Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China: a multicentre, retrospective cohort study

BACKGROUND

The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.

METHODS

We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.

RESULTS

1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.

CONCLUSION

Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.

A combination of QTL mapping and genome-wide association study revealed the key gene for husk number in maize

KEY MESSAGE

Two key genes Zm00001d021232 and Zm00001d048138 were identified by QTL mapping and GWAS. Additionally, they were verified to be significantly associated with maize husk number (HN) using gene-based association study. As a by-product of maize production, maize husk is an important industrial raw material. Husk layer number (HN) is an important trait that affects the yield of maize husk. However, the genetic mechanism underlying HN remains unclear. Herein, a total of 13 quantitative trait loci (QTL) controlling HN were identified in an IBM Syn 10 DH population across different locations. Among these, three QTL were individually repeatedly detected in at least two environments. Meanwhile, 26 unique single nucleotide polymorphisms (SNPs) were detected to be significantly (p < 2.15 × 10-6) associated with HN in an association pool. Of these SNPs, three were simultaneously detected across multiple environments or environments and best linear unbiased prediction (BLUP). We focused on these environment-stable and population-common genetic loci for excavating the candidate genes responsible for maize HN. Finally, 173 initial candidate genes were identified, of which 22 were involved in both multicellular organism development and single-multicellular organism process and thus confirmed as the candidate genes for HN. Gene-based association analyses revealed that the variants in four genes were significantly (p < 0.01/N) correlated with HN, of which Zm00001d021232 and Zm00001d048138 were highly expressed in husks and early developing ears among different maize tissues. Our study contributes to the understanding of genetic and molecular mechanisms of maize husk yield and industrial development in the future.

[Clinical application of non-invasive prenatal testing for twin pregnancies]

OBJECTIVE

To evaluate the feasibility of non-invasive prenatal testing (NIPT) for the screening of fetal chromosome aneuploidies in twin pregnancies.

METHODS

A total of 2 745 women with twin-pregnancies were subjected for NIPT screening. Chromosomal karyotyping and chromosomal microarray analysis (CMA) were carried out on amniotic fluid samples from those with a high risk for fetal chromosome aneuploidies, and the diagnosis and pregnancy outcome were followed up. The sensitivity, specificity, positive predictive value and false positive rate of the NIPT were calculated.

RESULTS

Compared with other chromosomal abnormalities, NIPT had a higher efficacy for trisomy 21 and sex chromosomal aneuploidy (SCA) in twin pregnancies (with sensitivity being 100%, 100%, and specificity being 99.93%, 99.9%, respectively). It is difficult to evaluate the efficacy for trisomies 18 and 13 due to the limited data. For chromosome microdeletions and microduplications spanning 15 ~ 21 Mb, NIPT also had a certain detection rate. Compared with women with natural conception, NIPT had a higher detection rate for those with twin pregnancies by assisted reproduction (P < 0.05).

CONCLUSION

It is feasible to use NIPT for the detection of chromosome aneuploidies in women with twin pregnancies.

Real-world effectiveness of nirmatrelvir-ritonavir versus azvudine in hospitalized patients with COVID-19 during the omicron wave in Beijing: a multicenter retrospective cohort study

BACKGROUND AND AIM

Two oral antivirals (Nirmatrelvir- ritonavir and Azvudine) are widely used in China practice during the Omicron wave of the pandemic. However, little evidence regarding the real-world effectiveness of these two oral antivirals in in-hospital patients. We aimed to evaluate the clinical effectiveness of nirmatrelvir-ritonavir versus azvudine among adult hospitalized patients with COVID-19.

METHODS

This retrospective cohort study used data from three Chinese PLA General Hospital medical centres. Hospitalized patients with COVID-19 treated with azvudine or nirmatrelvir-ritonavir from Dec 10, 2022, to February 20, 2023, and did not require invasive ventilation support on admission were eligible for inclusion.

RESULTS

After exclusions and propensity-score matching, the final analysis included 486 azvudine recipients and 486 nirmatrelvir-ritonavir recipients. By 28 days of initiation of the antivirus treatment, the crude incidence rate of all-cause death was similar in both types of antivirus treatment (nirmatrelvir-ritonavir group 2.8 events 1000 person-days [95% CI, 2.1-3.6] vs azvudine group 3.4 events/1000 person-days [95% CI, 2.6-4.3], P = 0.38). Landmark analysis showed that all-cause death was lower in the nirmatrelvir-ritonavir (3.5%) group than the azvudine (6.8%, P = 0.029) within the initial 10-day admission period, while no significant difference was observed for results between 10 and 28 days follow-up. There was no significant difference between the nirmatrelvir-ritonavir group and the azvudine group in cumulative incidence of the composite disease progression event (8.6% with nirmatrelvir-ritonavir vs. 10.1% with azvudine, HR, 1.22; 95% CI 0.80-1.86, P = 0.43).

CONCLUSION

Among patients hospitalized with COVID-19 during the omicron wave in Beijing, similar in-hospital clinical outcomes on 28 days were observed between patients receiving nirmatrelvir-ritonavir and azvudine. However, it is worth noticing that nirmatrelvir-ritonavir appears to hold an advantage over azvudine in reducing early mortality. Further randomized controlled trials are needed to verify the efficacy of those two antivirus medications especially in early treatment.

Neutrophil extracellular traps in central nervous system (CNS) diseases

Excessive induction of inflammatory and immune responses is widely considered as one of vital factors contributing to the pathogenesis and progression of central nervous system (CNS) diseases. Neutrophils are well-studied members of inflammatory and immune cell family, contributing to the innate and adaptive immunity. Neutrophil-released neutrophil extracellular traps (NETs) play an important role in the regulation of various kinds of diseases, including CNS diseases. In this review, current knowledge on the biological features of NETs will be introduced. In addition, the role of NETs in several popular and well-studied CNS diseases including cerebral stroke, Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), and neurological cancers will be described and discussed through the reviewing of previous related studies.

