[Evaluation of the clinical manifestations of COVID-19 in patients with aplastic anemia undergoing immunosuppressive therapy: a prospective cohort study (NICHE)]

Objective: To investigate the clinical features of coronavirus disease 2019 (COVID-19) in patients with aplastic anemia (AA) undergoing immunosuppressive therapy (IST) . Methods: In this prospective cohort study, we collected the demographic and clinical data of patients with AA and COVID-19 from December 1, 2022, to January 31, 2023. We described the clinical features of COVID-19 among patients with AA and evaluated the effects of IST on the signs and severity of COVID-19. Results: A total of 170 patients with AA and COVID-19 were included. The common early symptoms, including fever, dizziness or headache, muscle or body aches, and sore throat, disappeared within 1-2 weeks. Approximately 25% of the patients had persistent fatigue within 2 weeks. Many patients experienced cough after an initial 1-3 days of infection, which lasted for more than 2 weeks. There were no differences in the duration of total fever episodes and maximum body temperature when patients were stratified according to whether or not they underwent IST, by IST duration, or by use of anti-lymphocyte globulin (ALG) (P>0.05). No differences were observed in the occurrence of symptoms in either the early or recovery stages when patients with AA were stratified according to whether or not they underwent IST, or by IST duration (P>0.05). However, patients who received ALG had fewer fever episodes within 1 week after infection (P=0.035) and more sore throat episodes within 2 weeks after infection (P=0.015). There were no other significant differences in clinical symptoms between patients who did and patients who did not receive ALG (P>0.05) . Conclusion: The majority of patients with AA and COVID-19 recovered within 2 weeks of noticing symptoms when treated with IST.

[A study on alveolar ridge augmentation guided by orthodontic forced eruption in patients with severe periodontitis]

Objective: To evaluate the clinical effect of alveolar bone augmentation in teeth with severe periodontitis using orthodontic forced eruption. Methods: Twelve patients (5 males and 7 females) with severe periodontitis and malocclusion who visited the Department of Orthodontics and Department of Periodontology, Peking University School and Hospital of Stomatology from October 2018 to May 2022 were included in this retrospective study. The age was (38.8±6.6) years (24-49 years). A total of 16 maxillary incisors that could not be retained due to severe periodontitis were included. The orthodontic fixed appliance was used to extrude the teeth. Cone-beam CT (CBCT) images of the patients before and after orthodontic forced eruption were collected. The voxel-based registration was used to superpose the images before and after orthodontic forced eruption. The height, thickness, and apical alveolar bone area were measured on the sagittal plane. The alveolar bone volume before and after orthodontic forced eruption was measured using three-dimensional reconstruction technique, and the influencing factors related to the alveolar volume change were analyzed. Results: The results of this study showed that the eruption distance of the teeth was (2.37±0.82) mm, and the alveolar bone height increased by (1.11±0.79) and (0.98±0.79) mm (t=3.73, P=0.010; t=4.85, P<0.001). The proximal and distal alveolar bone height increased by (1.10±0.78) and (0.86±1.08) mm, respectively (t=5.59, P<0.001; t=3.18, P=0.006). The alveolar bone thickness decreased (0.30±0.31) mm (t=-3.75, P=0.002) and alveolar bone area increased (6.84±5.86) mm2 (t=3.71, P<0.001). The alveolar bone volume increased (53±49) mm3 (t=4.38, P<0.001). The alveolar bone volume was moderately positively correlated with eruption distance, apical and mesial alveolar bone thickness (r=0.55, P=0.028; r=0.63, P=0.008; r=0.67, P=0.005). Conclusions: Orthodontic forced eruption results in a favorable increase of the alveolar bone in the upper incisor that cannot be retained due to severe periodontitis, which provides better periodontal hard tissue conditions for subsequent dental implant.

Phytosulfokine contributes to suspension culture of Cunninghamia lanceolata through its impact on redox homeostasis

BACKGROUND

Suspension culture is widely used in the establishment of efficient plant regeneration systems, as well as in the mass production of plant secondary metabolites. However, the establishment of a suspension culture system of Cunninghamia lanceolata is genotype-dependent given that proembryogenic masses (PEMs) are prone to browning during this process in recalcitrant genotypes. Previously, we reported that the plant peptide hormone phytosulfokine (PSK) can tremendously decrease the hydrogen peroxide (H2O2) level and help to initiate somatic embryogenesis (SE) in recalcitrant C. lanceolata genotypes. However, to date, no studies have revealed whether or how PSK may contribute to the establishment of a suspension culture system in these recalcitrant genotypes.

RESULTS

Here, we demonstrated that exogenous application of PSK effectively inhibited PEM browning during suspension culture in a recalcitrant genotype of C. lanceolata. Comparative time-series transcriptome profiling showed that redox homeostasis underwent drastic fluctuations when PEMs were cultured in liquid medium, while additional PSK treatment helped to maintain a relatively stable redox homeostasis. Interestingly, PSK seemed to have a dual effect on peroxidases (PRXs), with PSK simultaneously transcriptionally repressing ROS-producing PRXs and activating ROS-scavenging PRXs. Furthermore, determination of H2O2 and MDA content, as well as cell viability, showed that exogenous PSK treatment inhibited PEM browning and safeguarded PEM suspension culture by decreasing the H2O2 level and increasing PEM activity.

