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Zhou Y, Tong RH, Zhong WL, Tan Y, Jiang M, Shi ZB, Yang ZC, Shen YQ, Wen J, Liang AS. Quasi-optical design for the cross-polarization scattering diagnostic on the HL-3 tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2024; 95:053507. [PMID: 38758767 DOI: 10.1063/5.0211022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/29/2024] [Indexed: 05/19/2024]
Abstract
As the plasma beta (β) increases in high-performance tokamaks, electromagnetic turbulence becomes more significant, potentially constraining their operational range. To investigate this turbulence, a cross-polarization scattering (CPS) diagnostic system is being developed on the HL-3 tokamak for simultaneous measurements of density and magnetic fluctuations. In this work, a quasi-optical system has been designed and analyzed for the Q-band CPS diagnostic. The system includes a lens group for beam waist size optimization, a rotatable wire-grid polarizer for polarization adjustment, and a reflector group for measurement range regulation and system response enhancement. Laboratory tests demonstrated a beam radius of order 4 cm at the target measurement location (near the plasma pedestal), cross-polarization isolation exceeding 30 dB, and poloidal and toroidal angle adjustment ranges of ±40° and ±15°, respectively. These results verify the system's feasibility through laboratory evaluations. The quasi-optical system has been installed on the HL-3 tokamak during the 2023 experimental campaign to support the development of CPS diagnostics.
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Gao X, Wang Y, Song Z, Jiang M, Huang T, Baccarelli AA. Early-life risk factors, accelerated biological aging and the late-life risk of mortality and morbidity. QJM 2024; 117:257-268. [PMID: 37930885 DOI: 10.1093/qjmed/hcad247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/18/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Early-life exposure increases health risks throughout an individual's lifetime. Biological aging is influenced by early-life risks as a key process of disease development, but whether early-life risks could accelerate biological aging and elevate late-life mortality and morbidity risks remains unknown. Knowledge is also limited on the potential moderating role of healthy lifestyle. METHODS We investigate associations of three early-life risks around birth, breastfeeding, maternal smoking and birth weight, with biological aging of 202 580 UK Biobank participants (54.9 ± 8.1 years old). Biological aging was quantified as KDM-BA, PhenoAge and frailty. Moderate alcohol intake, no current smoking, healthy diet, BMI <30 kg/m2 and regular physical activity were considered as healthy lifestyles. Mortality and morbidity data were retrieved from health records. RESULTS Individual early-life risk factors were robustly associated with accelerated biological aging. A one-unit increase in the 'early-life risk score' integrating the three factors was associated with 0.060 (SE=0.0019) and 0.036-unit (SE = 0.0027) increase in z-scored KDM-BA acceleration and PhenoAge acceleration, respectively, and with 22.3% higher odds (95% CI: 1.185-1.262) of frailty. Increased chronological age and healthy lifestyles could mitigate the accelerations of KDM-BA and PhenoAge, respectively. Associations of early-life risk score with late-life mortality and morbidity were mediated by biological aging (proportions: 5.66-43.12%). KDM-BA and PhenoAge accelerations could significantly mediate the impact on most outcomes except anxiety, and frailty could not mediate the impact on T2D. CONCLUSION Biological aging could capture and mediate the late-life health risks stemming from the early-life risks, and could be potentially targeted for healthy longevity promotion.
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Zhang W, Li M, Ye X, Jiang M, Wu X, Tang Z, Hu L, Zhang H, Li Y, Pan J. Disturbance of mitochondrial dynamics in myocardium of broilers with pulmonary hypertension syndrome. Br Poult Sci 2024; 65:154-164. [PMID: 38380624 DOI: 10.1080/00071668.2024.2308277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/05/2023] [Indexed: 02/22/2024]
Abstract
1. The following study investigated the relationship between pulmonary hypertension syndrome (PHS) and mitochondrial dynamics in broiler cardiomyocytes.2. An animal model for PHS was established by injecting broiler chickens with CM-32 cellulose particles. Broiler myocardial cells were cultured under hypoxic conditions to establish an in vitro model. The ascites heart index, histomorphology, mitochondrial ultrastructure, and mitochondrial dynamic-related gene and protein expression were evaluated.3. The myocardial fibres from PHS broilers had wider spaces and were wavy and twisted and the number of mitochondria increased. Compared with the control group, the gene and protein expression levels were decreased for Opa1, Mfn1, and Mfn2 in the myocardium of PHS broilers. The gene and protein expression was significantly increased for Drp1 and Mff.4. This study showed that PHS in broilers may cause myocardial mitochondrial dysfunction, specifically by diminishing mitochondrial fusion and enhancing fission, causing disturbances in the mitochondrial dynamics of the heart.
