element (TIE), an alpha beta-interferon response element (alpha beta-IRE) and an AP-3 site. The relationship between transcription regulated by these elements and the regulation of endogenous germ-line gamma 1 transcripts and switching to IgG1 is discussed.