Development of a ferroptosis-based molecular markers for predicting RFS in prostate cancer patients

The goal of this study was to develop a ferroptosis-based molecular signature that can predict recurrence-free survival (RFS) in patients with prostate cancer (PCa). In this study, we obtained ferroptosis-related genes (FRGs) in FerrDb database and clinical transcriptome data in TCGA database and GEO database. Consensus cluster analysis was used to identify three molecular markers of ferroptosis in PCa with differential expression of 40 FRGs, including PD-L1 expression levels. We conducted a new ferroptosis-related signature for PCa RFS using four FRGs identified through univariate and multivariate Cox regression analyses. The signature was validated in the training, testing, and validation cohorts, and it demonstrated remarkable results in the area under the time-dependent receiver operating characteristic (ROC) curve of 0.757, 0.715, and 0.732, respectively. Additionally, we observed that younger patients, those with stage T III and stage T IV, stage N0, cluster 1, and cluster 2 PCa were more accurately predicted by the signature as independent predictors of RFS. DU-145 and RWPE-1 cells were successfully analyzed by qRT-PCR and Western blot for ASNS, GPT2, RRM2, and NFE2L2. In summary, we developed a novel ferroptosis-based signature for RFS in PC, utilizing four FRGs identified through univariate and multivariate Cox regression analyses. This signature was rigorously validated across training, testing, and validation cohorts, demonstrating exceptional performance as evidenced by its ROC curves. Notably, our findings indicate that this signature is particularly effective as an independent predictor of RFS in younger patients or those with stage T III and T IV, stage N0, and in clusters 1 and 2. Finally, we confirmed the expression of these four FRGs in DU-145 and RWPE-1 cell lines.

Prenatal diagnosis of mosaic chromosomal aneuploidy and uniparental disomy and clinical outcomes evaluation of four fetuses

BACKGROUND

Few co-occurrence cases of mosaic aneuploidy and uniparental disomy (UPD) chromosomes have been reported in prenatal periods. It is a big challenge for us to predict fetal clinical outcomes with these chromosome abnormalities because of their highly heterogeneous clinical manifestations and limited phenotype attainable by ultrasound.

METHODS

Amniotic fluid samples were collected from four cases. Karyotype, chromosome microarray analysis, short tandem repeats, and whole exome sequencing were adopted to analyze fetal chromosomal aneuploidy, UPD, and gene variation. Meanwhile, CNVseq analysis proceeded for cultured and uncultured amniocytes in case 2 and case 4 and MS-MLPA for chr11 and chr15 in case 3.

RESULTS

All four fetuses showed mosaic chromosomal aneuploidy and UPD simultaneously. The results were: Case 1: T2(7%) and UPD(2)mat(12%). Case 2: T15(60%) and UPD(15)mat(40%). Case 3: 45,X(13%) and genome-wide paternal UPD(20%). Case 4: <10% of T20 and > 90% UPD(20)mat in uncultured amniocyte. By analyzing their formation mechanism of mosaic chromosomal aneuploidy and UPD, at least two adverse genetic events happened during their meiosis and mitosis. The fetus of case 1 presented a benign with a normal intrauterine phenotype, consistent with a low proportion of trisomy cells. However, the other three fetuses had adverse pregnancy outcomes, resulting from the UPD chromosomes with imprinted regions involved or a higher level of mosaic aneuploidy.

CONCLUSION

UPD is often present with mosaic aneuploidy. It is necessary to analyze them simultaneously using a whole battery of analyses for these cases when their chromosomes with imprinted regions are involved or known carriers of a recessive allele. Fetal clinical outcomes were related to the affected chromosomes aneuploidy and UPD, mosaic levels and tissues, methylation status, and homozygous variation of recessive genes on the UPD chromosome. Genetic counseling for pregnant women with such fetuses is crucial to make informed choices.

Secondary Metabolite Analysis of Phomopsis sp. LGT-5 Based on the Dual Guidance of Whole-genome Sequencing and HPLC-Q-ToF-MS/MS

Microorganisms produce a wealth of structurally diverse specialized metabolites with a remarkable range of biological activities. The Phomopsis sp. LGT-5 was obtained through tissue block and repeatedly crossed methods from Tripterygium wilfordii Hook. F. The antibacterial experiments of LGT-5 showed that it has high inhibitory activity against Staphylococcus aureus and Pseudomonas aeruginosa, and moderate inhibitory activity against Candida albicans. To research the generation of the antibacterial phenomenon of LGT-5 and provide support for further research and application, the whole genome sequencing (WGS) of LGT-5 was obtained by single-molecule real-time DNA sequencing platform Pacific Biosciences (PacBio) sequencing and Illumina paired-end sequencing. The final assembled LGT-5 genome is 54.79 Mb with a contig N50 of 290.07 kb; in addition, its secondary metabolites were detected through HPLC-Q-ToF-MS/MS. By comparing its MS/MS data, the secondary metabolites were analyzed based on visual network maps obtained on the Global Natural Products Social Molecular Networking (GNPS). The analysis results showed that the secondary metabolites of LGT-5 were triterpenes and various cyclic dipeptides.

GWAS across multiple environments and WGCNA suggest the involvement of ZmARF23 in embryonic callus induction from immature maize embryos

Combined GWAS, WGCNA, and gene-based association studies identified the co-expression network and hub genes for maize EC induction. ZmARF23 bound to ZmSAUR15 promoter and regulated its expression, affecting EC induction. Embryonic callus (EC) induction in immature maize embryos shows high genotype dependence, which limits the application of genetic transformation in transgenic breeding and gene function elucidation in maize. Herein, we conducted a genome-wide association mapping (GWAS) for four EC induction-related traits, namely rate of embryonic callus induction (REC), increased callus diameter (ICD), ratio of shoot formation (RSF), and length of shoot (LS) across different environments. A total of 77 SNPs were significantly associated these traits under three environments and using the averages (across environments). Among these significant SNPs, five were simultaneously detected under multiple environments and 11 had respective phenotypic variation explained > 10%. A total of 257 genes were located in the linkage disequilibrium decay of these REC- and ICD-associated SNPs, of which 178 were responsive to EC induction. According to the expression values of the 178 genes, we performed a weighted gene co-expression network analysis (WGCNA) and revealed an EC induction-associated module and five hub genes. Hub gene-based association studies uncovered that the intragenic variations in GRMZM2G105473 and ZmARF23 influenced EC induction efficiency among different maize lines. Dual-luciferase reporter assay indicated that ZmARF23 bound to the promoter of a known causal gene (ZmSAUR15) for EC induction and positively regulated its expression on the transcription level. Our study will deepen the understanding of genetic and molecular mechanisms underlying EC induction and contribute to the use of genetic transformation in maize.