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Miao WY, Xu JL, Zhang KL, Wang HB, Jiang M. [Establishment of acute graft-versus-host disease model after non-myeloablative haploidentical peripheral blood stem cell transplantation in aged mice]. ZHONGHUA YI XUE ZA ZHI 2024; 104:540-546. [PMID: 38317367 DOI: 10.3760/cma.j.cn112137-20230817-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Objective: To establish an acute graft-versus-host disease (aGVHD) model in aged mice after non-myeloablative haploidentical peripheral blood stem cell transplantation (haplo-PSCT). Methods: C57BL/6 (H-2b) male mice aged 6-8 weeks were used as donor mice, and CB6F1 (H-2b×d) female mice aged 14-16 months were used as recipient mice. The donor mice were injected subcutaneously with rehuman granulocyte-colony stimulating factor (rhG-CSF) 5 days before transplantation for hematopoietic stem cell mobilization.The recipient mice were divided into control group (CG), spleen cell low-dose group (SL), spleen cell medium-dose group (SM) and spleen cell high-dose group (SH) according to random number table method, with 16 rats in each group, all of which received total linear accelerator X-ray irradiation (TBI) with a total dose of 6 Gy. Peripheral blood mononuclear cells (PBMC) and spleen cells of different doses (0.5×107/each, 1.0×107/each and 2.0×107/each in SL group, SM group and SH group, respectively) were transfused through the tail vein within 4 hours after TBI, and only the same amount of normal saline was transfused in CG group. After transplantation, the survival and weight changes of mice in each group were observed for 30 days, and the changes of blood routine were monitored regularly. Mice peripheral blood was collected 21 days after transplantation to detect the chimerism rate of the donor. Hematoxylin-eosin staining was performed on the skin, liver and colon of mice 21 days after transplantation to analyze the histopathological changes of aGVHD target organs. Results: All the mice in each group were successfully transplanted. After TBI, the weight and activity of mice in all groups decreased, and the phenomenon of bone marrow suppression appeared. During the observation period, all mice in CG group and SL group survived, 3 mice in SM group died with survival time of (26.0±5.8) days, and 6 mice in SH group died with survival time of (20.9±7.3) days. The body weight of mice in SH group was lower than that in CG group, SL group and SM group 21days after transplantation [(25.0±0.7), (25.5±0.4), (25.0±1.4) vs (20.8±0.8) g, all P<0.05]. Compared with CG group, SL group and SM group, the levels of leukocyte, erythrocyte, hemoglobin and platelet in SH group decreased 21 days after transplantation (all P<0.05). There was no significant difference in donor chimerism rate among SL group, SM group and SH group [(95.8%±0.8%), (95.5%±1.4%) and (95.1%±1.3%), respectively, all P>0.05]. Compared with CG group, SL group and SM group, the tissue structure of aGVHD target organs in SH group was severely damaged, with a large number of inflammatory cells infiltratedand higher histopathological scores than SL group and SM group (all P<0.05). Conclusion: For aging CB6F1 mice, after 6 Gy TBI pretreatment with linear accelerator X-ray, PBMC (1×107/each) and spleen cells (2.0×107/each) were injected to successfully induce aGVHD model after non-myelablative haplo-PSCT.
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Jiang M, Zhao HZ, Li JX, Zhang TC, Xu WJ, Li X, Zheng LL. [Comparison of the impact of orthodontic treatment on pulp volume in adolescents and adults]. ZHONGHUA KOU QIANG YI XUE ZA ZHI = ZHONGHUA KOUQIANG YIXUE ZAZHI = CHINESE JOURNAL OF STOMATOLOGY 2024; 59:149-156. [PMID: 38280735 DOI: 10.3760/cma.j.cn112144-20230901-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
Objective: To compare the impact of orthodontic treatment on pulp volume in adolescents and adults. Methods: Cone-beam CT data of 62 patients undergoing orthodontic treatment at the Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, from January 2019 to March 2022 were collected. Patients were divided into two age groups (31 patients in each group): adolescent group (aged 13-17, 17 males and 14 females) and adult group (aged 21-25, 12 males and 19 females). Pre-and post-treatment reconstructions of the pulp and dental tissues of upper first molars (UM1) and lower central incisors (L1) were performed. Measurements included pulp volume for UM1 (UM1 P) and L1 (L1 P), pulp chamber volume (UM1 PC) and root canal volume (UM1 RC) for UM1, root length for L1 (L1 RL), and mesiobuccal root length for UM1 (UM1 RL), as well as chamber heights at specific landmarks [the lengths from the central fossa fusion site to the roof of the pulp chamber (H1), the floor of the pulp chamber (H2), the nearest point of root divergence as well as crown-root bifurcation (H3), the farthest point of root divergence (H4), and the pulp chamber height (H5)] in