Vitamin C-dependent lysine demethylase 6 (KDM6)-mediated demethylation promotes a chromatin state that supports the endothelial-to-hematopoietic transition

Hematopoietic stem cells (HSCs)/progenitor cells (HPCs) are generated from hemogenic endothelial cells (HECs) during the endothelial-to-hematopoietic transition (EHT); however, the underlying mechanism remains poorly understood. Here, using an array of approaches, including CRSPR/Cas9 gene knockouts, RNA-Seq, ChIP-Seq, ATAC-Seq etc., we report that vitamin C (Vc) is essential in HPC generation during human pluripotent stem cell (hPSC) differentiation in defined culture conditions. Mechanistically, we found that the endothelial cells generated in the absence of Vc fail to undergo the EHT because of an apparent failure in opening up genomic loci essential for hematopoiesis. Under Vc deficiency, these loci exhibited abnormal accumulation of histone H3 trimethylation at Lys-27 (H3K27me3), a repressive histone modification that arose because of lower activities of demethylases that target H3K27me3. Consistently, deletion of the two H3K27me3 demethylases, Jumonji domain-containing 3 (JMJD3 or KDM6B) and histone demethylase UTX (UTX or KDM6A), impaired HPC generation even in the presence of Vc. Furthermore, we noted that Vc and jmjd3 are also important for HSC generation during zebrafish development. Together, our findings reveal an essential role for Vc in the EHT for hematopoiesis, and identify KDM6-mediated chromatin demethylation as an important regulatory mechanism in hematopoietic cell differentiation.

Development of the triazole-fused pyrimidine derivatives as highly potent and reversible inhibitors of histone lysine specific demethylase 1 (LSD1/KDM1A)

Histone lysine specific demethylase 1 (LSD1) has been recognized as an important modulator in post-translational process in epigenetics. Dysregulation of LSD1 has been implicated in the development of various cancers. Herein, we report the discovery of the hit compound 8a (IC₅₀ = 3.93 μmol/L) and further medicinal chemistry efforts, leading to the generation of compound 15u (IC₅₀ = 49 nmol/L, and K_i = 16 nmol/L), which inhibited LSD1 reversibly and competitively with H3K4me2, and was selective to LSD1 over MAO-A/B. Docking studies were performed to rationalize the potency of compound 15u. Compound 15u also showed strong antiproliferative activity against four leukemia cell lines (OCL-AML3, K562, THP-1 and U937) as well as the lymphoma cell line Raji with the IC₅₀ values of 1.79, 1.30, 0.45, 1.22 and 1.40 μmol/L, respectively. In THP-1 cell line, 15u significantly inhibited colony formation and caused remarkable morphological changes. Compound 15u induced expression of CD86 and CD11b in THP-1 cells, confirming its cellular activity and ability of inducing differentiation. The findings further indicate that targeting LSD1 is a promising strategy for AML treatment, the triazole-fused pyrimidine derivatives are new scaffolds for the development of LSD1/KDM1A inhibitors.

Comparative transcriptome profiling of multi-ovary wheat under heterogeneous cytoplasm suppression

DUOII is a multi-ovary wheat line with two or three pistils and three stamens in each floret. The multi-ovary trait of DUOII is controlled by a dominant gene, whose expression can be suppressed by the heterogeneous cytoplasm of TeZhiI (TZI), a line with the nucleus of common wheat and the cytoplasm of Aegilops. DUOII (♀) × TZI (♂) shows multi-ovary trait, while TZI (♀) × DUOII (♂) shows mono-ovary. Observing the developmental process, we found that the critical stage of additional pistil primordium development was when the young spikes were 2–6 mm long. To elucidate the molecular mechanisms that are responsible for the heterogeneous cytoplasmic suppression of the multi-ovary gene, we RNA-sequenced the entire transcriptome of 2–6 mm long young spikes obtained from the reciprocal crosses between DUOII and TZI. A total of 600 differentially expressed genes (DEGs) was identified. Functional annotation of these DEGs showed that the heterogeneous cytoplasmic suppression of additional pistil development mainly involved four pathways, i.e., chloroplast metabolism, DNA replication and repair, hormone signal transduction, and trehalose-6-phosphate in the primordium development stage, which cooperated to modulate the multi-ovary gene expression under heterogeneous cytoplasmic suppression.