Association studies of genes in a Pb response-associated network in maize (Zea mays L.) reveal that ZmPIP2;5 is involved in Pb tolerance

Lead (Pb) in the soil affects the growth and development of plants and causes damages to the human body through the food chain. Here, we identified and cloned a Pb-tolerance gene ZmPIP2;5 based on a weighted gene co-expression network analysis and gene-based association studies. We showed that ZmPIP2;5 encodes a plasma membrane aquaporin and positively regulated Pb tolerance and accumulation in Arabidopsis and yeast. Overexpression of ZmPIP2;5 increased root length and fresh weight of Arabidopsis seedlings under Pb stress. Heterologous expression of ZmPIP2;5 in yeast caused the enhanced growth speed under Pb treatment and Pb accumulation in yeast cells. A (T/A) SNP in the ZmPIP2;5 promoter affected the expression abundance of ZmPIP2;5 and thereby led to the difference in Pb tolerance among different maize lines. Our study helps to understand the mechanism underlying plant tolerance to Pb stress and provides new ideas for breeding Pb-tolerance maize varieties via molecular marker-assisted selection.

Combined linkage mapping and association analysis uncovers candidate genes for 25 leaf-related traits across three environments in maize

Combined linkage and association analysis revealed five co-localized genetic loci across multiple environments. The key gene Zm00001d026491 was further verified to influence leaf length by candidate gene association analysis. Leaf morphology and number determine the canopy structure and thus affect crop yield. Herein, the genetic basis and key genes for 25 leaf-related traits, including leaf lengths (LL), leaf widths (LW), and leaf areas (LA) of eight continuous leaves under the tassel, and the number of leaves above the primary ear (LAE), were dissected by using an association panel and a biparental population. Using an intermated B73 × Mo17 (IBM) Syn10 doubled haploid (DH) population, 290 quantitative trait loci (QTL) controlling these traits were detected across different locations, among which 115 QTL were individually repeatedly identified in at least two environments. Using the association panel, 165 unique significant single-nucleotide polymorphisms (SNPs) were associated with target traits (P < 2.15E-06), of which 35 were separately detected across multiple environments. In total, 42 pleiotropic QTL/SNPs (pQTL/SNPs) were responsible for at least two of the LL, LW, LA, and LAE traits across multiple environments. Combining the QTL mapping and association study, five unique SNPs were located within the confidence intervals of seven QTL, and 77 genes were identified based on the linkage disequilibrium regions of co-localized SNP loci. Gene-based association studies verified that the intragenic variants in the candidate gene Zm00001d026491 influenced LL of the third leaf counted from the top node. These findings will provide vital information to understanding the genetic basis of leaf-related traits and help to cultivate maize varieties with ideal plant architecture.

Correlation between health literacy and health‐related quality of life in patients with diabetic peripheral neuropathy: The mediating role of self‐management

AIM

The aims of the study were to analyse the current situation of health literacy (HL), self-management and health-related quality of life (HRQOL) in patients with diabetic peripheral neuropathy (DPN), to explore the correlation between the three and to verify the mediating role of self-management in HL and HRQOL.

DESIGN

A cross-sectional survey.

METHODS

The convenience sampling method was used to select 401 DPN patients attending the First Hospital of Jinzhou Medical University in Liaoning Province, China, from December 2020 to December 2021 as the study population. The research instrument included socio-demographic characteristics questionnaire, Health Literacy Management Scale (HeLMS), Summary of Diabetes Self-Care Activities (SDSCA) and Short-Form 12-item Health Survey (SF-12). SPSS 25.0 was applied to the data for descriptive analysis, Pearson correlation analysis and stratified multiple regression analysis. Mediating effects were tested using SPSS PROCESS macro 4.0 software.

RESULTS

HL and self-management of DPN patients correlated positively with HRQOL. The mediation role of self-management was significant in the relationship between HL and physical and mental HRQOL (physical component summary: β = 0.26, P < 0.01; mental component summary: β = 0.18, P < 0.01), with mediating effects accounting for 35.62% and 34.62% of the total effect.

CONCLUSIONS

There was a positive correlation between HL, self-management and HRQOL in patients with DPN. Self-management plays a partially mediating role in the relationship between HL and HRQOL in DPN patients. It means that HRQOL in this population can be improved by increasing HL and thus self-management in DPN patients.

PATIENT OR PUBLIC CONTRIBUTION

None.

An Integration of Linkage Mapping and GWAS Reveals the Key Genes for Ear Shank Length in Maize

Ear shank length (ESL) has significant effects on grain yield and kernel dehydration rate in maize. Herein, linkage mapping and genome-wide association study were combined to reveal the genetic architecture of maize ESL. Sixteen quantitative trait loci (QTL) were identified in the segregation population, among which five were repeatedly detected across multiple environments. Meanwhile, 23 single nucleotide polymorphisms were associated with the ESL in the association panel, of which four were located in the QTL identified by linkage mapping and were designated as the population-common loci. A total of 42 genes residing in the linkage disequilibrium regions of these common variants and 12 of them were responsive to ear shank elongation. Of the 12 genes, five encode leucine-rich repeat receptor-like protein kinases, proline-rich proteins, and cyclin11, respectively, which were previously shown to regulate cell division, expansion, and elongation. Gene-based association analyses revealed that the variant located in Cyclin11 promoter affected the ESL among different lines. Cyclin11 showed the highest expression in the ear shank 15 days after silking among diverse tissues of maize, suggesting its role in modulating ESL. Our study contributes to the understanding of the genetic mechanism underlying maize ESL and genetic modification of maize dehydration rate and kernel yield.