UM1. Changes in these indices were calculated and analyzed using paired and independent sample t-tests for within-group and between-group differences, respectively. Pearson correlation was used to assess potential associations among H5, root length, and pulp volume changes. Results: Before and after orthodontic treatment, no significant difference was observed in the adult group for L1 P (t=-0.03, P=0.975), while significant differences were noted for UM1 P, UM1 PC, and UM1 RC (t=9.98, P<0.001; t=9.04, P<0.001; t=6.69, P<0.001). In the adolescent group, significant differences were found for both L1 P and UM1 P (t=2.25, P=0.029; t=6.30, P<0.001). After orthodontic treatment, the absolute value changes of UM1 P, UM1 PC, and L1 P in the adolescent group were (19.75±9.58), (15.07±7.65) and (1.89±6.29) mm3, respectively, and in the adult group were (13.33±9.41), (9.16±7.05) and (0.02±4.66) mm3, respectively (t=3.77, P<0.001; t=4.48, P<0.001; t=2.34, P=0.048). There was no significant absolute difference in the amount of UM1 RC between the two groups after orthodontic treatment (t=0.86, P=0.391). Before and after orthodontic treatment, the absolute value changes of L1 RL, H1 and H5 in the adolescent group were (0.54±0.41), (0.38±0.27) and (0.71±0.33) mm, respectively, and the absolute value changes in the adult group were (0.78±0.62), (0.26±0.20) and (0.57±0.28) mm, respectively (t=-2.43, P=0.017; t=2.96, P=0.004; t=2.57, P=0.011). Whereas no significant differences were observed for UM1 RL, H2, H3, and H4 (t=-0.85, P=0.400; t=0.43, P=0.669; t=-0.50, P=0.619; t=1.46, P=0.148). Additionally, significant correlations were found between changes in H5 and UM1 RL with UM1 P (r=0.35, P<0.001; r=0.19, P=0.030), but not between Changes in L1 RL and L1 P (r=0.11, P>0.05). Conclusions: The effect of orthodontic treatment on pulp volume in adolescents and adults were different.
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Li JC, Du J, Yang ZX, Jin F, Weng JW, Qi YJ, Huang JS, Hei MY, Jiang M. [Analysis of clinical characteristics and risk factors of postoperative complications in infants with early-onset necrotizing enterocolitis after enterostomy]. ZHONGHUA YI XUE ZA ZHI 2024; 104:38-44. [PMID: 38178766 DOI: 10.3760/cma.j.cn112137-20230926-00577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Objective: To investigate the clinical characteristics of children with early-onset necrotizing enterocolitis (NEC) undergoing enterostomy and analyze the risk factors for postoperative complications. Methods: Retrospective analysis was conducted on the clinical data (perinatal conditions, clinical characteristics, clinical outcomes, etc.) of NEC patients who underwent enterostomy at Beijing Children's Hospital from May 2016 to May 2023. The patients were divided into two groups based on the age of onset: an early-onset enterostomy group (<14 days) and a late-onset enterostomy group (≥14 days). Furthermore, the children with NEC were categorized into complication group and non-complication group based on whether there were complications after enterostomy. The differences in clinical data between these groups were analyzed, and the clinical characteristics of children with early-onset NEC and enterostomy were summarized. Multivariate logistic regression model was employed to analyze the risk factors for postoperative complications in NEC children with enterostomy. Results: A total of 68 cases were enrolled, including 43 cases in the early-onset enterostomy group [26 males and 17 females, aged (6.5±3.0) days] and 25 cases in the late-onset enterostomy group [15 males and 10 females, aged (21.0±3.0) days]. There were 28 cases (17 males and 11 females), age [M (Q1, Q3)] 9 (5, 14) days in the complication group and 33 cases (22 males and 11 females), aged of 14 (6, 21) days in the non-complication group. Compared to the late-onset enterostomy group, the early-onset enterostomy group had significantly higher rates of intraventricular hemorrhage [30.2% (13/43) vs 8.0% (2/25)], hemodynamically significant patent ductus arteriosus [37.2% (16/43) vs 12.0% (3/25)], mechanical ventilation≥72 hours after birth [39.5% (17/43) vs 16.0% (4/25)], stage Ⅲ NEC [(69.8% (30/43) vs 40.0% (10/25)], extensive NEC [27.9% (12/43) vs 8.0% (2/25)], and short-term postoperative complications [56.8% (21/37) vs 29.2% (7/24)] (all P<0.05).Multivariate logistic regression model analysis revealed that residual length of proximal small intestine was a protective factor for postoperative complications after enterostomy in NEC infants (OR=0.764, 95%CI: 0.648-0.901, P=0.001), but stage Ⅲ NEC was a risk factor (OR=1.042, 95%CI: 1.004-5.585, P=0.017). Conclusions: The incidence of postoperative complications is high, and the prognosis is poor in children with early-onset NEC enterostomy. The residual length of proximal enterostomy is a protective factor for postoperative complications of NEC enterostomy, but stage Ⅲ NEC is a risk factor.