Potent and specific MTH1 inhibitors targeting gastric cancer

Human mutT homolog 1(MTH1), the oxidized dNTP pool sanitizer enzyme, has been reported to be highly expressed in various malignant tumors. However, the oncogenic role of MTH1 in gastric cancer remains to be determined. In the current study, we found that MTH1 was overexpressed in human gastric cancer tissues and cells. Using an in vitro MTH1 inhibitor screening system, the compounds available in our laboratory were screened and the small molecules containing 5-cyano-6-phenylpyrimidine structure were firstly found to show potently and specifically inhibitory effect on MTH1, especially compound MI-743 with IC50 = 91.44 ± 1.45 nM. Both molecular docking and target engagement experiments proved that MI-743 can directly bind to MTH1. Moreover, MI-743 could not only inhibit cell proliferation in up to 16 cancer cell lines, especially gastric cancer cells HGC-27 and MGC-803, but also significantly induce MTH1-related 8-oxo-dG accumulation and DNA damage. Furthermore, the growth of xenograft tumours derived by injection of MGC-803 cells in nude mice was also significantly inhibited by MI-743 treatment. Importantly, MTH1 knockdown by siRNA in those two gastric cancer cells exhibited the similar findings. Our findings indicate that MTH1 is highly expressed in human gastric cancer tissues and cell lines. Small molecule MI-743 with 5-cyano-6-phenylpyrimidine structure may serve as a novel lead compound targeting the overexpressed MTH1 for gastric cancer treatment.

Linderae radix ethanol extract attenuates alcoholic liver injury via attenuating inflammation and regulating gut microbiota in rats

This study aimed to explore the influence of gut microbiota alterations induced by Linderae radix ethanol extract (LREE) on alcoholic liver disease (ALD) in rats and to study the anti-inflammatory effect of LREE on ALD through the lipopolysaccharide (LPS) toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) pathway. ALD rat models were established by intragastric liquor [50% (v/v) ethanol] administration at 10 mL/kg body weight for 20 days. Rats were divided into six groups: normal group (no treatment), model group (ALD rats), Essentiale group (ALD rats fed with Essentiale, 137 mg/kg), and LREE high/moderate/low dose groups (ALD rats fed with 4, 2, or 1 g LREE/kg). NF-κB and LPS levels were evaluated. Liver pathological changes and intestinal ultrastructure were examined by hematoxylin and eosin staining and transmission electron microscopy. The gut microbiota composition was evaluated by 16S rDNA sequencing. Expression levels of TLR4 and CD68 in liver tissue, and occludin and claudin-1 in intestinal tissue were measured. LREE treatment significantly reduced NF-κB and LPS levels, improved liver pathological changes, and ameliorated intestinal ultrastructure injury. Meanwhile, LREE-fed groups showed a higher abundance of Firmicutes and a lower abundance of Bacteroidetes than the rats in the model group. Administration of LREE suppressed TLR4 overexpression and promoted the expression of occludin and claudin-1 in intestine tissue. Thus, LREE could partly ameliorate microflora dysbiosis, suppress the inflammatory response, and attenuate liver injury in ALD rats. The protective effect of LREE might be related to the LPS-TLR4-NF-κB pathway.

Comparative transcriptome analyses of genes involved in sulforaphane metabolism at different treatment in Chinese kale using full-length transcriptome sequencing

Background

Sulforaphane is a natural isothiocyanate available from cruciferous vegetables with multiple characteristics including antioxidant, antitumor and anti-inflammatory effect. Single-molecule real-time (SMRT) sequencing has been used for long-read de novo assembly of plant genome. Here, we investigated the molecular mechanism related to glucosinolates biosynthesis in Chinese kale using combined NGS and SMRT sequencing.