Analysis of influencing factors on the plasma concentration of first-line anti-tuberculosis drugs-a single-center retrospective cohort study

Background

The four most commonly used first-line anti-tuberculosis (TB) drugs in clinical practice are isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA). The plasma concentration of anti-TB drugs is an important factor influencing the effectiveness of TB treatment. Factors affecting blood concentration of antituberculosis drugs have not been elaborated clearly. The purpose of this study is to investigate the status of plasma concentration of anti-TB drugs, explore the factors influencing anti-TB drug plasma concentration, and guide the rational use of clinical drugs.

Methods

This is a single-center retrospective cohort study. Patients with pulmonary TB received first-line anti-TB drugs in the 309th Hospital of the PLA from June 2014 to September 2018 were investigated. The primary endpoint was factors affecting the anti-tuberculosis drug plasma concentration which were determined by high performance liquid chromatography-mass spectrometry. The factors influencing plasma concentration analyzed by the multiple linear regression model.

Results

A total of 205 patients were included in the study. The rates of patients with substandard 2-hour plasma concentrations of INH, RFP, EMB, and PZA were 45.8%, 54.4%, 37.7%, and 52.9%, respectively. Intravenous administration of INH (P<0.001) significantly increased plasma concentrations compared with oral administration, and its plasma concentration was negatively correlated with blood uric acid levels (P=0.001). RFP 2-hour plasma concentrations were positively correlated with serum albumin levels (P=0.04). EMB 2-hour plasma concentrations were positively correlated with age (P=0.01), dose (P<0.001), and serum creatinine levels (P<0.001). PZA 2-hour plasma concentrations were positively correlated with dose (P<0.001) and total bilirubin levels (P<0.001), and were negatively correlated with blood urea nitrogen levels (P=0.001).

Conclusions

Age, gender, dose, intravenous administration, retreatment, blood uric acid level, serum albumin level, serum creatinine level, total bilirubin level, and blood urea nitrogen level were independent influencing factors of anti-TB drug plasma concentration. During anti-TB treatment, plasma concentration monitoring is essential and helpful to optimize the drug dose and carry out individualized treatment regimen.

2+0 CYP21A2 deletion carrier — a limitation of the genetic testing and counseling: A case report

BACKGROUND

CYP21A2 gene mutations may all cause reduction or loss of 21-hydroxylase activity, leading to development of congenital adrenal hyperplasia (CAH) with different clinical phenotypes. For families with CAH children, genetic testing of the parents and genetic counseling are recommended to assess the risk of recurrence.

CASE SUMMARY

We report a case of CAH with a high suspicion before delivery. The risk of the child suffering from CAH during the pregnancy had been underestimated due to the deviation of genetic counseling and genetic testing results. Our report confirmed a CYP21A2 homozygous deletion in this case, CYP21A2 heterozygous deletion in the mother, and a rare 2+0 CYP21A2 deletion in the father.

CONCLUSION

It is important to analyze the distribution of CYP21A2 gene in the two alleles of parents of children with CAH.

Prenatal Diagnosis of Holt-Oram Syndrome With a Novel Mutation of TBX5 Gene: A Case Report

Background: Holt-Oram syndrome (HOS) is an autosomal dominant disorder caused by mutations of TBX5 gene. Case presentation: We report a fetus with HOS diagnosed sonographically at 23 weeks of gestation. The fetal parents are non-consanguineous. The fetus exhibited short radius and ulna, inability to supinate the hands, absence of the right thumb, and heart ventricular septal defect (VSD), while the fetal father exhibited VSD and short radius and ulna only. Fetal brother had cubitus valgus and thumb adduction, except for VSD, short radius and ulna. The pregnancy was terminated. Whole-exome sequencing (WES) revealed a novel mutation in the TBX5 (c.510+1G>A) in the fetus inherited from the father. The variant (c.510+1G>A) occurs at splice donor and may alter TBX5 gene function by impact on splicing. It was not previously reported in China. Conclusion: Our case reported a novel mutation in TBX5, which expanded the known genetic variants associated with HOS.

Does total hip arthroplasty provide better outcomes than hemiarthroplasty for the femoral neck fracture? A systematic review and meta-analysis

PURPOSE

By comparing the outcomes of total hip arthroplasty with hemiarthroplasty in elderly patients with a femoral neck fracture to investigate the one-year mortality, dislocation, infection, reoperation rate, and thromboembolic event.

METHODS

The PubMed, EMBASE databases, and Cochrane library were systematically searched from the inception dates to April 1, 2020 for relevant randomized controlled trials in English language using the keywords: "total hip arthroplasty", "hemiarthroplasty" and "femoral neck fracture" to identify systematic reviews and meta-analyses. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration' stools, and discussed any disagreements. The third reviewer was consulted for any doubts or uncertainty. We derived risk ratios and 95% confidence intervals. Mortality was defined as the primary outcome. Secondary outcomes were other complications, dislocation, infection, reoperation rate, and thromboembolic event.

RESULTS

This meta-analysis included 10 studies with 1419 patients, which indicated that there were no significant differences between hemiarthroplasty and total hip arthroplasty in reoperation, infection rate, and thromboembolic event. However, there was a lower mortality and dislocation rate association with total hip arthroplasty at the one-year follow-up.

CONCLUSION

Based on our results, we found that total hip arthroplasty was better than hemiarthroplasty for a hip fracture at one-year follow-up.

[Prenatal diagnosis of a case of Pallister-Killian syndrome]

OBJECTIVE

To carry out G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA) for a fetus featuring multiple malformations.