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Li S, Yang Z, Li Y, Zhao N, Yang Y, Zhang S, Jiang M, Wang J, Sun H, Xie Z. Preoperative prediction of vasculogenic mimicry in lung adenocarcinoma using a CT radiomics model. Clin Radiol 2024; 79:e164-e173. [PMID: 37940444 DOI: 10.1016/j.crad.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/01/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
AIM To develop and validate a non-invasive computed tomography (CT)-based radiomics model for predicting vasculogenic mimicry (VM) status in lung adenocarcinoma (LA). MATERIALS AND METHODS Two hundred and three patients with LA were enrolled retrospectively and grouped into training and test groups with a ratio of 7:3. Uni- and multivariate logistic regression analyses were performed in the training cohort to screen the independent clinical and radiological factors for VM, and the clinical model was then established. A radiomics model was established based on the rad-scores through support vector machine (SVM). A radiomics nomogram model was subsequently constructed by combining the rad-score with clinical-radiological factors. The receiver operating characteristic curve (ROC), calibration curves, and decision curve analysis (DCA) were conducted to evaluate the performance of the three models. RESULTS Nine selected radiomics features were selected for the radiomics model and the maximum length and spiculation sign were constructed for the clinical model. The radiomics nomogram model integrating the maximum length, spiculation sign, and rad-score yielded the best AUC in both the training (AUC = 0.925) and test cohorts (AUC = 0.978), in comparison with the radiomics model (AUC = 0.907 and 0.964, in both the training and test cohorts) and the clinical model (AUC = 0.834 and 0.836 in both training and test cohorts). CONCLUSIONS The CT-based radiomics nomogram model showed satisfying discriminating performance for preoperatively and non-invasively predicting VM expression status in LA patients.
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Zheng XH, Jiang M, Li XL. [Interpretation of the 2023 European Society of Cardiology (ESC) Guidelines for the management of cardiomyopathies]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2023; 51:1199-1204. [PMID: 37963758 DOI: 10.3760/cma.j.cn112148-20230906-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
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Gao GY, Cao LJ, Yu ZQ, Jiang M, Han Y, Bai X, Su J, Ruan CG. [Analysis of clinical phenotype and gene mutation characteristics of MYH9-related disorder]. ZHONGHUA YI XUE ZA ZHI 2023; 103:2964-2970. [PMID: 37752057 DOI: 10.3760/cma.j.cn112137-20230328-00496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Objective: To investigate the clinical phenotype and gene mutation characteristics of MYH9-related disorder (MYH9-RD). Methods: The clinical data of 66 patients with MYH9-RD in the First Affiliated Hospital of Soochow University from January 2010 to December 2022 were retrospectively analyzed. According to the bleeding symptom, the patients were divided into bleeding and non-bleeding group, and according to the mutation sites, the patients were divided into non-muscle myosin heavy chain ⅡA head region (MD) and tail region (TD) mutation group. Statistical analysis was made to explore the clinical features in different groups such as platelet counts, bleeding, renal function, cataracts and hearing as well as MYH9 gene mutations. Results: A total of 66 MYH9-RD patients were included, with 28 males and 38 females, diagnosis age of 1-63(26±2) years. And 41% (27/66) of the patients had no family history. All patients presented with macrothrombocytopenia and normal platelet aggregation(10/10), 92% (54/59) of the patients had visible blue inclusion bodies in neutrophils, 30% (20/66) had bleeding symptoms, 45% (22/49) had proteinuria or glomerulonephropathy, 20% (8/41) had bilateral hearing impairment, and 10% (4/42) had bilateral cataracts. 18 mutation sites were identified in total, including 15 missense, 1 splicing and 2 termination mutations. Among them, p.Asp1424Asn, p.Arg1933* and p.Arg702His/Cys mutations were identified in 56% (29/52) of the patients, and p.Ser96Leu, Arg1165Cys and p.Glu1841Lys mutations were recurrent mutations, while p.Ala44Thr, p.Asp1447Ala and c.3838-2A>G mutations were novel mutations. The average platelet count of patients in bleeding group was (19±3)×109/L, which was significantly less than (36±3)×109/L in non-bleeding group (P<0.001). Compared with TD mutation group, patients of MD mutation group were presented with lower platelet count and higher risk of bleeding, as well as more severe clinical presentations including renal and hearing impairment and cataracts (all P<0.05). Conclusion: Mutations of p.Asp1424Asn, p.Arg1933* and p.Arg702His/Cys in MYH9 gene are hotspot mutations for MYH9-RD patients, Compared with TD mutation group, patients of MD mutation group were presented with lower platelet count and higher risk of bleeding, as well as more severe clinical presentations including renal and hearing impairment and cataracts.