Results

SMRT sequencing produced 185,134 unigenes, higher than 129,325 in next-generation sequencing (NGS). NaCl (75 mM), methyl jasmonate (MeJA, 40 μM), selenate (Se, sodium selenite 100 μM), and brassinolide (BR, 1.5 μM) treatment induced 6893, 13,287, 13,659 and 11,041 differentially expressed genes (DEGs) in Chinese kale seedlings comparing with control. These genes were associated with pathways of glucosinolates biosynthesis, including phenylalanine, tyrosine and tryptophan biosynthesis, cysteine and methionine metabolism, and glucosinolate biosynthesis. We found NaCl decreased sulforaphane and glucosinolates (indolic and aliphatic) contents and downregulated expression of cytochrome P45083b1 (CYP83b1), S-alkyl-thiohydroximatelyase or carbon–sulfur lyase (SUR1) and UDP-glycosyltransferase 74B1 (UGT74b1). MeJA increased sulforaphane and glucosinolates contents and upregulated the expression of CYP83b1, SUR1 and UGT74b1; Se increased sulforaphane; BR increased expression of CYP83b1, SUR1 and UGT74b1, and increased glucosinolates contents. The desulfoglucosinolate sulfotransferases ST5a_b_c were decreased by all treatments.

Conclusions

We confirmed that NaCl inhibited the biosynthesis of both indolic and aliphatic glucosinolates, while MeJA and BR increased them. MeJA and BR treatments, conferred the biosynthesis of glucosinolates, and Se and MeJA contributed to sulforaphane in Chinese kale via regulating the expression of CYP83b1, SUR1 and UGT74b1.

Electronic supplementary material

The online version of this article (10.1186/s12864-019-5758-2) contains supplementary material, which is available to authorized users.

A Network Meta-analysis of Randomized Controlled Trials Comparing Treatment Modalities for Infrapopliteal Lesions in Critical Limb Ischemia

BACKGROUND

We aimed to conduct a network meta-analysis of randomized controlled trials comparing treatment modalities for infrapopliteal lesions in critical limb ischemia.

METHODS

Five treatments for infrapopliteal lesions in critical limb ischemia were recognized. We compared primary patency, target lesion revascularization (TLR), major amputation at the 12-month follow-up, and technical success rate of the treatment modalities.

RESULTS

Altogether, 11 studies (22 study arms; 1,330 patients) were considered eligible. The drug-eluting balloon (DEB) significantly increased primary patency compared with balloon angioplasty (BA; odds ratio [OR] 9.02, 95% confidence interval [CI] 3.18-25.55), the bare metal stent (BMS; OR 14.39, 95% CI 4.33-47.87), and the drug-eluting stent (DES; OR 3.70, 95% CI 1.20-11.11). The DES significantly increased primary patency compared with BA (OR 2.42, 95% CI 1.57-3.74) and BMS (OR 3.86, 95% CI 2.24-6.65). DES significantly increased the technical success rate compared with BA (OR 11.78, 95% CI 1.42-97.59). According to the value of the surface under the cumulative ranking curve (SUCRA), DEB was considered the best treatment in terms of primary patency (SUCRA = 99.7) and TLR (SUCRA = 70.7), and DES was considered the best treatment in terms of technical success rate (SUCRA = 90.6) and major amputation (SUCRA = 85.9).

CONCLUSIONS

DEB has shown encouraging results in terms of primary patency for infrapopliteal lesions in critical limb ischemia; furthermore, DEB may be better than other treatments in terms of TLR. DES may be better than other treatments in terms of technical success and major amputation. In contrast, BA and BMS seem to be less effective treatment options.

