Two-dimensional substrate assisted SERS immunosensor for accurate detection of carcinoembryonic antigen

Accurate and sensitive detection of carcinoembryonic antigen (CEA) is essential for the detection of various diseases in healthcare and the medical field. Currently, due to the high false negative rate of CEA assay in clinical setting and its use as a common indicator for early cancer screening, a novel CEA detection method with high sensitivity, increased specificity and the lower cost has become a clinical challenge. Here, a facile sandwich type immunosensor based on surface-enhanced Raman scattering (SERS) was presented including 4-mercaptobenzonitrile (4MBN) labeled gold core-silver shell nanoparticles (Au@4MBN@Ag NPs) as SERS tag and 4-mercaptophenylboronic acid (4-MPBA) functionalized two-dimensional (2D) silver nanoparticle film (Ag FM) as SERS capture substrate for CEA detection. A linearity of 10-9-10-14M was observed with high sensitivity and excellent selectivity for the detection of CEA. Additionally, the spiking experiment yielded 105.33-127.00% recovery with variation coefficients below 10% demonstrating high assay accuracy and precision. The immunosensor we proposed here is a promising approach to quantify CEA in liquid biopsy samples with high sensitivity, which could be further developed for early cancer screening.

[A study on the first-order interaction of diagnostic performance of coronary CT angiography-derived fractional flow reserve]

Objective: To investigate the effect of image quality, degree of stenosis, calcification, and their first-order interactions on diagnostic performance of coronary computed tomography (CT) angiography-derived fractional flow reserve (CT-FFR). Methods: This is a reanalysis of data from a multi-center retrospective cross-sectional study of CT-FFR in China. A total of 522 patients with suspected or known coronary heart disease [mean age: 61.6 (34.0-83.0) years, 71.8% (354/493) were male] from 11 medical centers including the General Hospital of Eastern Theater Command from May 2015 to October 2019 were enrolled. All patients underwent coronary CT angiography (CCTA), CT-FFR, and invasive FFR examination. Subjective image quality scores of target vessels were recorded on CCTA images, and stenosis was visually assessed at the lesion level. Calcification arc and calcification remodeling index (CRI) were recorded for each lesion. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were compared. Two-way analysis of variance was used to analyze the first-order interaction effects of image quality, degree of stenosis, and calcification. Results: A total of 493 patients with 629 lesions with invasive FFR as a reference were included in the study. The overall sensitivity, specificity, and accuracy of CT-FFR were 80.4%, 93.8%, and 88.6%, respectively. The specificity (95.0% vs. 87.3%, χ2=4.11, P=0.043); accuracy (90.1% vs. 81.9%, χ2=6.22, P=0.013); and NPV (89.7% vs. 80.9%, χ2=4.25, P=0.039) of the group with image quality ≥3 was higher than the group with image quality <3. The degree of stenosis affected the sensitivity, PPV, and NPV of CT-FFR and the calcification arc affected the specificity of CT-FFR (all P>0.05). The specificity (95.8% vs. 90.5%, χ2=4.23, P=0.040); accuracy (91.0% vs. 86.1%, χ2=4.01, P=0.045); and NPV (91.1% vs. 83.8%, χ2=5.10, P=0.024) of the group with CRI<1 were higher than that of the group with CRI≥1. In the subgroup of mild and severe stenosis, no calcification, and CRI<1, the accuracy of CT-FFR with image quality ≥3 points were higher than that with image quality <3 points. The accuracy of CT-FFR in the moderate stenosis group was mainly affected by CRI; the accuracy of CT-FFR in the group with CRI<1 was higher than that in the group with CRI≥1 (after Bonferroni correction, P values between groups were statistically significant). Conclusion: Subjective image quality, degree of stenosis, calcification of lesions, and their first-order interactions can all negatively affect the diagnostic performance of CT-FFR.

Survival of 48866 cancer patients: results from Nantong area, China

Objective

This study aimed to provide a realistic observation of survival by major site for 48,866 cancer patients treated at a tertiary cancer hospital in a rural area of China.

Methods

Patients with cancer registered between 2007 and 2017 in the Nantong rural area were followed up. The starting date for survival calculation was the date of the first diagnosis of cancer at the Nantong Tumor Hospital, and the closing date was December 31, 2020. Observed survival (OS) was analyzed according to ICD-10 site, sex, age, region, and hospitalization period using the life table method and compared using the Wilcoxon (Gehan) statistic.

Results

The overall 5-year OS rate was 40.48% for all 48,866 patients, 30.19% for males, and 51.90% for females. The top five cancer sites, accounting for 60.51% of the total cases, were the esophagus, lung, stomach, liver, and cervix, with 5-year OS rates of 33.72%, 18.64%, 32.10%, 19.04%, and 71.51%, respectively. The highest 5-year OS was observed in the thyroid (87.52%) and the lowest was in the pancreas (6.37%). Survival was significantly higher in younger patients than in older patients, with 5-year OSs of 69.26% and 19.84% in those aged 20-29 and 90-99 years, respectively. Five-year OSs improved significantly from 39.35% in 2007-2011 to 41.26% in 2012-2017.

Conclusion

Overall survival improved over the years, although the improvement at some sites was not significant. The observed survival varies from region to region, reflecting differences in the patterns of major sites, disparities in proportions of hospitalization, and demographic characteristics.

[Clinicopathologic characteristics and prognostic analysis of testicular diffuse large B-cell lymphoma]

Objective: To analyze the clinicopathologic characteristics and prognosis of testicular diffuse large B-cell lymphoma (DLBCL) . Methods: A retrospective analysis was performed on 68 patients with testicular DLBCL admitted to Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2001 to April 2020. The gene mutation profile was evaluated by targeted sequencing (55 lymphoma-related genes) , and prognostic factors were analyzed. Results: A total of 68 patients were included, of whom 45 (66.2% ) had primary testicular DLBCL and 23 (33.8% ) had secondary testicular DLBCL. The proportion of secondary testicular DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ (P<0.001) , elevated LDH (P<0.001) , ECOG score ≥ 2 points (P=0.005) , and IPI score 3-5 points (P<0.001) is higher than that of primary testicular DLBCL patients. Sixty-two (91% ) patients received rituximab in combination with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP) -based first-line regimen, whereas 54 cases (79% ) underwent orchiectomy prior to chemotherapy. Patients with secondary testicular DLBCL had a lower estimated 5-year progression-free survival (PFS) rate (16.5% vs 68.1% , P<0.001) and 5-year overall survival (OS) rate (63.4% vs 74.9% , P=0.008) than those with primary testicular DLBCL, and their complete remission rate (57% vs 91% , P=0.003) was also lower than that of primary testicular DLBCL. The ECOG scores of ≥2 (PFS: P=0.018; OS: P<0.001) , Ann Arbor stages Ⅲ-Ⅳ (PFS: P<0.001; OS: P=0.018) , increased LDH levels (PFS: P=0.015; OS: P=0.006) , and multiple extra-nodal involvements (PFS: P<0.001; OS: P=0.013) were poor prognostic factors in testicular DLBCL. Targeted sequencing data in 20 patients with testicular DLBCL showed that the mutation frequencies of ≥20% were PIM1 (12 cases, 60% ) , MYD88 (11 cases, 55% ) , CD79B (9 cases, 45% ) , CREBBP (5 cases, 25% ) , KMT2D (5 cases, 25% ) , ATM (4 cases, 20% ) , and BTG2 (4 cases, 20% ) . The frequency of mutations in KMT2D in patients with secondary testicular DLBCL was higher than that in patients with primary testicular DLBCL (66.7% vs 7.1% , P=0.014) and was associated with a lower 5-year PFS rate in patients with testicular DLBCL (P=0.019) . Conclusion: Patients with secondary testicular DLBCL had worse PFS and OS than those with primary testicular DLBCL. The ECOG scores of ≥2, Ann Arbor stages Ⅲ-Ⅳ, increased LDH levels, and multiple extra-nodal involvements were poor prognostic factors in testicular DLBCL. PIM1, MYD88, CD79B, CREBBP, KMT2D, ATM, and BTG2 were commonly mutated genes in testicular DLBCL, and the prognosis of patients with KMT2D mutations was poor.