CONCLUSIONS

Collectively, these findings provide a valuable tool for the future establishment of large-scale C. lanceolata PEM suspension culture without genotype limitations.

The effects of computer-aided cognitive rehabilitation combined with virtual reality technology on event-related potential P300 and cognitive function of patients with cognitive impairment after stroke

OBJECTIVE

The aim of this study was to explore the effects of computer-aided cognitive rehabilitation (CACR) combined with virtual reality (VR) technology on event-related potential P300 and cognitive function in patients with cognitive impairment after stroke.

PATIENTS AND METHODS

Clinical data from 94 patients with post-stroke cognitive impairment, admitted to our hospital from January 2020 to March 2023, were retrospectively analyzed. Of them, 45 patients received routine rehabilitation training (Control group), and 49 patients received CACR combined with VR technology (Observation group). Cognitive rehabilitation status, event-related potential P300 examination status, biochemical indices levels, and daily living activity scores of the two groups were evaluated and compared.

RESULTS

After treatment, cognitive function significantly improved in the Observation group compared to the Control group. The amplitude of P300 in the Observation group was significantly higher, and the latency was significantly lower compared to the Control group. The levels of brain-derived neurotrophic factor (BDNF) in the Observation group were significantly higher (p<0.05), while the levels of cystatin C (Cys-C) and neuron-specific enolase (NSE) were significantly lower than those in the Control group (p<0.05 each). Patients in the Observation group demonstrated a significantly higher ability to perform daily living activities compared to the Control group (p<0.05).

CONCLUSIONS

Compared with conventional rehabilitation training, the combination of CACR and VR technology in the treatment of stroke-induced cognitive impairment is more effective in improving patients' cognitive function, regulating BDNF, Cys-C, and NSE levels, and enhancing patients' ability to perform daily living activities.

Concurrent Chemoradiotherapy plus Programmed Death-1 (PD-1) Blockade for Locally Advanced Cervical Cancer: Preliminary Results of a Single-Arm, Open-Label, Phase II Trial

PURPOSE/OBJECTIVE(S)

This study aims to assess the anti-tumor activity and safety of concurrent chemoradiotherapy plus PD-1 blockade in patients with locally advanced cervical cancer.

MATERIALS/METHODS

This is a single-arm, open-label, prospective phase II study. The key inclusion criteria were treatment-naive patients aged 18-75 years with stage II A2-IVA (FIGO 2018) locally advanced cervical cancer. All patients were treated with concurrent chemoradiotherapy including 2 cycle cisplatin (75mg/m2, for three days, every 3 weeks[Q3W]), nedaplatin or carboplatin can be selected for patients who can't tolerate cisplatin. After CCRT, patients achieving complete response (CR), partial responses(PR), stable disease(SD) received adjuvant chemotherapy (docetaxel 75 mg/m2 day 1+ cisplatin DDP 25 mg/m2 day 1-3, Q3W) for 2 cycle. PD-1 blockade Sintilimab and Tislelizumab was administered intravenously at 200 mg every 3 weeks up to 1 year or until disease progression, unacceptable toxicity, or withdrawal of consent. The primary endpoint was objective response rate (ORR) assessed by investigators per Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1. Secondary endpoints were the 12, 24-month overall survival (OS) rates, the 12, 24-month disease free survival (DFS) rates and safety.

RESULTS

From February 2020 to June 2022, a total of 15 patients was enrolled. Median age was 57 years (range, 36-74 years). Stage IIA1 was documented in 2 patients, stage IIA2 in two patients, stage IIIA in one patient, stage IIIC1 in eight patients, and stage IVA in two patients. And 66.7% (10/15) of patients had Metastatic lymph node. Four patients received adjuvant chemotherapy. The ORR was 100%, with 4 patients achieving CR and 11 PR. The 12 and 24-month OS rates are 93.3% and 84%, the 12 and 24-month DFS rates are 86% and 75.4%, respectively. Treatment-related adverse events (TRAEs) occurred in 86.7% (13/15) of patients. Grade 3 TRAEs are leukocyte (n = 1), thrombocytopenia (n = 1), hepatitis (n = 1), skin reaction (n = 1). No treatment-related deaths occurred. And IFN-γ was significantly elevated after radiotherapy (p = 0.0073).

CONCLUSION

Concurrent chemoradiotherapy plus PD-1 blockade showed promising antitumor activity and manageable toxicities in patients with locally advanced cervical cancer. Long-term outcomes are still pending to further evaluate their therapeutic effects. (ChiCTR2000032856).