Effect of SCR Atmosphere on the Removal of Hg0 by a V2O5-CeO2/AC Catalyst at Low Temperature

A series of V₂O₅-xCeO₂/AC (noted as V-Ce/AC) catalysts were synthesized by the impregnation method, which combined the advantage of AC and V-Ce. The effects of SCR atmosphere on Hg⁰ removal were systematically investigated at low temperature. The experimental results indicated that NO had a positive effect on Hg⁰ removal. In addition, an interesting experimental phenomenon was found that NH₃ also showed a positive effect on Hg⁰ removal, which is different from many studies that have reported a negative effect of NH₃ on Hg⁰ removal by other catalysts. NH₃-TPD experiment showed that there was no apparent competition between NH₃ and Hg⁰. An FT-IR gas analyzer and in situ DRIFTS were used to study the mechanism for the effect of NH₃ on the catalyst surface and found that a small part of NH₃ was overoxidized to NO₂ in this catalytic system. O₂ acted as a promoter in the whole process of NO and Hg⁰ removal. However, H₂O showed an inhibiting effect on Hg⁰ and NO removal over V-Ce/AC catalysts, which may be caused by the competitive adsorption of H₂O and pollutants (NO and Hg⁰). Additionally, 1 V-8Ce/AC catalyst exhibited high stability ( E_Hg = 87.6%, E_NO = 82.84%) after 72 h reaction in SCR atmosphere at 150 °C.

Comparative proteomic analysis of multi-ovary wheat under heterogeneous cytoplasm suppression

BACKGROUND

DUOII is a multi-ovary wheat (Triticum aestivum L.) line with two or three pistils and three stamens in each floret. The multi-ovary trait of DUOII is controlled by a dominant gene, whose expression can be suppressed by the heterogeneous cytoplasm of TeZhiI (TZI), a line with the nucleus of common wheat and the cytoplasm of Aegilops. Crosses between female DUOII plants and male TZI plants resulted in multi-ovary F₁s; whereas, the reciprocal crosses resulted in mono-ovary F₁s. Although the multi-ovary trait is inherited as single trait controlled by a dominant allele in lines with a Triticum cytoplasm, the mechanism by which the special heterogeneous cytoplasm suppresses the expression of multi-ovary is not well understood.

RESULTS

Observing the developmental process, we found that the critical stage of additional pistil primordium development was when the young spikes were 2-6 mm long. Then, we compared the quantitative proteomic profiles of 2-6 mm long young spikes obtained from the reciprocal crosses between DUOII and TZI. A total of 90 differentially expressed proteins were identified and analyzed based on their biological functions. These proteins had obvious functional pathways mainly implicated in chloroplast metabolism, nuclear and cell division, plant respiration, protein metabolism, and flower development. Importantly, we identified two key proteins, Flowering Locus K Homology Domain and PEPPER, which are known to play an essential role in the specification of pistil organ identity. By drawing relationships between the 90 differentially expressed proteins, we found that these proteins revealed a complex network which is associated with multi-ovary gene expression under heterogeneous cytoplasmic suppression.

CONCLUSIONS

Our proteomic analysis has identified certain differentially expressed proteins in 2-6 mm long young spikes, which was the critical stage of additional primordium development. This paper provided a universal proteomic profiling involved in the cytoplasmic suppression of wheat floral meristems; and our findings have laid a solid foundation for further mechanistic studies on the underlying mechanisms that control the heterogeneous cytoplasm-induced suppression of the nuclear multi-ovary gene in wheat.

Vorapaxar stabilizes permeability of the endothelial barrier under cholesterol stimulation via the AKT/JNK and NF‑κB signaling pathways