[Analysis of the effects of low/intermediate dose of coagulation factor Ⅷ on 30 adult patients with severe hemophilia A in a single center]

Objective: To evaluate the clinical effects of low- and intermediate-dose factor Ⅷ (F Ⅷ) prophylaxis in Chinese adult patients with severe hemophilia A. Methods: Thirty adult patients with severe hemophilia A who received low- (n=20) /intermediate-dose (n=10) F Ⅷ prophylaxis at Nanjing Drum Tower Hospital affiliated with Nanjing University Medical College were included in the study. The annual bleeding rate (ABR), annual joint bleeding rate (AJBR), number of target joints, functional independence score of hemophilia (FISH), quality of life score, and health status score (SF-36) before and after preventive treatment were retrospectively analyzed and compared. Results: The median follow-up was 48 months. Compared with on-demand treatment, low- and intermediate-dose prophylaxis significantly reduced ABR, AJBR, and the number of target joints (P<0.05) ; the improvement in the intermediate-dose prophylaxis group was better than that in the low-dose prophylaxis group (P<0.05). Compared with on-demand treatment, the FISH score, quality of life score, and SF-36 score significantly improved in both groups (P<0.05), but there was no significant difference between the two groups (P>0.05) . Conclusion: In Chinese adults with severe hemophilia A, low- and intermediate-dose prophylaxis can significantly reduce bleeding frequency, delay the progression of joint lesions, and improve the quality of life of patients as compared with on-demand treatment. The improvement in clinical bleeding was better with intermediate-dose prophylaxis than low-dose prophylaxis.

[Clinical characteristics and prognosis of primary and secondary diffuse large B-cell lymphoma of the pancreas]

Objective: To analyze the clinical characteristics and prognosis of primary and secondary pancreatic diffuse large B-cell lymphoma (DLBCL) . Methods: Clinical data of patients with pancreatic DLBCL admitted at Shanghai Rui Jin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from April 2003 to June 2020 were analyzed. Gene mutation profiles were evaluated by targeted sequencing (55 lymphoma-related genes). Univariate and multivariate Cox regression models were used to evaluate the prognostic factors of overall survival (OS) and progression-free survival (PFS) . Results: Overall, 80 patients were included; 12 patients had primary pancreatic DLBCL (PPDLBCL), and 68 patients had secondary pancreatic DLBCL (SPDLBCL). Compared with those with PPDLBCL, patients with SPDLBCL had a higher number of affected extranodal sites (P<0.001) and had higher IPI scores (P=0.013). There was no significant difference in the OS (P=0.120) and PFS (P=0.067) between the two groups. Multivariate analysis indicated that IPI intermediate-high/high risk (P=0.025) and double expressor (DE) (P=0.017) were independent adverse prognostic factors of OS in patients with pancreatic DLBCL. IPI intermediate-high/high risk (P=0.021) was an independent adverse prognostic factor of PFS in patients with pancreatic DLBCL. Targeted sequencing of 29 patients showed that the mutation frequency of PIM1, SGK1, BTG2, FAS, MYC, and MYD88 in patients with pancreatic DLBCL were all >20%. PIM1 (P=0.006 for OS, P=0.032 for PFS) and MYD88 (P=0.001 for OS, P=0.017 for PFS) mutations were associated with poor OS and PFS in patients with SPDLBCL. Conclusion: There was no significant difference in the OS and PFS between patients with PPDLBCL and those with SPDLBCL. IPI intermediate-high/high risk and DE were adverse prognostic factors of pancreatic DLBCL. PIM1, SGK1, BTG2, FAS, MYC, and MYD88 were common mutations in pancreatic DLBCL. PIM1 and MYD88 mutations indicated worse prognosis.

Inhibition by rno-circRNA-013017 of the apoptosis of motor neurons in anterior horn and descending axonal degeneration in rats after traumatic spinal cord injury

Introduction

Spinal cord injury (SCI) often causes continuous neurological damage to clinical patients. Circular RNAs (circRNAs) are related to a lot of diseases, including SCI. We previously found five candidate circRNAs which were likely to regulate the secondary pathophysiological changes in rat model after traumatic SCI.

Methods

In this study, we first selected and overexpressed target circRNA in rats. We then explored its functional roles using various functional assays in a rat model after SCI.

Results

We found that rno-circRNA-013017-the selected target circRNA-reduced neuron apoptosis, preserved the survival and activity of motor neurons, and regulated apoptosis-related proteins at 3 days post-SCI using western blot, immunofluorescence and polymerase chain reaction. Additionally, we found that rno-circRNA-013017 inhibited descending axonal degeneration and preserved motor neurons and descending axons at 6 weeks post-SCI using immunofluorescence, biotin dextran amine diffusion tensor imaging. Finally, the overexpression of rno-circRNA-013017 promoted the locomotor function of rats after SCI using open-field test and gait analysis.

Conclusion

Focusing on the functions of rno-circRNA-013017, this study provides new options for future studies exploring therapeutic targets and molecular mechanisms for SCI.

[Status and related factors on the drinking behavior among primary and secondary students in China rural middle and western regions in 2019]

Objective: To analyze the daily drinking behavior and related factors of primary and middle school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) pilot regions. Methods: Multi-stage stratified random cluster sampling method was used to select one to three national pilot counties in 22 provinces in central and western China where the NIPRCES was implemented in 2019. According to different feeding patterns, two primary schools and two middle schools were selected as key monitoring schools. One or two classes were selected from grade 3 to grade 9. The student questionnaire was used to collect the basic information and daily drinking behavior. Taking whether the drinking water ≥5 cups every day as the dependent variable, multivariate logistic regression model was used to analyze the related factors of drinking behavior among students. Results: A total of 27 374 students were included. On average, primary and middle school students in the regions where NIPRCES was implemented had 3.9 cups of water every day. Logistic regression model showed that boys (OR=1.230, P<0.001), primary school students (OR=1.379, P<0.001), father worked outside the home (OR=1.169, P<0.001), both parents worked outside the home (OR=1.228, P<0.001), non-resident students (OR=1.142, P<0.001), the school in the village (OR=1.638, P<0.001) or township (OR=1.358, P<0.001), school feeding (OR=1.252, P<0.001), the school building with flush toilets (OR=1.384, P<0.001) and the central regions (OR=1.300, P<0.001) students were more likely to drink ≥5 cups water every day. Conclusion: The water consumption of primary and middle school students in the pilot regions of NIPRCES is low, and their drinking behaviors are affected by many factors.

[Overweight and obesity status and its associated factors among primary and secondary school students in China rural middle and western regions]

Objective: To analyze the overweight and obesity status of students in the national pilot counties of the Nutrition Improvement Program for Rural Compulsory Education Students in 2019 and its associated factors. Methods: In 2019, a multi-stage cluster random sampling method was used to select about 40 students from each grade in primary and secondary schools in China's central and western regions where the Nutrition Improvement Program for Rural Compulsory Education Students was implemented. The height and weight of the children were measured using height or weight scales. The school questionnaire and county questionnaire were used to investigate the associated factors. A Chi-square test was used for comparison between groups. The logistic regression analysis was used to analyze the associated factors. Results: In 2019, the prevalence of overweight and obesity among rural primary and secondary school students aged 6-15 years in central and western China 2019 was 11.5%. It was higher for boys (13.1%) than that for girls (9.8%), higher in central (14.3%) than that in the west (9.9%) and higher for elementary school students (12.4%) than that for secondary school students (9.5%, all P<0.001). The logistic regression showed that boys (OR=1.388), primary school students (OR=1.271), students without other dietary subsidies(OR=1.037), schools in rural areas (OR=1.133), schools with enterprise-based feeding mode (OR=1.043), schools without the provision of lunch (OR=1.143), schools without the provision of dinner (OR=1.122), and schools without providing drinking water (OR=1.015) were positively associated with overweight and obesity among students (P<0.05). Schools with snack shops (OR=0.952) were negatively associated with overweight and obesity among students (P<0.001). Conclusion: A certain proportion of primary and secondary school students in rural areas of central and western China are overweight and obese. The prevalence is not only related to children's gender, school section and county area but also related to school meals, whether schools provide drinking water and other factors.