METHODS

The fetus was found to have increased nuchal thickness, generalized edema, asymmetric lower limbs, tetralogy of Fallot, nasal bone anomaly and cleft palate. Following amniocentesis, G-band karyotyping and CMA were carried out.

RESULTS

The fetus had a karyotype of 47,XX,+i(12)(p10) [14]/46,XX[6]. CMA has identified a 33.9 Mb duplication at 12p13.33-p11.1, which was suggestive of tetrasomy 12p.

CONCLUSION

Combined chromosomal karyotyping and CMA can delineate the origin of abnormal chromosomal fragments during prenatal diagnosis. The fetus was diagnosed with Pallister-Killian syndrome.

A new frameshift mutation in L1CAM producing X-linked hydrocephalus

Background

X‐linked hydrocephalus (XLH), characterized by mental retardation and bilateral adducted thumbs, often come out to be a genetic disorder of L1CAM. It codes the protein L1 cell adhesion molecule (L1CAM), playing a crucial role in the development of the nervous system. The objective of the study was to report a new disease‐causing mutation site of L1CAM, and gain further insight into the pathophysiology of hydrocephalus.

Methods

We collect the samples of a couple and their second hydrocephalic fetus. Then, the whole‐exome sequencing and in‐depth mutation analysis were performed.

Results

The variant c.2491delG (p.V831fs), located in the exon 19 of L1CAM (chrX:153131214), could damage the L1CAM function by producing a frameshift in the translation of fibronectin type‐III of L1CAM.

Conclusion

We identified a novel disease‐causing mutation in L1CAM for the first time, which further confirmed L1CAM as a gene underlying XLH cases.

Whole exome sequencing identifies c.963T > A and c.492 + 1G > A mutations in REN responsible for autosomal recessive renal tubular dysgenesis

AIM

This study was aimed to identify the potentially pathogenic gene variants that contribute to the etiology of the autosomal recessive renal tubular dysgenesis (RTD) in the aborted fetus.

METHODS

Illumina infinium global screening array was used to analyze chromosome karyotype of the aborted fetus. The exomes of the aborted fetus and his parents were sequenced using the whole exome sequencing technology. The resulting variants from whole exome sequencing were filtered by basic and advanced biological information analysis and the candidate mutation was verified by Sanger sequencing.

RESULTS

Trisomy in chromosome 10 was found in the aborted fetus. The exon heterozygous variant of c.963T > A (p.Y321X) (nonsense mutation) and intron heterozygous variant of c.492 + 1G > A (splicing site mutation) in REN was first identified and validated by Sanger sequencing. Moreover, the exon heterozygous variant of c.963T > A (p.Y321X) and intron heterozygous variant of c.492 + 1G > A was from the mother and father, respectively.

CONCLUSION

Our results reported the novel exon heterozygous variant of c.963T > A (p.Y321X) and intron heterozygous variant of c.492 + 1G > A in REN may contribute to autosomal recessive RTD, expanding our understanding of the causally relevant mutations for this disorder.

Identification of a novel heterozygous missense mutation of SEMA3E (c.1327G>A; p. Ala443Thr) in a labor induced fetus with CHARGE syndrome

BACKGROUND

CHARGE syndrome is a complex multisystem genetic disease. We aimed to find the potential gene mutation in the labor induced fetus with CHARGE syndrome.

METHODS

Genomic DNA was extracted from the fetal thigh muscle tissue and the peripheral blood of his parents. The resulting exomes were sequenced using whole exome sequencing (WES) followed by the selection of the candidate causative mutation genes. The deleteriousness of the identified variants was predicted. Analysis of multiple alignment of protein sequences and protein conserved domains was performed by online software. Finally, Sanger sequencing was applied for validation of the identified variants in the WES.

RESULTS

After sequencing and bioinformatics filtering, a heterozygous missense mutation of SEMA3E (c.1327G>A; p. Ala443Thr) was found in the fetus, while the mutation was absent in his parents. Genotyping results showed that the mutation cosegregated fully with definite CHARGE phenotypes between the fetus and his parents. This change was located in the Sema superfamily and highly conserved across different species. Sanger validation result was consistent with the WES analysis.

CONCLUSION

Our investigations suggested that the heterozygous missense mutation of SEMA3E (c.1327G>A; p. Ala443Thr) may be a potential causal variant in the fetus with CHARGE syndrome.

[Prenatal diagnosis for a pregnant woman affected with Williams-Beuren syndrome]

OBJECTIVE

To carry out genetic diagnosis for a pregnant woman and her fetus.

METHODS

Chromosome G-banding and microarray analysis were used to analyze the woman featuring dysmorphism and recognition defect and her fetus featuring developmental retardation.

RESULTS

The karyotype of the woman was normal, but chromosome microarray analysis showed that she has carried a 1423 kb deletion at 7q11.23 region. Her fetus has carried a 1530 kb deletion at the same region. Both individuals were diagnosed as Williams-Beuren syndrome.

CONCLUSION

Familiarity with its clinical features and proper selection of genetic testing methods are crucial for the diagnosis of Williams-Beuren syndrome.

Quantum Criticality of the Ising-like Screw Chain Antiferromagnet SrCo_{2}V_{2}O_{8} in a Transverse Magnetic Field

The quantum criticality of an Ising-like screw chain antiferromagnet SrCo_{2}V_{2}O_{8}, with a transverse magnetic field applied along the crystalline a axis, is investigated by ultralow temperature NMR measurements. The Néel temperature is rapidly and continuously suppressed by the field, giving rise to a quantum critical point (QCP) at H_{C_{1}}≈7.03  T. Surprisingly, a second QCP at H_{C_{2}}≈7.7  T featured with gapless excitations is resolved from both the double-peak structure of the field-dependent spin-lattice relaxation rate 1/^{51}T_{1} at low temperatures and the weakly temperature-dependent 1/^{51}T_{1} at this field. Our data, combined with numerical calculations, suggest that the induced effective staggered transverse field significantly lowers the critical fields, and leads to an exposed QCP at H_{C_{2}}, which belongs to the one-dimensional transverse-field Ising universality.