Atherosclerosis (AS) is an inflammatory disease that occurs in the arterial wall and is characterized by progressive lipid accumulation within the intima of large arteries, leading to the dysfunction of endothelial cells and further destruction of the endothelial barrier and vascular tone. Arterial intima injury accelerates the adhesion and activation of platelets at the injury site. The activation of platelets results in the secretion of growth factors, leading to the migration and proliferation of vascular smooth muscle cells (VSMCs), promoting the formation of plaque, resulting in the formation of thrombus. The present study found that vorapaxar could alleviate the inflammatory response induced by a high concentration of cholesterol stimulation and increase the release of nitric oxide (NO) via the protein kinase B (AKT) signaling pathway and regulation of the intracellular concentration of Ca2+ ([Ca2+]i). We also found that vorapaxar could reduce the damage of DNA caused by cholesterol stimulation and regulate the cell cycle via the AKT/JNK signaling pathway and its downstream molecules glycogen synthase kinase 3β (GSK‑3β) and connexin 43, maintaining the integrity of the endothelial barrier and proliferation of endothelial cells, serving a protective role in endothelial cells.

Molecular cloning and mRNA expression of IFIT5 in tissues of ducklings infected with virulent duck hepatitis A virus type 3

Interferon-induced proteins with tetratricopeptide repeats (IFITs) are a family of proteins strongly induced downstream of type I interferon signaling. The function of IFITs has been investigated extensively in mammals. IFIT5 is the sole protein in this family found in birds and little information is available about the function of avian IFIT5. In this study, duck IFIT5 was cloned from peripheral blood mononuclear cells. Multiple amino acid sequence alignment and phylogenetic analysis showed that duck IFIT5 is highly homologous to chicken IFIT5. Tissue specificity analysis demonstrated that duck IFIT5 was ubiquitously expressed in all examined tissues of five-day-old ducklings, with the highest expression levels in heart, followed by thymus, cerebrum, liver, and lung; kidney expressed the lowest. Quantitative real-time PCR (qRT-PCR) analysis revealed that duck IFIT5 expression rapidly increased both in vitro and in vivo after stimulation with polyinosinic:polycytidylic acid [poly (I:C)] and infection with virulent duck hepatitis A virus type 3 (DHAV-3), respectively. Altogether, these results indicate that the expression of duck IFIT5 is positively correlated with viral load and may play an important role in the immune response to DHAV-3 infection. This study lays a foundation for further research into the innate antiviral immune responses of ducklings.

An alternative CTCF isoform antagonizes canonical CTCF occupancy and changes chromatin architecture to promote apoptosis

CTCF plays key roles in gene regulation, chromatin insulation, imprinting, X chromosome inactivation and organizing the higher-order chromatin architecture of mammalian genomes. Previous studies have mainly focused on the roles of the canonical CTCF isoform. Here, we explore the functions of an alternatively spliced human CTCF isoform in which exons 3 and 4 are skipped, producing a shorter isoform (CTCF-s). Functionally, we find that CTCF-s competes with the genome binding of canonical CTCF and binds a similar DNA sequence. CTCF-s binding disrupts CTCF/cohesin binding, alters CTCF-mediated chromatin looping and promotes the activation of IFI6 that leads to apoptosis. This effect is caused by an abnormal long-range interaction at the IFI6 enhancer and promoter. Taken together, this study reveals a non-canonical function for CTCF-s that antagonizes the genomic binding of canonical CTCF and cohesin, and that modulates chromatin looping and causes apoptosis by stimulating IFI6 expression.

CTCF plays key roles in gene regulation, chromatin insulation and organizing the higher-order chromatin architecture of mammalian genomes. Here the authors investigate the function an alternatively spliced shorter CTCF isoform, finding that this isoform antagonizes canonical CTCF occupancy and changes chromatin architecture to promote apoptosis.