[Anemia prevalence and its influencing factors among students involved in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze anemia prevalence and its influencing factors of students involved in the Nutritional Improvement Program for Rural Compulsory Education Students in 2019. Methods: From the 2019 surveillance system of the Nutrition Improvement Program for Rural Compulsory Education Students, 47 297 primary and middle school students aged 6-17 were included in the study. Hemoglobin level was tested according to the criteria of WHO 2011. Anemia prevalence of different genders, ages, and regions was analyzed. Results: The average hemoglobin level was 135.19 g/L, with the prevalence of anemia as 8.7% in the children aged 6-17. The prevalence of anemia was 10.0% in girls, higher than that in boys (7.4%). The prevalence rates in western and central areas were 9.8% and 7.1%, respectively. From northwest, southwest, central and south, east, north to northeast areas of China, the anemia rate appeared gradually decreasing (10.2%, 9.7%, 8.3%, 7.5%, 5.7% and 3.5%). The anemia prevalence rates were 8.0%, 8.3%, and 10.9% in children from the 6-, 11-, and 14-17 years age groups, respectively. Logistic regression models revealed that students from schools not using catering software (OR=1.482, 95%CI:1.296-1.694,P<0.001), schools not serving lunch (OR=1.241, 95%CI:1.103-1.395,P<0.001), and from relatively low-income families (OR=1.297, 95%CI:1.211-1.389, P<0.001) showed as risk factors for anemia. After supplementing students' dietary factors, the results showed that students who ate meat three or more times a week had a lower risk of anemia (OR=0.907, 95%CI:0.832-0.989, P=0.026). Conclusions: The Nutritional Improvement Program for Rural Compulsory Education Students had an essential impact on improving the anemia prevalence of primary and middle school students. Family income, school location, economic factors, school feeding, and students' diet programs all impacted the prevalence of anemia.

[Growth retardation of children and its influencing factors in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To understand the growth retardation among primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students and its influencing factors to provide evidence for improving the nutrition status of rural students in China. Methods: The multi-stage cluster random sampling method selected 1 550 969 primary and secondary school students aged 6-15 years from China's central and western regions. The ratio of male and female students was balanced. The height was measured, and the growth retardation of students was determined according to the Screening Criteria for School-age Children and Adolescents malnutrition (WS/T 456-2014), from the school and county questionnaire survey related factors. The number of cases and percentages described the growth retardation of students, and the χ² test was used for comparison between groups. Binary logistic regression was used to analyze students' growth retardation factors. Results: In 2019, the growth retardation rate of primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students was 5.7% (88 631/1 550 969), the growth retardation rate in the western part (7.1%, 66 167/927 954) was higher than that in the central part (3.7%,19 511/533 973) with difference statistically significant (P<0.001). The growth retardation rate of the boys (6.3%,50 665/803 851) were higher than that of girls (5.1%, 37 966/747 118), the difference was statistically significant (P<0.001). The growth retardation rate of primary school students in central China was 3.9%(14 914/380 598), higher than that of junior middle school students (3.0%,4 597/153 375, P<0.001). In contrast, the growth retardation rate of the western junior high school students (7.2%, 21 494/297 217) were higher than that of elementary school students (7.1%, 44 673/630 737), with a difference statistically significant (all P=0.009). Multi-factor logistic regression results showed that, in high income area (OR=0.829, 95%CI: 0.816-0.842, P<0.001), parents providing part of the meal cost (OR=0.948, 95%CI: 0.931-0.965, P<0.001), enterprises providing meals (OR=0.845, 95%CI: 0.805-0.887, P<0.001), schools providing milk (OR=0.780, 95%CI: 0.767-0.793, P<0.001), health education courses (OR=0.702, 95%CI: 0.682-0.723, P<0.001) and other local nutrition improvement efforts (OR=0.739, 95%CI: 0.720-0.758, P<0.001) were negatively correlated with the occurrence of growth retardation, The growth retardation rate of the students was lower. Conclusions: There appeared significant regional, gender, and age differences in the growth retardation rate of primary and middle school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students. Appropriate food supply in schools, health education courses, and parental participation in nutritional improvement was related to children's lower growth retardation rate.

[Status and influencing factors on the leftover school meals among students the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze the situation and influencing factors of school meals leftover among primary and secondary school students in the area of the Nutrition Improvement Program for Rural Compulsory Education Students, improve the quality of school meals, develop healthy dietary behavior, and reduce food waste. Methods: In 2019, among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns.This study randomly selected one or two classes from grade 3 to grade 9. Basic information and school meals of 26 778 students were collected by using a student questionnaire. Multivariate logistic regression was used to analyze the influencing factors of leftovers rate. Results: 54.93% (14 709) of students wasted school meals, in which the highest rate was the staple food, with the main reason as "not in favor". 11.87% (1 743) of the students wasted school meals 6-7 days a week, with 54.20% (7 957) of students wasted but in less amount. The leftover rate of staple food was the highest (29.78%), followed by vegetables and meat. The main reason of leftovers was that they didn't like this kind of food (33.52%). The rate of school meal waste was higher for girls (OR=1.19,95%CI:1.13-1.25), junior high school students (OR=1.17, 95%CI: 1.11-1.25), resident students (OR=1.06, 95%CI: 1.00-1.12), lower economic level (OR=1.06, 95%CI: 1.00-1.12), parents working outside their houses (OR=1.22, 95%CI: 1.13-1.30), health education classes (OR=1.70, 95%CI: 1.40-2.06), company-based meals (OR=1.89, 95%CI: 1.71-2.07) and school meals were not as good as home food(OR=1.89, 95%CI: 1.78-2.00)(P<0.05). Conclusions: It is common for poor rural primary and middle school students in central and western China to waste school meals, and the reasons were affected by many factors. Reducing food waste requires the joint efforts of individuals, families, schools and society.

[Bioinformatics Analysis of Microarray Data in Myelodysplastic Syndrome Based on Gene Expression Omnibus Database]

OBJECTIVE

To identify the key genes and explore mechanisms in the development of myelodysplastic syndrome (MDS) by bioinformatics analysis.

METHODS

Two cohorts profile datasets of MDS were downloaded from Gene Expression Omnibus (GEO) database. Differentially expressed gene (DEG) was screened by GEO2R, functional annotation of DEG was gained from GO database, gene ontology (GO) enrichment analysis was performed via Kyoto Encyclopedia of Genes and Genomes (KEGG) database, and key genes were screened by Matthews correlation coefficient (MCC) based on STRING database.

RESULTS

There were 112 DEGs identified, including 85 up-regulated genes and 27 down-regulated genes. GO enrichment analysis showed that biological processes were mainly enriched in immune response, etc, cellular component in cell membrane, etc, and molecular function in protein binding, etc. KEGG signaling pathway analysis showed that main gene enrichment pathways were primary immunodeficiency, hematopoietic cell lineage, B cell receptor signaling pathway, Hippo signaling pathway, and asthma. Three significant modules were screened by Cytoscape software MCODE plug-in, while 10 key node genes (CD19, CD79A, CD79B, EBF1, VPREB1, IRF4, BLNK, RAG1, POU2AF1, IRF8) in protein-protein interaction (PPI) network were screened based on STRING database.

CONCLUSION

These screened key genes and signaling pathways are helpful to better understand molecular mechanism of MDS, and provide theoretical basis for clinical targeted therapy.