Effects of Cantharidin and Norcantharidin on Larval Feeding and Adult Oviposition Preferences of the Diamondback Moth (Lepidoptera: Plutellidae)

The diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae), is a destructive insect pest of cruciferous plants that has developed resistance to almost every listed commercial insecticide. Cantharidin as an animal-derived biopesticide is a natural defensive compound produced by Meloidae insects with toxicity to many insects including P. xylostella. Norcantharidin is an important substitute of cantharidin and has similar insecticidal activities to cantharidin. Although the toxicity of cantharidin and norcantharidin to P. xylostella has been reported, little research has focused on the effects of cantharidin or norcantharidin on the behavior of P. xylostella. In this study, we investigated the feeding behavior of third-instar larvae and the oviposition preference of adult P. xylostella in order to explore the effects of different concentrations of cantharidin and norcantharidin. Results show that cantharidin and norcantharidin have antifeedant effect on P. xylostella larvae. The values for AFC50 were 13.0228 and 149.4210 mg/ml, respectively. Furthermore, the oviposition deterrence rate of cantharidin on P. xylostella ranged from 49.37 to 58.24% and that of norcantharidin was from 20.88 to 33.33%. These results suggest cantharidin and norcantharidin may have repellent and antifeedant effect on P. xylostella, which could contribute toward using biopesticides to manage P. xylostella and may provide a new strategy for integrated pest management.

Microemulsion formulation of a new biopesticide to control the diamondback moth (Lepidoptera: Plutellidae)

This study was designed to develop a microemulsion formulation of norcantharidin for the control of the diamondback moth (DBM), Plutella xylostella (Linnaeus), a notorious pest of brassica crops worldwide. The oil phase was screened and selected based on norcantharidin solubility while the surfactants were selected on the basis of their efficiency to form microemulsion. Optimized batches were selected using pseudo ternary phase diagrams. The microemulsion system were stabilized using mixtures composed of norcantharidin, surfactants (Tx13 and Tw80), and cosurfactant (ethanol). Its physicochemical characteristics were also demonstrated to have a higher cloud point than 72 °C as well as good thermodynamic and dilution stability. In additon, a subsequent insecticidal bioassay indicated that the acute LC50 for norcantharidin microemulsion to P. xylostella was estimated to be 12.477 mg/L (11.58-13.41, 95% CL). Our results provide an environment-friendly promising alternative to control P. xylostella and possibly contribute to ameliorating any pesticide resistance in P. xylostella.

Bio-syncretic tweezers actuated by microorganisms: modeling and analysis

Advancements in micro-/nano-technology have led to the development of micro-manipulators. However, some challenges remain; for instance, the efficiency, precision and flexibility of micro-manipulators restrain their applications. This paper proposes a bio-tweezer system to flexibly manipulate micro-objects with bio-actuation via local light-induced high-concentration microorganisms in two different manipulation modes: light-spot induced mode and geometric shape-induced mode. Depending on the shape of micro-objects, either 2-dimensional translation or 1-dimensional rotation can be achieved. Based on the Langevin equation, a mathematical model considering both hydrodynamics and mimicked Brownian motion is proposed to analyze the bio-manipulation performance of the microorganisms; the model was validated by experiments to translate micro-particles in a two-dimensional plane and to rotate a micro-gear structure around its axis. This paper will aid in the development of micro-manipulators and the quantitative understanding of micro-/nano-manipulation actuated by microorganisms.

Toxicity, bio-distribution and metabolism of CO-releasing molecules based on cobalt

CO-releasing molecules (CORMs) containing [Co2(CO)6] moiety show many bioactivities, such as anti-inflammatory and antitumor cell proliferation. However, so far, no one knows their properties in vivo. So, here, we evaluated some these kind CORMs from drug-like properties including cytotoxicity, toxicity in vivo, distribution and metabolism. The results show all the tested complexes displayed antiproliferative activity to HeLa cell and HepG2 cell lines, and their IC50 values were 36-110µM against HeLa cells and 39-140µM against HepG2 cells. Toxicity tests of mice, we used oral acute toxic class method and got their LD50 values; among them, LD50 of complex 1 and complex 4 were in 2500-5000mgkg(-1) and complex 7 over 5000mgkg(-1). The developmental toxicities of the complexes were investigated in embryonic zebrafish. The mortality, hatch rate, malformation, heart rate, spontaneous movement, and larval behavior were examined, and we found both complexes 4 and 7 have not toxicity at low concentration (<1.0μM) but have higher toxicity at high concentration (>5.0μM). After several consecutive i.p administrations, tested complexes severely damaged rat liver and kidney in both functional and morphological aspects. Through metal ion measurement using ICP-AES, we found the tested complexes were unevenly distributed in tissues and organs; complex 4 has a big prone to collect in liver, whereas complex 7 easily enters to kidney. After administration 480min later, most of complex 7 excreted from kidney and entered urine, while complex 4 needed 9h at least. This results show cobalt did not accumulate, and could excrete with the urine. In vivo, Co(0) in complexes was oxidised to Co(II). In addition, the substituents significantly affected the rate of CO-release, cytotoxicity and their bio-distribution. In the view of these aspects, the CORMs based cobalt has a potential property to be a medicine.