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Deng WC, Shi ZB, Shi PW, Yang ZC, Chen W, Huang M, Zhang F, Yu X, Jiang M, Wen J, Liang AS, Shen YQ, Zhou Y, Tong RH, Zhong WL. Preliminary results of the 105 GHz collective Thomson scattering system on HL-2A. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:094701. [PMID: 37668510 DOI: 10.1063/5.0150123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
A 105 GHz collective Thomson scattering (CTS) diagnostic has been successfully developed for fast-ion measurements on the HL-2A tokamak, and it has been deployed during an experimental campaign. Enhanced signals exhibiting synchronous modulation characteristics have been observed across all CTS channels upon the launch of a modulated probe wave. Results show that the intensity of the CTS signal increases with Neutral Beam Injection (NBI) power and is proportional to neutron count, indicating that the scattering signal contains a contribution from fast ions. Compared with the signal without NBI, the enhanced scattering spectrum due to NBI is slightly wider than the predicted fast ion range. Such broadening might be attributed to the heating effects of the gyrotron.
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Shen YQ, Yang ZC, Zhong WL, Jiang M, Shi ZB, Santos J, Shi PW, Tong RH, Xue GQ, Zhou Y, Wen J, Yu X, Deng WC, Wang S, Yang ZJ, Chen ZY, Li D, Zha XQ, Jin ZY, Xu X, Xu M. Plasma position measurements by O-mode and X-mode reflectometry systems in tokamak plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:063505. [PMID: 37862534 DOI: 10.1063/5.0140390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/07/2023] [Indexed: 10/22/2023]
Abstract
Plasma Position Reflectometry (PPR) is planned to provide plasma position and shape information for plasma operation in future fusion reactors. Its primary function is to calibrate the drift of the magnetic signals due to the integral nature of magnetic measurement. Here, we attempt to measure plasma position using ordinary mode (O-mode) and extraordinary mode (X-mode) reflectometry systems on two tokamaks. A new physical model based on the phase shift is proposed to deduce the relative movement of the cut-off layer without density inversion. We demonstrate the plasma position measurements by absolute measurement from density profile inversion and relative measurement from phase shift. The combination of X-mode and O-mode reflectometers can minimize the limitations of single polarization reflectometry and further increase the accuracy of plasma position measurement. These results could provide an important technical basis for the further development of a real-time control system based on PPR.
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Xu W, Yi SH, Feng R, Wang X, Jin J, Mi JQ, Ding KY, Yang W, Niu T, Wang SY, Zhou KS, Peng HL, Huang L, Liu LH, Ma J, Luo J, Su LP, Bai O, Liu L, Li F, He PC, Zeng Y, Gao D, Jiang M, Wang JS, Yao HX, Qiu LG, Li JY. [Current status of diagnosis and treatment of chronic lymphocytic leukemia in China: A national multicenter survey research]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:380-387. [PMID: 37550187 PMCID: PMC10440613 DOI: 10.3760/cma.j.issn.0253-2727.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Indexed: 08/09/2023]
Abstract
Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
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Cheng MX, Ran HQ, Jiang M, Huang XJ, Zhang T, Zhang P. [Tumor-to-tumor metastasis of lung adenocarcinoma into a pleura solitary fibrous tumor: report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2023; 52:411-413. [PMID: 36973208 DOI: 10.3760/cma.j.cn112151-20220717-00616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Li YC, Jiang M, Xu Y, Shi ZB, Xu JQ, Liu Y, Liang AS, Yang ZC, Wen J, Zhang YP, Wang XQ, Zhu YJ, Zhou H, Li W, Luo Y, Su X. MHD instability dynamics and turbulence enhancement towards the plasma disruption at the HL-2A tokamak. Sci Rep 2023; 13:4785. [PMID: 36959269 PMCID: PMC10036549 DOI: 10.1038/s41598-023-31304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/09/2023] [Indexed: 03/25/2023] Open
Abstract
The evolutions of MHD instability behaviors and enhancement of both electrostatic and electromagnetic turbulence towards the plasma disruption have been clearly observed in the HL-2A plasmas. Two types of plasma disruptive discharges have been investigated for similar equilibrium parameters: one with a distinct stage of a small central temperature collapse ([Formula: see text] 5-10%) around 1 millisecond before the thermal quench (TQ), while the other without. For both types, the TQ phase is preceded by a rotating 2/1 tearing mode, and it is the development of the cold bubble from the inner region of the 2/1 island O-point along with its inward convection that causes the massive energy loss. In addition, the micro-scale turbulence, including magnetic fluctuations and density fluctuations, increases before the small collapse, and more significantly towards the TQ. Also, temperature fluctuations measured by electron cyclotron emission imaging enhances dramatically at the reconnection site and expand into the island when approaching the small collapse and TQ, and the expansion is more significant close to the TQ. The observed turbulence enhancement near the X-point cannot be fully interpreted by the linear stability analysis by GENE. Evidences suggest that nonlinear effects, such as the reduction of local [Formula: see text] shear and turbulence spreading, may play an important role in governing turbulence enhancement and expansion. These results imply that the turbulence and its interaction with the island facilitate the stochasticity of the magnetic flux and formation of the cold bubble, and hence, the plasma disruption.