Clinical diagnostic value of spiral CT in invasive pulmonary fungal infection

This study explored the diagnostic value of computed tomography (CT) in pulmonary fungal infection to provide a theoretical basis for the clinical diagnosis of pulmonary fungal infections. The clinical data of 82 suspected invasive fungal infection (IFI) patients admitted to the Department of Critical Care Medicine of The Affiliated Hospital of Qingdao University from January 2016 to May 2018 were retrospectively analyzed, and 64 of them were diagnosed with IFI by pathology and sputum culture. The CT results of the 82 patients were compared with the X-ray results in order to analyze the diagnostic value of CT imaging. Taking pathological diagnosis as the gold standard, the number of true-negative, true-positive, false-negative and false-positive results in X-ray diagnosis were 13, 43, 21 and 5, respectively, while those in CT diagnosis were 11, 59, 5 and 7, respectively. The sensitivity, specificity, accuracy, positive coincidence rate, negative coincidence rate, misdiagnosis rate and missed diagnosis rate of CT in IFI were 92.18, 61.11, 85.37, 89.39, 68.75, 38.89 and 7.81%, respectively, while those of X-ray in IFI were 67.19, 72.22, 68.29, 89.58, 38.24, 27.78 and 32.81%, respectively. The sensitivity, accuracy and negative coincidence rate of CT in the diagnosis of IFI were significantly higher than those of X-ray (P<0.05), with a sensitivity of 92.18%, which indicates that CT has a higher diagnostic value in IFI. The results of CT combined with the basic condition of the patients can be used to initially diagnose pulmonary fungal infections, which is of high diagnostic value and can improve clinical treatment.

Comparisons in geese of the courtship, mating behaviors and fertility of the Carlos and Sichuan breeds and the breed crosses

The Chinese goose originated from the swan goose (Anser cygnoides) and the European goose originated from the greylag goose (Anser anser). The Chinese and European geese have the potential to crossbreed. Whether interspecific differences in mating behaviors affect successful hybridization is unknown. In this study, 10-month-old Carlos geese (n = 120; Anser anser) and Sichuan geese (Anser cygnoides) were selected, and 12 multi-male parent families (3♂+12♀) were established. The courtship and mating behaviors of pure and cross-bred combinations of the Carlos and Sichuan geese were recorded using video cameras. Initiative courtship by males was the main type of courtship. Fixed mating, mating interference, and uncooperative mating were common in the flocks. The frequencies of some courtship and mating behaviors were less in the cross-bred groups (Carlos ganders × Sichuan geese, Sichuan ganders × Carlos geese) compared with the Sichuan pure-bred groups (P < 0.05). The Carlos male geese had some unique mating behaviors (i.e., one-to-one mating, formation of distinct hierarchies, and competition interference). The fertility rate had a significant correlation with the frequency of successful mating (r_p = 0.992, P < 0.05), rather than with the courtship behavior. These results indicate there were lesser frequencies of courtship and successful matings in the cross-breeding than purebreeding groups. Furthermore, the fertility rate depended largely on the successful mating behavior and was independent of the courtship behavior.

[Effects of intravenous methylprednisolone pulse therapy on optic neuritis associated with AQP4 antibody seropositive neuromyelitis optica]

Objective: To observe the effect of intravenous methylprednisolone pulse (IVMP) therapy on the recovery of visual acuity and its influencing factors in patients with the first attack of optic neuritis associated with aquaporin-4(AQP4) antibody seropositive neuromyelitis optica. Methods: Retrospective case series study. A total of 165 eyes of 120 patients diagnosed as optic neuritis related to neuromyelitis optica for the first time in the Neuro-ophthalmology Clinic of Beijing Tongren Hospital from September 2012 to December 2017 were selected in this research. All patients had AQP4 antibody seropositivity and clinical manifestations of acute optic neuritis, excluding other diagnoses. All the patients received the treatment of IVMP 500 mg/d or 1 000 mg/d for 3 days, followed by a slowly tapering course of oral glucocorticoids. The post-treatment and pre-treatment visual acuities were compared. Improving four lines or more was considered as effective markedly, improving two or three lines as effective, and improving one line or no change or a decline as no effect. The onset age, visual acuity before treatment and doses in the acute exacerbation were analyzed. The Mann-Whitney U test and Kruskal-Wallis test were used for statistical analyses. Results: Among the 120 patients, there were 17 males and 103 females, with age ranging from 16 to 80 years (median, 44 years). There were 17.6% (29/165) of the eyes with conspicuous therapy, 33.3% (55/165) of the eyes with effective therapy and 49.1% (81/165) of the eyes with ineffective therapy. The effect of IVMP decreased obviously when the age of onset was over 50 years old [41.1%(23/56) vs. 56.0%(61/109), Z=2.645, P=0.008]. Patients with no light perception and light perception before treatment had better therapeutic effect than those with counting fingers-0.3 before treatment [72.2%(26/36), 72.7%(24/33) vs. 30.1%(25/83), Z=2.726, 2.967; P=0.006, 0.003]. Although the efficacy of patients with visual acuity of onset over 0.3 (9/13) was better than patients with counting fingers-0.3, but the difference was not statistically significant (Z=1.743, P=0.081). Different doses, including IVMP 1 000 mg/d and 500 mg/d, had no significant difference in the effect (Z=1.115, P=0.265). Conclusions: IVMP therapy is only valid for a half of eyes with optic neuritis associated with AQP4 antibody seropositive neuromyelitis optica. The effect of IVMP treatment at doses of 500 mg/d and 1 000 mg/d is similar. Furthermore, the visual acuity from finger counting to 0.3 and age of onset over 50 years old have an influence on the treatment effect. (Chin J Ophthalmol, 2019, 55: 180-185).