[Toxicology and bioactivities of CO-releasing molecules based on cobalt complexes]

Complexes containing cobalt and carbon monoxide ligands, CO releasing molecules(CORMs), have the potential of anti-tumor and anti-inflammatory. In this paper, three hybrid CORMs 1-3 were synthesized and tested for their toxicology in vivo and bioactivities. The results suggest that the complexes have a long half-life in the range of 43-53 min; their oral LD(50) to mouse are between 1 500 mg·kg(-1) and 5 000 mg·kg(-1). After the successive administration, complex 1 exhibited a toxic activity in rats’ liver, and induced an injury to liver cells. Complex 1 had a strong growth inhibition activity(IC(50) 36.20 μmol·L(-1) and 39.25 μmol·L(-1)) in both He La cells and Hep G2 cells, complex 2 displayed a lower activity in the inhibition of He La cells proliferation than the control 5-FU(IC(50) 114.19 μmol·L(-1)), but had a higher activity in the inhibition of Hep G2 cells than the control 5-FU(IC(50) 171.34 μmol·L(-1)). The anti-inflammatory study suggests that all of them reduce intracellular nitrite level, complexes 1 and 2 have a stronger activity than complex 3. Their anti-inflammatory activity attributes to the CO molecules of the CORMs, which was confirmed by comparison with the corresponding ligand.

[Detection of chromosomal aneuploidies in spontaneous abortion samples by fluorescence in situ hybridization]

OBJECTIVE

To analyze 81 spontaneous abortion samples with fluorescence in situ hybridization (FISH).

METHODS

Chromosome 13, 21, 16, 22, 18, X and Y probes were used to detect the samples.

RESULTS

FISH was successful in 80 cases (98.77%). Among these, 35 (43.75%) had an abnormal karyotype, which included 19 autosomal aneuploidies, 6 sex chromosome aneuploidies, 9 triploidies and 1 tetraploidy.

CONCLUSION

FISH is a rapid and easy method for detecting chromosomal aneuploidies in spontaneous abortion samples, and has a higher detection rate in early spontaneous abortion samples.

Nanoscale distribution of CD20 on B-cell lymphoma tumour cells and its potential role in the clinical efficacy of rituximab

Rituximab is an exciting monoclonal antibody drug approved for treating B-cell lymphomas and its target is the CD20 antigen which is expressed on the surface of B cells. In recent years, the variable efficacies of rituximab among different lymphoma patients have become an important clinical issue and urgently need to be solved for further development of antibodies with enhanced efficacies. In this work, atomic force microscopy (AFM) was used to investigate the nanoscale distribution of CD20 on the surface of tumour B cells from lymphoma patients to examine its potential role in the clinical therapeutic effects of rituximab. By performing ROR1 fluorescence labelling (ROR1 is a specific tumour cell surface marker) on the bone marrow cells prepared from B-cell lymphoma patients, the tumour B cells were recognized, and then AFM tips carrying rituximabs via polyethylene glycol crosslinkers were moved to the tumour cells to probe the specific CD20-rituximab interactions. By applying AFM single-molecule force spectroscopy (SMFS) at the local areas (500×500 nm²) on the surface of tumour B cells, the nanoscale distributions of CD20 on the surface of tumour B cells were mapped, visually showing that CD20 distributed heterogeneously on the cell surface. Bone marrow cell samples from three clinical B-cell lymphoma cases were collected to analyze the binding affinity and nanoscale distribution of CD20 on tumour cells. The experimental results showed that CD20 distribution on tumour cells were to some extent related to the clinical therapeutic outcomes while the CD20-rituximab binding forces did not have distinct effects to the clinical outcomes. These results can provide novel insights in understanding the rituximab's clinical efficacies from the nanoscale distribution of CD20 on the tumour cells at single-cell and single-molecule levels.

Gate dependent photo-responses of carbon nanotube field effect phototransistors

Gate dependent photoconductivity of carbon nanotube (CNT) field effect phototransistors (FEPs) was systematically investigated in this study. The photo-response comparisons of CNT FEPs with symmetric and asymmetric metal structures connecting to the same CNT revealed that the gate effect contributed to a sensitivity improvement with a lower dark current, a higher photocurrent, and an enhanced photovoltage. A functionalized asymmetric FEP, fabricated by partially doping the CNT utilizing a polyethylene imine (PEI) polymer, verified that FEPs delivered a better performance by using asymmetric structures. A multi-gate FEP, with three pairs of side-gates that can electrostatically dope different sections of a CNT independently, was fabricated to examine the gate structure dependent photo-responses. Experimental measurements showed an unconventional photocurrent improvement that was weakly dependent on the gate location, which was attributed to the unique charge distribution of one-dimensional semiconductors.

Childhood psoriasis treatment: evidence published over the last 5 years

Psoriasis is a common skin condition seen in pediatrics. Treatment modalities used to treat psoriasis in children are different from those prevailing in the adult population and require adequate testing in pediatric subjects. This article reviews the published evidence on the different treatment modalities for pediatric psoriasis over the past 5 years.

[Preparation and in vitro drug release study of long-circulating hydroxycamptothecin nanoparticles]

OBJECTIVE

To prepare long-circulating hydroxycamptothecin nanoparticles and study its in vitro drug release characteristics.

METHODS

The HCPT-PEG-PCL-NPs were prepared by solvent-diffusion method using PEG-PCL block copolymer synthesized as a matrix and HCPT as an antitumor agent. Then the obtained NPs were evaluated and its in vitro drug release characteristics were investigated.

RESULTS

When using PEG4000-PCL2000, PEG4000-PCL1250, PEG2000-PCL2000, PEG2000-PCL1250 as the carrier material to prepare NPs, the average particle size of NPs in turn were 116.1, 110.0, 119.9, 99.1 nm; the zeta potential were -22.4, - 16. 9, -33.5, - 28.8 mV; the entrapment efficiency were 88.29%, 83.10%, 80.67%, 77.46%; and the drug loading were 2.96%, 2.56%, 2.31%, 2.14%, respectively. HCPT-PEG-PCL-NPs all showed a certain degree of sustained-release characteristics and their release mechanisms were fitted to Weibull modle, which showed that the drug release process included passive diffusion and matrix-eroded procedure.

CONCLUSION

The HCPT-PEG-PCL-NPs has high entrapment efficiency, drug loading, uniform particle size, and can retard drug release in vitro, so it provides an extensive prospect for clinical application of HCPT.