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Xie L, Yang C, Jiang M, Qiu YQ, Cai R, Hu LL, Jiang YX, Wang L, Chen QC, Wu S, Shi XL, Hu QH, Li YH. [Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:386-392. [PMID: 36922172 DOI: 10.3760/cma.j.cn112150-20220823-00832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.
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Jiang M, Ren X, Han L, Ma T, Zheng X. Association between Household Solid Fuel Use and Sarcopenia Risk among Middle-Aged and Older Adults in China: A Nationwide Population-Based Cohort Study. J Nutr Health Aging 2023; 27:472-478. [PMID: 37357332 DOI: 10.1007/s12603-023-1933-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/29/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUNDS Household solid fuel have been associated with changes of handgrip strength, and exposure to ambient air pollution might be one risk factor of sarcopenia. However, the prospective association between household solid fuel use and sarcopenia remains limited. METHODS A total of 11,924 participants (5,723 men (48%) and 6,201 women (52%) with the average age was 59.17 ± 9.57 years) from the China Health and Retirement Longitudinal Study 2011 were included in cross-sectional analyses. 7,507 participants at baseline were included in longitudinal analyses and were followed up in 2015. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. RESULTS In cross-sectional analyses, the participants who used solid fuel for cooking and heating had higher prevalence of sarcopenia than those who used clean fuel. During the follow-up, 302 (4.02%) participants experienced sarcopenia. In the longitudinal analysis, after multivariable adjustment of age, sex and other risk factors, individuals who used solid fuel for cooking had an elevated risk of new-onset sarcopenia, with corresponding odds ratio of 1.32 (95% confidence interval, 1.03-1.71). Consistently, individuals reported solid fuels use for heating were associated with 20% (odds ratio=1.20, 95% confidence interval: 1.01-1.56) increased risk of sarcopenia. In addition, a self-reported switch from clean to solid fuel for cooking appeared to have an increased sarcopenia risk (odds ratio=1.20, 95% confidence interval: 1.02-1.43). CONCLUSION Using household solid fuel for cooking and heating was associated with increased risk of sarcopenia prevalence and incidence.
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Zhang Z, Shan L, Wang Y, Li W, Jiang M, Liang F, Feng S, Lu Z, Wang H, Dai J. Primate preoptic neurons drive hypothermia and cold defense. Innovation (N Y) 2022; 4:100358. [PMID: 36583100 PMCID: PMC9793322 DOI: 10.1016/j.xinn.2022.100358] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Maintaining body temperature within a narrow range is vital for warm-blooded animals. In rodents, the preoptic area (POA) of the hypothalamus detects and regulates core body temperature. However, knowledge about the thermal regulation center in primates remains limited. Here, we show that activating a subpopulation of POA neurons by a chemogenetic strategy reliably induces hypothermia in anesthetized and freely moving macaques. Comprehensive monitoring of physiological parameters reveals that such hypothermia is accompanied by autonomic changes including a rise in heart rate, skeletal muscle activity, and correlated biomarkers in blood. Consistent with enhanced ambulatory movement during hypothermia, the animals show a full range of cold-defense behaviors. Resting-state fMRI confirms the chemogenetic activation of POA and charts a brain-wide network of thermoregulation. Altogether, our findings demonstrate the central regulation of body temperature in primates and pave the way for future application in clinical practice.
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Albuquerque-Souza E, Crump K, Rattanaprukskul K, Li Y, Shelling B, Xia-Juan X, Jiang M, Sahingur S. TLR9 Mediates Periodontal Aging by Fostering Senescence and Inflammaging. J Dent Res 2022; 101:1628-1636. [PMID: 35918888 PMCID: PMC9703528 DOI: 10.1177/00220345221110108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
TLR9 is a critical nucleic acid sensing receptor in mediating periodontitis and periodontitis-associated comorbidities. Emerging evidence implicates TLR9 as a key sensor during aging, although its participation in periodontal aging is unexplored. Here, we investigated whether TLR9-mediated host responses can promote key hallmarks of aging, inflammaging, and senescence, in the course of periodontitis using a multipronged approach comprising clinical and preclinical studies. In a case-control model, we found increased TLR9 gene expression in gingival tissues of older (≥55 y) subjects with periodontitis compared to older healthy subjects as well as those who are younger (<55 y old) with and without the disease. Mechanistically, this finding was supported by an in vivo model in which wild-type (WT) and TLR9-/- mice were followed for 8 to 10 wk (young) and 18 to 22 mo (aged). In this longitudinal model, aged WT mice developed severe alveolar bone resorption when compared to their younger counterpart, whereas aged TLR9-/- animals presented insignificant bone loss when compared to the younger groups. In parallel, a boosted inflammaging milieu exhibiting higher expression of inflammatory/osteoclast mediators (Il-6, Rankl, Cxcl8) and danger signals (S100A8, S100A9) was noted in gingival tissues of aged WT mice compared to the those of aged TLR9-/- mice. Consistently, WT aged mice displayed an increase in prosenescence balance as measured by p16INK4a/p19ARF ratio compared to the younger groups and aged TLR9-/- animals. Ex vivo experiments with bone marrow-derived macrophages primed by TLR9 ligand (ODN 1668) further corroborated in vivo and clinical data and showed enhanced inflammatory-senescence circuit followed by increased osteoclast differentiation. Together, these findings reveal first systematic evidence implicating TLR9 as one of the drivers of periodontitis during aging and functioning by boosting a deleterious inflammaging/senescence environment. This finding calls for further investigations to determine whether targeting TLR9 will improve periodontal health in an aging population.