[Management of toxicities associated with pegaspargase in treatment of patients with lymphoid malignancy: experience from 443 cases in a single center]

目的

总结培门冬酶治疗淋巴系统肿瘤的不良反应以及处理经验。

方法

通过回顾性分析北京同仁医院血液科2011年8月至2015年12月使用培门冬酶患者的临床资料，总结培门冬酶相关的不良反应以及处理经验。

结果

129例患者使用培门冬酶，累计共使用443例次，不良反应发生情况：2例（1.6%）患者出现过敏反应；19例（14.7%）患者发生胰腺炎（其中包括6例急性症状性胰腺炎、13例单纯胰酶升高的化学性胰腺炎），15例（11.6%）患者出现高甘油三酯血症，85例（65.9%）患者出现高血糖，7例（5.4%）患者出现低血糖；25例（19.4%）患者出现2级以上的转氨酶增高，21例（15.5%）患者发生高胆红素血症，62例（48.1%）患者发生低白蛋白血症；61例（47.3%）患者出现APTT延长，22例（17.1%）患者出现PT延长，15例（11.6%）患者出现TT延长，75例（58.1%）患者出现低纤维蛋白原血症，有11例患者（8.5%）出现血栓事件，有3例（2.3%）患者出现活动性出血。以上不良反应，分别经过抗过敏、抑制胰液分泌、降脂、降糖、保肝、补充血浆、止血等对症治疗后症状均好转。部分严重不良反应影响培门冬酶的按计划应用甚至导致停用。

结论

培门冬酶的不良反应非常广泛，有些非常严重，需要治疗时密切监测。

[Analysis of psychological status and relevant factors of patients with esophageal and gastric cardia precancerous lesions in Linzhou of Henan]