Maternal regulation of biliary disease in neonates via gut microbial metabolites

Maternal seeding of the microbiome in neonates promotes a long-lasting biological footprint, but how it impacts disease susceptibility in early life remains unknown. We hypothesized that feeding butyrate to pregnant mice influences the newborn’s susceptibility to biliary atresia, a severe cholangiopathy of neonates. Here, we show that butyrate administration to mothers renders newborn mice resistant to inflammation and injury of bile ducts and improves survival. The prevention of hepatic immune cell activation and survival trait is linked to fecal signatures of Bacteroidetes and Clostridia and increases glutamate/glutamine and hypoxanthine in stool metabolites of newborn mice. In human neonates with biliary atresia, the fecal microbiome signature of these bacteria is under-represented, with suppression of glutamate/glutamine and increased hypoxanthine pathways. The direct administration of butyrate or glutamine to newborn mice attenuates the disease phenotype, but only glutamine renders bile duct epithelial cells resistant to cytotoxicity by natural killer cells. Thus, maternal intake of butyrate influences the fecal microbial population and metabolites in newborn mice and the phenotypic expression of experimental biliary atresia, with glutamine promoting survival of bile duct epithelial cells.

The pathogenesis of biliary atresia remains poorly understood. Here, the authors report that maternal butyrate treatment alters the gut microbiome and glutamine/hypoxanthine metabolites similar to human subjects, and suppresses biliary atresia in newborn mice.

[Effect of measurement sites on coronary computed tomography angiography-derived instantaneous wave-free ratio in the diagnosis of coronary stenosis ischemia]

Objective: To explore the influence of measurement sites on the diagnostic performance of coronary computed tomography angiography (CCTA) -derived instantaneous wave-free ratio (iFR_CT) for coronary stenosis ischemia. Methods: A total of 44 patients, including 27 males and 17 females aged from 44 to 83 (59±90) years, who underwent coronary computed tomography angiography (CCTA) and invasive fractional flow reserve (FFR) in the Department of Radiology, Eastern Theater Command General Hospital from February 2009 to May 2018 were retrospectively collected. Based on CCTA images, iFR_CT values at different locations (stenosis, proximal downstream of stenosis, 2 cm downstream of stenosis, 3 cm downstream of stenosis, and 4 cm downstream of stenosis) were calculated through fluid mechanics simulation. With invasive FFR≤0.80 as the reference standard, receiver operating characteristic (ROC) was used to analyze and evaluate the diagnostic performance of iFR_CT in different sites. Bland-Altman and spearman correlation coefficient were used to analyze the consistency between iFR_CT and invasive FFR. Intraclass correlation coefficient (ICC) and spearman correlation coefficient were used to test the repeatability of iFR_CT. Results: iFR_CT values at the proximal downstream of the stenosis (approximately 1 cm downstream of the stenosis) was superior to other measurement sites in the diagnosis of coronary ischemic specific stenosis. The threshold, area under the curve, sensitivity, specificity and accuracy of iFR_CT at the stenosis were 0.91, 0.87 (95%CI:0.76~0.96), 82% (95%CI:48%~97%), 76% (95%CI:57%~88%) and 77% (95%CI: 63%~87%), respectively. Bland-Altman analysis showed that the mean differences between iFR_CT and FFR at the proximal downstream of the stenosis was 0.07 (95%LoA: 0.06~0.09) and Spearman correlation coefficient was 0.53 (P<0.001). At the proximal downstream of the stenosis, the intraobserver ICC of iFR_CT was 0.92 (95%CI: 0.85 ~0.95), the correlation coefficient was 0.85 (P<0.001); the interobserver ICC was 0.84 (95%CI: 0.60~0.94), correlation coefficient was 0.75 (P<0.001), demonstrating good repeatability between iFR_CT and FFR. Conclusion: With the invasive FFR value as reference standard, iFR_CT had a high diagnostic performance in detecting myocardial ischemia and the best measurement site was the proximal downstream of the stenosis.

Nickel(II)-Catalyzed [3 + 2] Cycloaddition of Nitrones and Allenoates to Access N-Vinylindoles and N-Vinylpyrroles

A variety of N-vinylindoles and N-vinylpyrroles were prepared in moderate to good yields through the nickel(II)-catalyzed [3 + 2] cycloaddition of α,β-unsaturated nitrones with allenoates under mild reaction conditions. A rational mechanism for the formation of N-vinylindoles was proposed based on the ¹⁸O-labeled experiments and key intermediates detected by high-resolution mass spectrometry trace experiments. The present method highlights a nickel(II)-controlled cyclization, atom-economical reaction, broad substrate scope, good functional group tolerance, and high Z-stereoselectivity for the enamine bond.

Deletion of Fam172a accelerates advanced atherosclerosis and induces plaque instability

BACKGROUND AND AIMS

Vascular smooth muscle cells (VSMCs) play a critical role in atherosclerosis. The family with sequence similarity 172, member A (FAM172A) is a novel protein and its role in atherosclerosis has not been explored so far. Therefore, our aim is to investigate whether FAM172A affects atheroprogression through VSMCs and its possible mechanism.

METHODS

Fam172a^-/- mice were generated using CRISPR/Cas9 technology. Fam172a^-/- and Apoe^-/- double knockout (Fam172a^-/-/Apoe^-/-) mice and their littermates (Fam172a^+/+/Apoe^-/-) were fed with a Western diet for 18 weeks to induce advanced atherosclerotic lesions. The role and mechanism of Fam172a in phenotypic switching, proliferation and migration of VSMCs were investigated through in vivo and in vitro experiments.

RESULTS

Compared with Fam172a^+/+/Apoe^-/- mice, Fam172a^-/-/Apoe^-/- mice showed increased atherosclerotic lesion size and plaque instability such as increased necrotic core area and decreased fiber deposition. Additionally, knockout of Fam172a promoted expression of CD68 and KLF4 and decreased expression of α-SMA and SM22α in atherosclerotic lesions. Furthermore, overexpression of Fam172a promoted Movas cells proliferation and migration, increased expression of α-SMA and SM22α and decreased expression of KLF4. Meanwhile, knockdown of Fam172a in Movas cells and deletion of Fam172a in VSMCs from Fam172a^-/-/Apoe^-/- mice showed opposite phenotypes. Similar phenotypes were also observed in human aortic smooth muscle cells.

CONCLUSIONS

Our results provide the first direct evidence that Fam172a has a protective role in advanced atherosclerosis by increasing atherosclerotic plaque stability and inhibiting transition of VSMCs from contractile to synthetic phenotype, which may be through KLF4-dependent pathway.

[The involvement of neuropilin-1 in primary immune thrombocytopenia]

Objective: To explore the relationship between the expression of neuropilin-1 (NRP-1) on Treg cells and its ligands semaphorins-3A (Sema3A) , transforming growth factor-β(1) (TGF-β(1)) as well as the balance of type 1 helper T cells (Th(1)) and type 2 helper T cells (Th(2)) cells. Methods: This study enrolled 62 patients with immune thrombocytopenia (ITP; 33 and 29 newly diagnosed and chronic ITP, respectively) from March 2014 to May 2015. Consequently, 30 healthy people in the same period were selected as the normal control group. The expression of NRP-1 in Treg cells was detected via flow cytometry. The Sema3A, TGF-β(1), IFN-γ, and IL-4 levels in plasma were detected by enzyme-linked immunosorbent assay. The real-time polymerase chain reaction technique was used to detect the mRNA expression levels of NRP-1, Sema3A, and TGF-β(1). The one-way analysis of variance and independent sample t-test was used for comparison between three and two groups, respectively. Correlations among the mRNA expression levels of NRP-1, Sema3A, and TGF-β(1) were assessed via Spearman correlation coefficients. Results: Treg cells in the newly diagnosed ITP group significantly increased compared with those in the chronic ITP and normal control groups. The expression of NRP-1 decreased[ (0.15 ± 0.03) %, (0.33 ± 0.15) %, and (0.46 ± 0.06) %; P<0.01], the plasma Sema3A level increased[ (8.10 ± 1.32) μg/L, (7.41±1.30) μg/L, and (2.88±0.82) μg/L; P<0.01], and the plasma TGF-β(1) level decreased[ (16.50±3.36) μg/L, (35.17±10.26) μg/L, and (41.00±10.02) μg/L; P<0.01]. Moreover, the level of plasma IFN-γ increased[ (17.21+2.80) ng/L, (10.23+1.59) ng/L, and (8.18+3.27) ng/L; P<0.01], and the ratios of Th(1)/Th(2) (IFN-γ/IL-4) increased (1.29±0.30, 0.72±0.16, and 0.61±0.27; P<0.01) . The mRNA expressions of NRP-1 and Sema3A in the newly diagnosed ITP and chronic ITP groups were lower than that in the normal control group (P<0.01) . Consequently, the NRP-1 mRNA expression was positively correlated with Sema3A and TGF-β(1) mRNA expression in the newly diagnosed ITP group. Conclusion: NRP-1 played an essential role in the pathogenesis of ITP.