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Jiang M, Yan S, Ren WC, Xing NN, Li HY, Zhang MQ, Liu MQ, Liu XB, Ma W. Genetic Diversity and Population Structure of Traditional Chinese Herb Radix bupleuri Resources Using Genome-Wide SNPs through Genotyping-by-Sequencing. RUSS J GENET+ 2022. [DOI: 10.1134/s1022795422120055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Wang J, Yang L, Jiang M, Zhao C, Liu X, Berry K, Waisman A, Langseth AJ, Novitch BG, Bergles DE, Nishiyama A, Lu QR. Olig2 Ablation in Immature Oligodendrocytes Does Not Enhance CNS Myelination and Remyelination. J Neurosci 2022; 42:8542-8555. [PMID: 36198499 PMCID: PMC9665935 DOI: 10.1523/jneurosci.0237-22.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 11/21/2022] Open
Abstract
The oligodendrocyte (OL) lineage transcription factor Olig2 is expressed throughout oligodendroglial development and is essential for oligodendroglial progenitor specification and differentiation. It was previously reported that deletion of Olig2 enhanced the maturation and myelination of immature OLs and accelerated the remyelination process. However, by analyzing multiple Olig2 conditional KO mouse lines (male and female), we conclude that Olig2 has the opposite effect and is required for OL maturation and remyelination. We found that deletion of Olig2 in immature OLs driven by an immature OL-expressing Plp1 promoter resulted in defects in OL maturation and myelination, and did not enhance remyelination after demyelination. Similarly, Olig2 deletion during premyelinating stages in immature OLs using Mobp or Mog promoter-driven Cre lines also did not enhance OL maturation in the CNS. Further, we found that Olig2 was not required for myelin maintenance in mature OLs but was critical for remyelination after lysolecithin-induced demyelinating injury. Analysis of genomic occupancy in immature and mature OLs revealed that Olig2 targets the enhancers of key myelination-related genes for OL maturation from immature OLs. Together, by leveraging multiple immature OL-expressing Cre lines, these studies indicate that Olig2 is essential for differentiation and myelination of immature OLs and myelin repair. Our findings raise fundamental questions about the previously proposed role of Olig2 in opposing OL myelination and highlight the importance of using Cre-dependent reporter(s) for lineage tracing in studying cell state progression.SIGNIFICANCE STATEMENT Identification of the regulators that promote oligodendrocyte (OL) myelination and remyelination is important for promoting myelin repair in devastating demyelinating diseases. Olig2 is expressed throughout OL lineage development. Ablation of Olig2 was reported to induce maturation, myelination, and remyelination from immature OLs. However, lineage-mapping analysis of Olig2-ablated cells was not conducted. Here, by leveraging multiple immature OL-expressing Cre lines, we observed no evidence that Olig2 ablation promotes maturation or remyelination of immature OLs. Instead, we find that Olig2 is required for immature OL maturation, myelination, and myelin repair. These data raise fundamental questions about the proposed inhibitory role of Olig2 against OL maturation and remyelination. Our findings highlight the importance of validating genetic manipulation with cell lineage tracing in studying myelination.
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Jiang M. Neural circuits underlying motor and non-motor defects of Parkinson's disease. Innovation (N Y) 2022; 3:100308. [PMID: 36148022 PMCID: PMC9486115 DOI: 10.1016/j.xinn.2022.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
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Jiang M, Llibre Rodriguez JJ, Sosa AL, Acosta D, Jimenez-Velasquez IZ, Guerra M, Salas A, Huang YQ, Prince M, Albanese E. Incidence and predictors of frailty in Latin America and China: evidence from 10/66 cohort studies. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Evidence on the incidence and risk factors of frailty in low- and middle-income countries is very limited. We aimed to compare the incidence of frailty and explore its determinants in rural and urban areas in six Latin American countries and China.
Methods
The 10/66 is a multi-site cohort study in older adults. We conducted baseline and follow-up surveys in 2003-2006, and 2007-2010. We assessed frailty using a modified Fried frailty phenotype criterion, and adjudicated frailty (yes/no) when two or more of the following indicators were present: exhaustion, low physical activity, slow gait speed, and weight loss. We excluded frail participants at baseline and calculated person-years as the time interval between baseline and follow-up for frailty-free people who were survived and reinterviewed or the midpoint of it for incident frailty cases. We used Poisson and Cox regressions to model the incidence of frailty and its risk factors.