[Preparation and characterization of hydroxycamptothecin nanoparticles of amphiphilic block copolymer]

OBJECTIVE

To prepare hydroxycamptothecin nanoparticles of amphiphilic block copolymer and study its characterization initially.

METHODS

Polyethyleneglycol-polycaprolactone (PEG-PCL) was synthesized and its structure was characterized by 1H-NMR. The HCPT-PEG-PCL-NPs were prepared by solvent-diffusion method using PEG-PCL block copolymer as a matrix and HCPT as an antitumor agent. Then the obtained NPs were evaluated and the physical stabilities of both suspl and freeze drying powder were investigated.

RESULTS

The mean particle size of the prepared NPs was 164.5 nm, polydispersity index (PI) was 0.14, drug loading (DL) was 5.49%, entrapment efficiency (EE) was 83.2%, zeta potential was -26.1 mV. The physical stability of freeze drying powder was better and hot environment seemed to be bad for the stability.

CONCLUSION

The HCPT-PEG-PCL-NPs increase the solubility of HCPT in water and are valuable for the development of the novel dosage form of HCPT.

Force measurement and mechanical characterization of living Drosophila embryos for human medical study

The objective of this paper is to investigate and characterize the force behaviour and mechanical properties of living Drosophila embryos using an in situ polyvinylidene fluoride (PVDF) piezoelectric microforce-sensing tool with a resolution in the range of submicro newtons. The Drosophila embryo is one of the most studied organisms in biological research, medical research, genetics, and developmental biology and has implications in the cure of human diseases. It is also used to study the wiring of the human brain and the nervous system. For a highly efficient and accurate microinjection of genetic material into a Drosophila embryo, it is absolutely necessary to allow close monitoring of the magnitude and direction of microinjection and other biomanipulation forces acting on the embryo during the injection process. In this paper, a networked microrobotic biomanipulation platform integrating a twoaxis (two-dimensional) PVDF microforce-sensing tool is used to implement force sensing and injection of living Drosophila embryos. Based on the event synchronization for the feedback of injection video and microforce, the developed networked microrobotic platform can greatly advance operations in microinjection and biomanipulation. Through experiments, quantitative relationships between the applied force and membrane structural deformation of embryos in different stages of embryogenesis and their microinjection force behaviours were investigated. Ultimately, the technology will provide a critical and major step towards the development of automated biomanipulation for batch injection of living embryos in genetic and developmental studies, which will facilitate the development of medicine for the cure of human diseases.

[Preparation of 10-hydroxycamptothecin semisolid lipid nanoparticles and investigation of its stability]

OBJECTIVE

To prepare 10-hydroxycamptothecin-semisolid lipid nanoparticles (HCPT-SSLN) and investigate its stability.

METHODS

HCPT-SSLN was prepared by the method of "emulsion evaporation at a high temperature and solidification at a low temperature"; The morphology was examined by transmission electron microscope; The particle size and xi potential were determined by laser granularity equipment; The physical stability of both suspl and freeze drying powder of HCPT-SSLN were investigated.

RESULTS

The mean particle size of the prepared HCPT-SSLN was 130.5 nm, drug loading was 2.51%, entrapment efficiency was 79.19%, xi potential was -33.1 mV; Placed at room temperature and 4 degrees C for 6 months, the appearance, particle size and entrapment efficiency of HCPT-SSLN were all stable. Moreover, the freeze drying powder was more stable than the suspl.

CONCLUSION

The HCPT-SSLN has high entrapment efficiency and drug loading, uniform particle size, good stability, which initially indicates that HCPT is fit for being incorporated into SSLN.

[Preparation and surface modification of the magnetic fluid as a targeted drug carrier]

Magnetic fluid containing Fe(3)O(4) as mother nucleus was prepared by chemical coprecipitation and treated with dextran-70 for surface modification. The dextran-70-modified magnetic fluid was reacted with 6-bromohexanoic acid and their chemical stability was studied, with the structure characterized by using laser granulometer, X-ray diffraction, Fourier-transform infrared analysis and transmission electron microscopy. The results showed that the magnetic fluid with surface modification by dextran-70 exhibited high stability in the presence strong alkali or acid. No chemical changes occurred in the magnetic Fe(3)O(4) nucleus surrounded by alkali-treated dextran-70 and the organic chain linked to the surface dextran rendered the reaction to the anti-cancer drug such as mitomycin C possible, suggesting the potential of the preparation as a drug carrier.

Interaction of Cu(II) 3,5-diisopropylsalicylate with human serum albumin--an evaluation of spectroscopic data

The copper(II) complex of 3,5-diisopropylsalicylate is a lipophilic water-insoluble binuclear complex, Cu(II)2(3,5-DIPS)4, that has attracted interest because of a wide range of pharmacological activities. This study was undertaken to examine bonding interactions between the complex and human serum albumin (HSA) to help elucidate the mode of transport of the complex in vivo. Electron paramagnetic resonance, numerical magnetic resonance and UV-visible absorption spectroscopic studies were performed using 200 microM aqueous solutions (pH 7.5) of HSA to which had been added up to three molar equivalents of CuCl2, CuSO4, or Cu(II)2(3,5-DIPS)4. Both EPR and UV-visible spectra demonstrated the presence of more than one copper bonding site on HSA, and proton NMR spectra showed that the 3,5-DIPS ligand is also bonded to HSA. These results indicate that there is no observable direct coordination of the ligand to copper in the presence of HSA, and that the majority of the copper and 3,5-DIPS bond to HSA at separate sites. Addition of solid Cu(II)2(3,5-DIPS)4 to HSA at pH 7.5 similarly resulted in spectra suggest that there are no ternary Cu(II)(3,5-DIPS), Cu(II)(3,5-DIPS)2, or Cu(II)2(3,5-DIPS)4 complexes formed with HSA. It is concluded that any ternary complexes formed in the presence of HSA are below the spectroscopic detection limits and represent less than 5% of the total copper.