Robot-assisted thoracoscopic plication for diaphragmatic eventration

BACKGROUND

Though conventional thoracoscopic plication is a favorable option of diaphragmatic eventration (DE), ribs limited the movement of trocars, making it difficult to suturing, knot-tying and time-consuming. The purpose of this study was to evaluate delicate surgical maneuvers and suturing time for the management of DE in robot-assisted thoracoscopic plication (RATP).

METHODS

From January 2015 to November 2019, 20 patients (14 males; mean age: 10.5 ± 5.2 months; mean weight: 8.6 ± 4.5 kg) who underwent diaphragmatic plication for DE were reviewed at our institution. There were 13 patients with congenital diaphragmatic eventration and 7 patients with acquired diaphragm eventration after congenital heart surgery. RATP was performed on 9 patients (3 on the left and 6 on the right), and conventional thoracoscopic plication (CTP) was applied to 11 patients (5 on the left and 6 on the right). Demographics, the suturing time and complications were respectively evaluated.

RESULTS

There was no difference between 2 groups with respect to gender, age at surgery and weight (p > 0.05). No conversion to thoracotomy was needed. The suturing time in RATP group was shorter than CTP group (27.7 ± 3.4 min vs 48.1 ± 4.2 min, p < 0.001). One patient (9.09%) experienced recurrence in CTP group and none was found in RATP group.

CONCLUSIONS

Diaphragmatic plication with robot-assisted thoracoscopy or conventional thoracoscopy in DE has minimally invasive and good effect on children. RATP overcome the intercostal limitations to complete delicate suturing and free knot-tying, and has better ergonomics.

LEVEL OF EVIDENCE

Level III.

FAM172A promotes follicular thyroid carcinogenesis and may be a marker of FTC

Our aims were to uncover the role of FAM172A (Family with sequence similarity 172 member A) in the pathogenesis of follicular thyroid carcinoma (FTC) and to evaluate its value in the differential diagnosis between malignant and benign thyroid follicular lesions. FAM172A expression was evaluated by q-PCR, immunoblotting and immunohistochemistry (IHC). The ability of proliferation, migration and invasion of cells were assessed by Cell Counting Kit-8 assay (CCK8), clone-formation and Transwell assays. Nude mouse tumorigenicity assays were used to investigate the role of FAM172A in the pathogenesis of FTC in vivo. The value of FAM172A in the differential diagnosis for FTC was assessed using 120 formalin-fixed paraffin-embedded (FFPE) tissues after the operation and 81 fine-needle aspiration biopsy (FNAB) samples before the operation. FAM172A was highly expressed in FTC tissues and FTC cell lines. Downregulation of FAM172A inhibited the proliferation, invasion and migration of FTC cells through Erk1/2 and JNK pathways. Subcutaneous tumorigenesis in nude mice showed that knockdown of FAM172A inhibited tumor growth and progression in vivo. The FAM172A IHC scores of 3.5 had 92% sensitivity and 63% specificity to separate FTC from benign/borderline thyroid follicular lesions, and 92% sensitivity and 80% specificity to discriminate FTC from benign thyroid follicular lesions in postoperative FFPE samples. The corresponding values were 75 and 78%, and 75 and 89% in preoperative FNA samples, respectively. FAM172A plays an important role in the pathogenesis of FTC through Erk1/2 and JNK pathways. FAM172A may be a potential marker for the preoperative diagnosis of FTC based on the IHC results of thyroid FNAB samples.

[Comparisons of clinical characteristics and prognosis between patients with primary and secondary thyroid lymphoma]

Objective: To compare clinical characteristics and prognosis between patients with primary (PTL) and secondary thyroid lymphoma (STL) . Methods: A retrospective analysis was performed on 46 patients with thyroid lymphoma (PTL 19, STL 27) from January 2002 to October 2018. Results: ①PTL group included 4 males and 15 females, with a median age of 57 years. The STL group included 10 males and 17 females, with a median age of 61 years. Diffuse large B-cell lymphoma (DLBCL) was the main pathological subtype in both PTL and STL groups, with 14 cases (73.7%) and 20 cases (74.1%) respectively. In terms of clinical manifestations, goiter was the most common symptom in PTL patients 100.0% (19/19) , while 29.6% (8/27) STL had goiter (P<0.001) . The incidences of increased thyroglobulin antibody (TRAb) /thyroid peroxidase antibody (TPO) were 81.3% (13/16) in PTL group and 43.8% (7/16) in STL group (P=0.028) respectively. Concerning the clinical features of patients, only two PTL patients (10.5%) with advanced Ann Arbor stage (Ⅲ/Ⅳ) , while 21 (77.8%) STL experienced advanced Ann Arbor stage (P<0.001) . Elevated serum β(2)-MG were appeared in 1 (7.1%) PTL and 9 (47.4%) STL patients (P=0.013) , and advanced IPI score (3-5) was more common in STL than PTL (59.3% vs 5.3%, P<0.001) . ②Among the 17 PTL patients who received treatments, 15 (88.2%) achieved remission; as for STL patients received treatments, 23/25 (92.0%) were in remission. The 5-year overall survival (OS) rates of PTL (n=17) and STL groups (n=25) were (87.4±8.4) % and (70.0±13.1) % (P=0.433) respectively. ③The 5-year OS rate in 41 patients with B-cell thyroid lymphoma was (81.1±7.5) %. Univariate analysis showed that IPI score of 3-5 (P=0.040) and high level of serum IL-8 (P=0.022) were significantly associated with poor outcome. Conclusion: DLBCL was the most common subtype in both PTL and STL, and goiter was the major symptom in PTL. IPI score of 3-5 and high level of serum IL-8 were unfavorable prognostic factors for patients with B-cell thyroid lymphoma.

[Analysis on the trend of physical development of children aged 7-17 years old in China from 1982 to 2012]

Data of physical measurement of children aged 7-17 years old in China was from National Nutrition and Health Survey in 1982, 1992, 2002 and 2010-2012. From 1982 to 2012, the height and weight of children aged 7-17 years old continued to increase. The height of urban boys, urban girls, rural boys and rural girls ranged from 118.8 to 171.1, 117.8 to 159.9, 113.3 to 168.2 and 111.7 to 158.1 cm, and weight ranged from 21.3 to 61.4, 20.2 to 53.1, 19.4 to 57.9, and 19.0 to 51.5 kg, respectively. The height and weight of urban children were larger than those of rural children. The height and weight of boys were larger than those of girls, except for adolescents. From 1982 to 2012, the height increment of urban boys, urban girls, rural boys and rural girls was 8.8, 6.2, 12.9 and 10.8 cm, and weight increment was 9.9, 6.2, 9.8 and 7.6 kg, respectively. The increment of urban children was smaller than that of rural children, which implied that the disparity between urban and rural was shrinking. The increment of boys was larger than that of girls, which implied that the gender disparity was increasing.