Results
We included 9,747 participants (≥65 years) for the analysis of frailty risk factors. Of whom, 8,212 were reinterviewed with an average of 4.0 years of follow-up, the incidence of frailty was lowest in Venezuela (21.9 per 1000 person-years) and rural Peru (24.3 per 1000 person-years), highest in rural Mexico (110.5 per 1000 person-years) and urban Peru (84.0 per 1000 person-years). In the overall Cox regression, we found significant prospective associations of incident frailty with living in rural areas (HR: 1.97, 95% CI: 1.69, 2.29), dementia (HR: 1.76, 95% CI: 1.42, 2.18), depression (HR: 1.69, 95% CI: 1.49, 1.93), comorbidity, female gender, older age, disability, hearing, and vision problems. Higher arm circumference was associated with a lower frailty risk (HR: 0.97, 95% CI: 0.96, 0.98).
Conclusions
The incidence of frailty varied substantially in Latin America and China, and between urban and rural areas. The identified risk factors could be potential intervention targets to decrease the global burden of frailty.
Key messages
• In Latin America and China, the incidence of frailty varied from 21.9 to 110.5 cases per 1000 person-years.
• We identified 9 risk factors and 1 protective factor for developing frailty, and the most relevant risk factors were living in the rural area, dementia, and depression.
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Yu X, Shi ZB, Jiang M, Yu GY, Zhu YL, Yang ZC, Chen W, Zhu YR, Fang KR, Tong RH, Han JH, Zhang XR. Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2022; 93:083518. [PMID: 36050087 DOI: 10.1063/5.0098907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (Te) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (Te0) and density (ne0) is greater than 35 × 1019 keV m-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.
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Yang CR, Wei Q, Jiang M, Zhang XB, Zhang ZX, Nong GM. [Hoyeraal-Hreidarsson syndrome with combined immunodeficiency and enterocolitis caused by a DCK1 gene variant]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2022; 60:248-249. [PMID: 35240749 DOI: 10.3760/cma.j.cn112140-20220117-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Jiang M, Yang F, Zhang L, Xu D, Jia Y, Cheng Y, Han S, Wang T, Chen Z, Su Y, Zhu Z, Chen S, Zhang J, Wang L, Yang L, Yang J, Luo X, Xing Q. Unique motif shared by HLA-B*59:01 and HLA-B*55:02 is associated with methazolamide-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Han Chinese. J Eur Acad Dermatol Venereol 2022; 36:873-880. [PMID: 35122707 DOI: 10.1111/jdv.17980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Methazolamide (MTZ) has been occasionally linked to the lethal Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are associated with HLA-B*59:01. However, some MTZ-induced SJS/TEN (MTZ-SJS/TEN) cases are negative for HLA-B*59:01, implying that other genetic factors besides HLA-B*59:01 are contributing to MTZ-SJS/TEN. OBJECTIVES To comprehensively identify HLA and non-HLA genetic susceptibility to MTZ-SJS/TEN in Han Chinese. METHODS Eighteen patients with MTZ-SJS/TEN, 806 subjects of the population control and 74 MTZ-tolerant individuals were enrolled in this study. Both exome-wide and HLA-based association studies were conducted. Molecular docking analysis was employed to simulate the interactions between MTZ and risk HLA proteins. RESULTS We found a strong signal in the major histocompatibility complex region on chromosome 6 with 22 SNPs reaching exome-wide significance. Compared with MTZ-tolerant controls, a significant association of HLA-B*59:01 with MTZ-SJS/TEN was validated (odds ratio [OR] = 146.00, 95% confidence interval [CI]: 16.12-1321.98; P = 6.19 × 10-10 ). Moreover, 66.7% of MTZ-SJS/TEN patients negative for HLA-B*59:01 were carriers of HLA-B*55:02, while 2.7% of the tolerant individuals were observed with HLA-B*55:02 (OR = 71.00, 95% CI: 7.84-643.10; P = 1.43 × 10-4 ). Within HLA-B protein, the E45-L116 motif could completely explain the association of HLA-B*59:01 and HLA-B*55:02 with MTZ-SJS/TEN (OR = 119.33, 95% CI: 29.19-1227.96; P = 4.36 × 10-13 ). Molecular docking analysis indicated that MTZ binds more stably to the pocket of HLA-B*59:01 and HLA-B*55:02 than to that of non-risk alleles of HLA-B*40:01 and HLA-C*01:02. CONCLUSIONS This study confirmed the association of HLA-B*59:01 with MTZ-SJS/TEN and identified HLA-B*55:02 as a novel risk allele in Han Chinese with the largest sample size to date. Notably, the rs41562914(A)-rs12697944(A) haplotype, encoding E45-L116, is capable of serving as a powerful genetic predictor for MTZ-SJS/TEN with a sensitivity of 89% and specificity of 96%.
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