Objective: To explore the psychological status and related factors in patients with precancerous of esophageal and gastric cardia in Linzhou of Henan. Methods: Clinical psycho-rating scale of Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS, score ≥50 points with symptoms of anxiety) and Self-Rating Depression Scale (SDS, score ≥53 points with the symptoms of depression) were applied to survey life events and psychological status of subjects who aged 40-69 years old and participated in"The Early diagnosis and Early Treatment"program in Linzhou cancer hospital from July 2015 to Jan 2016. Patients with lower intraepithelial neoplasia or high-grade intraepithelial neoplasia were selected as precancerous lesions (n=118), and patients with normal grade were selected as healthy controls (n=210). Compare the differences of the scores between the two groups, and the logistic regression model was used to analyze the related factors of precancerous lesions and psychological status of the study subjects. Results: Precancerous lesions included esophageal (72 cases), gastric cardia (40 cases), esophageal and cardia dual source (6 cases); Precancerous lesions and healthy controls aged (57.17±7.71) and (53.12±7.99) years old, the difference was statistically significant (P<0.001). The anxiety and depression scale showed that the scores of SAS and SDS scores in the precancerous lesions were (37.18±10.01), (40.44±8.37) points, and (34.02±6.63), (38.49±8.73) points in control group, the difference was statistically significant (P=0.002, 0.032). While the social support total score (38.26±5.26), and subjective support score (24.08±3.83) and objective support score (7.50±1.89) in control group were all higher than those of precancerous group (36.80±6.18, 23.01±3.93, 6.93±1.57), and the difference were statistically significant (P=0.024, 0.016, 0.004). In addition, the Logistic analysis showed that subjects with low objective social support, subjective social support and anxiety symptoms were more likely to develop precancerous lesions, and the OR were 0.81, 0.72 and 1.05, respectively (P=0.028, 0.005, 0.009). Conclusion: Social support, anxiety and depression status may be related to the occurrence and development of esophageal and gastric cardia precancerous lesions.

[Status of diagnosis and management of acute appendicitis in 2017: a national multi-center retrospective study]

OBJECTIVE

To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.

METHODS

Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary.

RESULTS

A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001).

CONCLUSIONS

The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.

Decoupling of Airborne Dynamic Bending Deformation Angle and Its Application in the High-Accuracy Transfer Alignment Process

In the traditional airborne distributed position and orientation system (DPOS) transfer alignment process, the coupling angle between the dynamic deformation and body angular motion is not estimated or compensated, which causes the process to have low precision and long convergence time. To achieve high-precision transfer alignment, a decoupling method for the airborne dynamic deformation angle is proposed in this paper. The model of the coupling angle is established through mathematical derivation. Then, taking the coupling angle into consideration, angular velocity error and velocity error between the master INS and slave IMU are corrected. Based on this, a novel 27-state Kalman filter model is established. Simulation results demonstrate that, compared with the traditional transfer alignment model, the model proposed in this paper has faster convergence time and higher accuracy.

The affinity, intrinsic activity and selectivity of a structurally novel EP2 receptor agonist at human prostanoid receptors

BACKGROUND AND PURPOSE

Prostanoid EP₂ receptor agonists exhibit several activities including ocular hypotension, tocolysis and anti-inflammatory activity. This report describes the affinity and selectivity of a structurally novel, non-prostanoid EP₂ receptor agonist, PGN-9856, and its therapeutic potential.

EXPERIMENTAL APPROACH

The pharmacology of a series of non-prostanoid EP₂ receptor agonists was determined according to functional and radioligand binding studies, mostly using human recombinant prostanoid receptor transfectants. The selectivity of PGN-9856, as the preferred compound, was subsequently determined by using a diverse variety of non-prostanoid target proteins. The therapeutic potential of PGN-9856 was addressed by determining its activity in relevant primate cell, tissue and disease models.

KEY RESULTS

PGN-9856 was a selective and high affinity (pKi ≥ 8.3) ligand at human recombinant EP₂ receptors. In addition to high affinity binding, it was a potent and full EP₂ receptor agonist with a high level of selectivity at EP₁ , EP₃ , EP₄ , DP, FP, IP and TP receptors. In cells overexpressing human recombinant EP₂ receptors, PGN-9856 displayed a potency (pEC₅₀ ≥ 8.5) and a maximal response (increase in cAMP) comparable to that of the endogenous agonist PGE₂ . PGN-9856 exhibited no appreciable affinity (up 10 μM) for a range of 53 other receptors, ion channels and enzymes. Finally, PGN-9856 exhibited tocolytic, anti-inflammatory and long-acting ocular hypotensive properties consistent with its potent EP₂ receptor agonist properties.

CONCLUSIONS AND IMPLICATIONS

PGN-9856 is a potent, selective and efficacious prostanoid EP₂ receptor agonist with diverse potential therapeutic applications: tocolytic, anti-inflammatory and notably anti-glaucoma.