Pathological significance of tRNA-derived small RNAs in neurological disorders

Non-coding RNAs (ncRNAs) are a type of RNA that is not translated into proteins. Transfer RNAs (tRNAs), a type of ncRNA, are the second most abundant type of RNA in cells. Recent studies have shown that tRNAs can be cleaved into a heterogeneous population of ncRNAs with lengths of 18–40 nucleotides, known as tRNA-derived small RNAs (tsRNAs). There are two main types of tsRNA, based on their length and the number of cleavage sites that they contain: tRNA-derived fragments and tRNA-derived stress-induced RNAs. These RNA species were first considered to be byproducts of tRNA random cleavage. However, mounting evidence has demonstrated their critical functional roles as regulatory factors in the pathophysiological processes of various diseases, including neurological diseases. However, the underlying mechanisms by which tsRNAs affect specific cellular processes are largely unknown. Therefore, this study comprehensively summarizes the following points: (1) The biogenetics of tsRNA, including their discovery, classification, formation, and the roles of key enzymes. (2) The main biological functions of tsRNA, including its miRNA-like roles in gene expression regulation, protein translation regulation, regulation of various cellular activities, immune mediation, and response to stress. (3) The potential mechanisms of pathophysiological changes in neurological diseases that are regulated by tsRNA, including neurodegeneration and neurotrauma. (4) The identification of the functional diversity of tsRNA may provide valuable information regarding the physiological and pathophysiological mechanisms of neurological disorders, thus providing a new reference for the clinical treatment of neurological diseases. Research into tsRNAs in neurological diseases also has the following challenges: potential function and mechanism studies, how to accurately quantify expression, and the exact relationship between tsRNA and miRNA. These challenges require future research efforts.

Transumbilical enterostomy for Hirschsprung's disease with a two-stage laparoscopy-assisted pull-through procedure

BACKGROUND

A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease (HD) due to its superior cosmetic results. One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications. However, enterostomy is required in some HD cases for enterocolitis and dilated colon. Our transumbilical enterostomy (TUE) and two-stage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation, but the effect in patients with HD is unclear.

AIM

To evaluate the safety, efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD.

METHODS

From June 2013 to June 2018, 53 patients (40 boys, 13 girls; mean age at enterostomy: 5.5 ± 2.2 mo) who underwent enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution. Two enterostomy approaches were used: TUE in 24 patients, and conventional abdominal enterostomy (CAE) in 29 patients. Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon. 26 patients had long-segment HD, and 16 patients had total colonic aganglionosis (TCA). The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure, and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure. Demographics, enterostomy operative time, complications and cosmetic results were respectively evaluated.

RESULTS

There were no differences between the groups with respect to gender, age at enterostomy, weight and clinical type (P > 0.05). No conversion to open technique was required. Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group (8.33% vs 3.45%, P > 0.05). No parastomal hernia was observed in either of the two groups. Wound infection at the stoma was seen in 1 case in the TUE group, and 2 cases in the CAE group (4.17% vs 6.90%, P > 0.05). No obstruction was noted in any of the patients in the TUE group, whereas obstruction was found in 1 patient in the CAE group. Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group, respectively (12.50% vs 17.24%, P > 0.05). There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation (P > 0.05). The cosmetic result using the scar score in the TUE group was better than that in the CAE group (6.83 ± 0.96 vs 13.32 ± 1.57, P < 0.05).

CONCLUSION

TUE is a safe and feasible method for the treatment of HD, and the staged enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure.

[Prognostic study of 229 follicular lymphoma patients treated with rituximab combined with chemotherapy]

目的

探究滤泡性淋巴瘤（FL）的临床特征，以及FL国际预后指数（FLIPI）、FLIPI2、IPI、修正IPI（R-IPI）、NCCN-IPI在中国FL患者的预后意义。

方法

对2008年11月至2018年4月期间以利妥昔单抗联合CHOP（环磷酰胺、多柔比星、长春新碱及泼尼松）方案治疗的229例初治FL患者资料进行回顾性分析，并对所有患者进行各项预后指数评分。对201例完成化疗且有完整随访记录的患者进行单因素及多因素生存分析。

结果

229例患者中男126例，女103例，中位年龄53（21~82）岁。①对上述预后评分系统中所含的危险因素在患者总生存（OS）和无进展生存（PFS）中的影响进行分析，单因素分析结果显示：年龄>60岁、HGB<120 g/L、血β₂微球蛋白升高、骨髓浸润及C反应蛋白（CRP）升高是影响患者OS和PFS的不良因素（P值均<0.05），利妥昔单抗维持组（RM）与非维持组（non-RM）患者的5年OS率分别为93.33%、87.10%（P=0.020），5年PFS率分别为90.81%、63.47%（P=0.003），前者均优于后者；多因素分析结果显示：HGB<120 g/L（P=0.001）、骨髓浸润（P=0.050）、CRP升高（P=0.010）和non-RM（P=0.010）是影响OS的不良预后因素，HGB<120 g/L（P=0.003）、CRP升高（P=0.009）和non-RM（P=0.003）是影响PFS的不良预后因素。②对FLIPI和FLIP2评分预后模型进行比较分析，结果显示：FLIPI预后模型中，低危、中危和高危组患者的5年OS率（P=0.230）和5年PFS率（P=0.160）差异均无统计学意义。FLIP2预后模型中，5年OS率和5年PFS率差异均有统计学意义（P值均<0.001），在利妥昔单抗治疗组中进行分析，低危、中危和高危组患者的5年OS率分别为96.77%、88.89%、80.00%，差异有统计学意义（P=0.042）。

结论

利妥昔单抗时代FLIPI2可以更好地用于FL危险分层。

[Efficacy of RCDOP regimen in the treatment of patients with diffuse large B-cell lymphoma]

Objective: To investigate the efficacy of RCDOP (Rituximab, cyclophosphamide, liposome doxorubicin, vincristine and prednisone) regimen in patients with de novo diffuse large B-cell lymphoma (DLBCL), especially in those patients with multiple extra-nodal involvement or Bulky diseases. Methods: A total of 87 newly diagnosed DLBCL patients who received RCDOP regimen from October 2012 to October 2017 were enrolled into this study. Survival functions were estimated using the Kaplan-Meier method and compared by the log-rank test, and χ(2) tests were used for categorical data. Results: Among the 87 DLBCL patients treated with RCDOP regimen, 81 patients achieved complete remission (CR) or partial remission (PR), with ORR as 93.1%. Patients were further classified into groups, according to the risk factors, such as IPI scores, multiple extra-nodal involvement, bulky disease, age>60, tumor Ki-67>80%, elevated serum LDH level and advanced Ann Arbor stage. The progression-free survival (PFS, P=0.084) and overall survival (OS, P=0.515) had no statistical difference among the IPI low risk (0-1 score) group, intermediate risk (2-3 scores) group and high risk (4-5 scores) group. Similarly, no statistical difference were fou nd in PFS and OS of patients with extra-nodal involvements ≥2 (P=0.303 and P=0.624), with bulky disease (P=0.518 and P=0.466), with age>60 (P=0.600 and P=0.183), with elevated serum LDH level (P=0.054 and P=0.880), with advanced Ann Arbor stage (P=0.075 and P=0.286), and with tumor Ki-67 over 80% (P=0.190 and P=0.109), when compared with those of patients without these risk factors. Conclusion: RCDOP can improve the therapeutic effect and prognosis of DLBCL patients with certain high risk factors, such as intermediate and high IPI risks, multiple extra-nodal involvements, bulky disease, age over 60, elevated LDH level, advanced Ann Arbor stage and tumor Ki-67 over 80%.

[Prognostic significance of NCCN-International Prognostic Index (NCCN-IPI) for patients with peripheral T-cell lymphoma treated with CHOP-based chemotherapy]

目的

明确美国国家综合癌症网络国际预后指数（NCCN-IPI）对外周T细胞淋巴瘤（PTCL）患者化疗后的预后评估价值。

方法

回顾性分析2003年1月至2013年5月接受CHOP或CHOP样方案化疗的162例初治PTCL患者的临床资料，采用国际预后指数（IPI）和NCCN-IPI进行危险分层和预后评估。

结果

①162例患者预期5年总生存（OS）和无进展生存（PFS）率分别为33%和20%，中位OS和PFS时间分别为17.0和9.2个月。②多因素分析提示美国东部肿瘤协作组体能状态评分（ECOG评分）≥2分（PFS：HR＝2.418，95%CI 1.535～3.809，P<0.001；OS：HR＝2.347，95%CI 1.435～3.839，P＝0.001）和存在特定的结外病变部位（PFS：HR＝1.800，95%CI 1.216～2.665，P＝0.003；OS：HR＝1.608，95%CI 1.054～2.454，P＝0.027）是影响患者PFS和OS的独立危险因素；ALK⁺是影响间变性大细胞淋巴瘤患者PFS（HR＝0.424，95%CI 0.184～0.975，P＝0.043）及OS（HR＝0.276，95%CI 0.087～0.877，P＝0.029）的独立预后良好因素。③NCCN-IPI低危组患者的生存率显著高于IPI低危组患者（5年OS率74%对54%，χ²＝5.041，P＝0.025；5年PFS率50%对38%，χ²＝5.295，P＝0.021），差异均有统计学意义。

结论

NCCN-IPI较IPI对低危PTCL患者具有更好的预后判断意义，可作为PTCL患者有效的预后分层工具。

[Associations between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students in 2016]

Objective: To investigate the association between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in 2016, and to provide basic data for improving the nutritional status of the poor rural pupils. Methods: Using the multi-stage stratified random cluster sampling method, 22 315 students from grade three to nine from primary and junior high schools were randomly selected from the 50 key counties under the monitor programs, in 22 provinces of NNIPRCS. Questionnaire was used. Among all the students, with equal number of genders, morning fasting height and weight were measured by trained investigators. Status of nutrition was classified as malnutrition, normal, overweight/obesity, by age-specific height and BMI. Multivariate linear and logistic regression methods were used to analyze the relationship between milk consumption and the status of nutrition of the students. Results: Only 31.4% of the students that were on the monitoring programs would drink milk at breakfast. Proportions of milk intake at breakfast were higher in students from the western regions, in lower grades and in girls (P<0.05). The proportions of malnutrition and overweight/obesity were 11.0% and 10.0% respectively. After controlling factors as gender, age, ethnicity, region of residency and types of parental employment, students who drank milk at breakfast showed an average height of 0.4 cm taller than those who did not drink milk (P=0.001). However, no significant relationships were noticed between milk intake at breakfast and weight, malnutrition or overweight/obesity. Conclusion: Milk intake at breakfast seemed associated with the height of the students under study, suggesting that this program can be promoted, especially in students from the poor rural areas.

[Efficacy of additional two cycles of rituximab administration for patients with diffuse large B-cell lymphoma in first remission]

Objective: To analyze the efficacy of additional two cycles of rituximab administration for Chinese patients with diffuse large B-cell lymphoma (DLBCL) in first complete remission (CR) after six cycles of standard 21-day rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP21). Methods: Retrospective analysis was performed in 351 patients with DLBCL diagnosed from March 2003 to March 2012. International Prognosis Index (IPI), Revised (R)-IPI and National Comprehensive Cancer Network (NCCN)-IPI were calculated for each patient. Patients were divided into GCB and non-GCB subtype according to Han's Classification. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods. Results: 282 (80.3%) patients achieved CR and 132 (46.8%) of 282 cases received additional two rituximab therapy. The other 150 (53.2%) patients entered into observation on the intention of the patients. No significant difference was observed in baseline characteristics between the two groups. 3-year estimated PFS for additional rituximab group and observation group were 80.0% and 78.1% (P=0.334), while 3-year estimated OS were 89.7% vs. 86.1% (P=0.452). By subgroup analysis, prolonged PFS were observed in R-IPI low-risk and NCCN-IPI low-risk patients after additional two rituximab cycles. Conclusion: For patients with DLBCL in first remission after standard six cycles of R-CHOP21 regimen, additional two cycles of rituximab maintenance did not significantly improve the general prognosis, but low-risk subgroups of R-IPI and NCCN-IPI could benefit from this regimen.

Synthesis and anti-inflammatory evaluation of novel paclitaxel analogs

A series of paclitaxel analogs modified at C-3'-N and C-7 positions were synthesized from baccatin III and their structures were confirmed by ¹H-NMR, ¹³C-NMR, HR-MS. Compound 7e exhibited potent ability to decrease TNFα (tumor necrosis factor α) in the LPS-activated RAW264.7 murine macrophage-like cell line. The preliminary data indicated that the anti-inflammatory effects may be related to MD-2 and Toll-like receptor 4 (TLR4), rather than Toll-like receptor 2 (TLR2).

[Study on breakfast consumption of children aged from 6-17 in China in 2010-2012]

Objective: To investigate breakfast status and influencing factors among children aged 6-17 in China in 2010-2012. Methods: Data were collected from China National Nutrition and Health Surveillance in 2010-2012. By using multi-stage stratified sampling and population proportional stratified random sampling method, the research objects were 29 393 children, who aged 6 to 17 y from 150 sites in 31 provinces in mainland China. The information of breakfast frequency and the numbers of breakfast dinning out (in restaurant and at schools) in the past week with seven days were collected by questionnaire; and compared by different ages, genders and areas. Results: During the past week, 91.1% (26 776/29 393) of the children aged 6 to 17 y had their breakfast daily, and 94.6% (13 457/14 221) of children aged 6 to 11 y was higher than 87.8% (13 319/15 172) of children aged 12 to 17 y, the highest proportion of the children never eat breakfast (0 time in the past week) found in poor rural areas was 3.6% (189/5 261), the ratio of big cities, small-medium cities and normal rural areas was 1.1% (77/7 104), 0.6% (51/8 361), and 0.6% (54/8 667), respectively (P<0.001). The rate of boys and girls ate their breakfast daily in the past week were 91.3% (13 481/14 761), and 90.9% (13 295/14 632), respectively (P>0.05). Totally 42.2% (12 398/29 393) of children ate breakfast outside-home (the restaurant and the school) in the past week, the percentage of children aged 12 to 17 y and poor rural areas was higher, 50.9% (7 722/15 172), and 52.4% (2 756/5 261), respectively (P<0.001). 42.1% (6 208/14 761) boys and 42.3% (6 190/14 632) girls ate their breakfast outside-home (P>0.05). The place of most school-age children eat outside-home was school, the ratio was 32.2% (9 477/29 393). Conclusion: It was common for school-aged children in China to skip breakfast during their daily lives, especially in poor rural areas and older children, lots of school-aged children ate breakfast outside-home, and most of them ate breakfast in school.

Apoptotic Mechanism of Human Leukemia K562/A02 Cells Induced by Magnetic Ferroferric Oxide Nanoparticles Loaded with Wogonin

Background:

Traditional Chinese medicine wogonin plays an important role in the treatment of leukemia. Recently, the application of drug-coated magnetic nanoparticles (MNPs) to increase water solubility of the drug and to enhance its chemotherapeutic efficiency has attracted much attention. Drugs coated with MNPs are becoming a promising way for better leukemia treatment. This study aimed to assess the possible molecular mechanisms of wogonin-coated MNP-Fe₃O₄ (Wog-MNPs-Fe₃O₄) as an antileukemia agent.

Methods:

After incubated for 48 h, the antiproliferative effects of MNPs, wogonin, or Wog-MNPs-Fe₃O₄ on K562/A02 cells were determined by methyl thiazolyl tetrazolium (MTT) assay. The apoptotic rates of K562/A02 cells treated with either wogonin or Wog-MNPs-Fe₃O₄ were determined by flow cytometer (FCM) assay. The cell cycle arrest in K562/A02 cells was determined by FCM assay. The elementary molecular mechanisms of these phenomena were explored by Western blot and reverse transcriptase polymerase chain reaction (RT-PCR).

Results:

With cell viabilities ranging from 98.76% to 101.43%, MNP-Fe₃O₄ was nontoxic to the cell line. Meanwhile, the wogonin and Wog-MNPs-Fe₃O₄ had little effects on normal human embryonic lung fibroblast cells. The cell viabilities of the Wog-MNPs-Fe₃O₄ group (28.64–68.36%) were significantly lower than those of the wogonin group (35.53–97.28%) in a dose-dependent manner in 48 h (P < 0.001). The apoptotic rate of K562/A02 cells was significantly improved in 50 μmol/L Wog-MNPs-Fe₃O₄ group (34.28%) compared with that in 50 μmol/L wogonin group (23.46%; P < 0.001). Compared with those of the 25 and 50 μmol/L wogonin groups, the ratios of G0/G1-phase K562/A02 cells were significantly higher in the 25 and 50 μmol/L Wog-MNPs-Fe₃O₄ groups (all P < 0.001). The mRNA and protein expression levels of the p21 and p27 in the K562/A02 cells were also significantly higher in the Wog-MNPs-Fe₃O₄ group compared with those of the wogonin group (all P < 0.001).

Conclusions:

This study demonstrated that MNPs were the effective drug delivery vehicles to deliver wogonin to the leukemia cells. Through increasing cells arrested at G0/G1-phase and inducing apoptosis of K562/A02 cells, MNPs could enhance the therapeutic effects of wogonin on leukemia cells. These findings indicated that MNPs loaded with wogonin could provide a promising way for better leukemia treatment.

Synthesis, optical and electrochemical properties of 2-[(9H-fluoren-2-yl)aryl]-1H-benz[d]imidazole and 2,7-bis[(1H-benz[d]imidazol-2-yl)aryl]- 9H-fluorene derivatives

A series of 2-[(9H-fluoren-2-yl)aryl]-1H-benzo[d]imidazoles 11–13 and 2,7-bis[(1H-benzo[d]imidazol-2-yl)aryl]-9H-fluorenes 14–16 containing different linking aromatic units were synthesized in good yields. Their absorption and fluorescence properties were investigated in solution and in the solid state. Most compounds possess good fluorescence-emitting ability with φFL values in the region of 0.31–0.99 in solution and display strong blue emission. Structure–optical behavior characteristics and further details of the electronic properties from cyclic voltammetry measurements and theoretical calculations are discussed.

Syntheses and biological evaluation of C-3'-N-acyl modified taxane analogues from 1-deoxybaccatin-VI

A series of side-chain modified taxane analogues were synthesized and their in vitro anticancer activities against four human cancer cell lines: MDA-MB-231 (human breast cancer), PC-3 (human prostatic cancer), HepG2 and H460 (human hepatoma) were studied. The three hydroxyl groups at C-7, C-9 and C-10 enable the behavior of these compounds to be evidently distinct from other similar compounds. The strong cytotoxicity in the four cell lines showed by the newly synthesized taxane analogues 13a and 13d indicated them as potential lead compounds for anticancer drug design.

Combined treatment with the antibiotics kanamycin and streptomycin promotes the conjugation of Escherichia coli

It is widely accepted that antibiotics provide a critical selective pressure for the horizontal transfer of antibiotic resistance between bacterial species. This study demonstrated that a combination of low doses of kanamycin and streptomycin, which inhibited the growth of recipient and donor cells, respectively, had positive effects on the transmission of the conjugation plasmids pRK2013, pSU2007, and RP4 from Escherichia coli DH5α to HB101 at their minimum inhibitory concentrations (MICs). Administration of either antibiotic alone as well as other antibiotics in combination or alone did not have this effect. Two-dimensional electrophoresis revealed that 60 proteins were downregulated and 14 proteins were upregulated in the conjugation of E. coli DH5α (pRK2013) and HB101 in the presence of kanamycin and streptomycin. Of these proteins, 64 were subsequently identified by mass spectrometry. Two antibiotic-induced genes encoding oligopeptide-binding protein (OppA) and ribose-binding protein (RbsB) were further confirmed by quantitative real-time PCR. When these genes were deleted, the number of transconjugants decreased in the same fashion as when the cells were treated with kanamycin and streptomycin. These results indicate that the process of E. coli conjugation may be promoted by combination treatment with kanamycin and streptomycin and that two proteins potentially participated in this process.

Association of polymorphisms of cytosine arabinoside-metabolizing enzyme gene with therapeutic efficacy for acute myeloid leukemia

BACKGROUND

The cytosine arabinoside (Ara-C)-based chemotherapy is the major remedial measure for acute myeloid leukemia (AML). Deoxycytidine kinase (DCK) and cytidine deaminase (CDA) are the key enzymes in the metabolism of Ara-C. Many single nucleotide polymorphisms (SNPs) and haplotypes of DCK and CDA, which contribute to susceptibility to Ara-C, have been identified in Africans and Europeans. However, there has been no report about the relation among three SNPs in DCK (rs115543896, rs72552079, and rs111454937) and two SNPs in CDA (rs2072671 and rs60369023), and their clinical response to Ara-C for a Chinese population. In this study, we aimed to investigate whether these five SNPs are associated with the therapeutic outcomes of Ara-C-based chemotherapy regimens in patients with AML.

METHODS

A total of 151 Chinese patients with AML were enrolled in our study. SNPs genotyping were performed using the MassARRAY system by means of the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) method.

RESULTS

The results illustrated that DCKrs111454937 AA genotype was more frequent in patients with higher platelet count, and A allele frequency was significantly higher in the group £40 years, lower white blood cell (WBC) count patients group and the group with platelet counts > 60'10(9)/L. Meanwhile, both DCKrs72552079 TC (OR = 1.225, 95%CI = 1.225 - 9.851, P = 0.0192) and CDArs60369023 GA (OR = 9.851, 95%CI = 1.31 - 77.93, P = 0.0263) significantly improved Ara-C-based chemotherapy response. While DCKrs11554389 AA (OR = 0.147, 95%CI = 0.027 - 0.801, P = 0.0267) was associated with the decrease of Ara-C-based chemotherapy response.

CONCLUSION

It is evident that the DCK and CDA polymorphisms might be the important markers for the AML patients' therapy outcomes in a Chinese population.

[Detection of single nucleotide polymorphisms of mthfr and dpyd genes in leukemia cell lines K562 and K562/A02]

This study was purposed to detect single nucleotide polymorphisms (SNP) of 2 pharmacokinetics-related genes in K562 and K562/A02 cell lines. Leukemia cell line K562 and its resistant line K562/A02 were cultured, the genomic DNA was isolated by QIAamp DNA Blood Mini kit, primers were designed, the related DNA fragments were amplified by PCR. The SNP genotyping of mthfr gene rs1801131, rs1801133 and rs2274976 and dpyd gene rs1801159, rs1801160 and rs17376848 was performed by means of matrix assisted laser desorption ionization-time of flight mass spectrometry method (MALDI-TOFMS). The results showed that the genotype of mthfr gene locus 1801131 was AC, rs1801133 was CC, rs2274976 was GG, genotype of dpyd gene locus 1801159 was GG, rs1801160 was GG, rs17376848 was AA in both K562 and K562/A02 cell lines. It is concluded that the above-mentioned loci of mthfr and dpyd genes in K562 and K562/A02 cell lines are not expressed differently.

[Correlation between single nucleotide polymorphisms and hematological malignancies]

Single nucleotide polymorphisms (SNPs) are the 3rd generation of molecular genetic markers of human populations.SNPs determine the functional units of genes and the inherent characteristics of genetic variation, and reflect the individual phenotype, disease susceptibility and differences of response to drug and environmental factors. Hematological malignancy is a multi-gene genetic diseases, and involve in the role of multigenic susceptible genes. This review intends to introduce the single nucleotide polymorphisms and their relevant progress of research on hematologic malignancies, including the SNP of carcinogen-metabolizing enzymes genes, the SNP of DNA repair genes, the SNP of oncogenes and anti-oncogene genes, the SNP of drug-metabolizing enzyme genes and so on.