CT-based radiomics nomogram for the preoperative prediction of microsatellite instability and clinical outcomes in colorectal cancer: a multicentre study

AIM

To develop and validate a computed tomography (CT)-based radiomics nomogram for preoperative prediction of microsatellite instability (MSI) status and clinical outcomes in colorectal cancer (CRC) patients.

MATERIALS AND METHODS

This retrospective study enrolled 497 CRC patients from three centres. Least absolute shrinkage and selection operator regression was utilised for feature selection and constructing the radiomics signature. Univariate and multivariate logistic regression analyses were employed to identify significant clinical variables. The radiomics nomogram was constructed by integrating the radiomics signature and the identified clinical variables. The performance of the nomogram was evaluated through receiver operating characteristic curves, calibration curves, and decision curve analysis. Kaplan-Meier analysis was performed to investigate the prognostic value of the nomogram.

RESULTS

The radiomics signature comprised 10 radiomics features associated with MSI status. The nomogram, integrating the radiomics signature and independent predictors (age, location, and thickness), demonstrated favourable calibration and discrimination, achieving areas under the receiver operating characteristic (ROC) curves (AUCs) of 0.89 (95% confidence interval [CI]: 0.83-0.95), 0.87 (95% CI: 0.79-0.95), 0.88 (95% CI: 0.81-0.96), and 0.86 (95% CI: 0.78-0.93) in the training cohort, internal validation cohort, and two external validation cohorts, respectively. The nomogram exhibited superior performance compared to the clinical model (p<0.05). Additionally, survival analysis demonstrated that the nomogram successfully stratified stage II CRC patients based on prognosis (hazard ratio [HR]: 0.357, p=0.022).

CONCLUSION

The radiomics nomogram demonstrated promising performance in predicting MSI status and stratifying the prognosis of patients with CRC.

Using Proteome Microarray and Gene Expression Omnibus Database to Screen Tumour-Associated Antigens to Construct the Optimal Diagnostic Model of Oesophageal Squamous Cell Carcinoma

AIMS

Autoantibodies against tumour-associated antigens (TAAs) are promising biomarkers for early immunodiagnosis of cancers. This study was designed to screen and verify autoantibodies against TAAs in sera as diagnostic biomarkers for oesophageal squamous cell carcinoma (ESCC).

MATERIALS AND METHODS

The customised proteome microarray based on cancer driver genes and the Gene Expression Omnibus database were used to identify potential TAAs. The expression levels of the corresponding autoantibodies in serum samples obtained from 243 ESCC patients and 243 healthy controls were investigated by enzyme-linked immunosorbent assay (ELISA). In total, 486 serum samples were randomly divided into the training set and the validation set in the ratio of 2:1. Logistic regression analysis, recursive partition analysis and support vector machine were performed to establish different diagnostic models.

RESULTS

Five and nine candidate TAAs were screened out by proteome microarray and bioinformatics analysis, respectively. Among these 14 anti-TAAs autoantibodies, the expression level of nine (p53, PTEN, GNA11, SRSF2, CXCL8, MMP1, MSH6, LAMC2 and SLC2A1) anti-TAAs autoantibodies in the cancer patient group was higher than that in the healthy control group based on the results from ELISA. In the three constructed models, a logistic regression model including four anti-TAA autoantibodies (p53, SLC2A1, GNA11 and MMP1) was considered to be the optimal diagnosis model. The sensitivity and specificity of the model in the training set and the validation set were 70.4%, 72.8% and 67.9%, 67.9%, respectively. The area under the receiver operating characteristic curve for detecting early patients in the training set and the validation set were 0.84 and 0.85, respectively.

CONCLUSIONS

This approach to screen novel TAAs is feasible, and the model including four autoantibodies could pave the way for the diagnosis of ESCC.

H2H Standardized Nutritional Support Management Mode Improves Nutritional Status of Patients with Head and Neck Cancer Receiving Radiotherapy: A Randomized Controlled Study

PURPOSE/OBJECTIVE(S)

Malnutrition which occurs in 90% patients with head and neck cancer (HNC) receiving concurrent chemoradiotherapy (CCRT). It may lead to inferior efficacy of antitumor treatment, increasing the adverse effects and reducing the quality of life. Several studies reported that hospital to home (H2H) standardized nutritional support management mode improved the nutritional status of patients with HNC during CCRT. However, these published studies were limited by retrospective data and small sample size. This randomized controlled study aimed to explore the improving nutritional status efficacy of H2H whole-course standardized nutritional support management mode in patients with HNC receiving CCRT.

MATERIALS/METHODS

From March 2021 to September 2021, patients with HNC receiving CCRT were randomly assigned into H2H nutrition management group (H2H group) and Routine nutritional management group (RTM group) in a 1:1 ratio. For H2H group, patients not only received individual nutritional management which was formulated by doctors, nutritionists and nutrition nurses from the hospital to the family at least once a week, but also received education of nutrition from network platforms. For RTM group, doctors and nurses made nutrition therapy according to nutritional status of patients. The primary endpoints of this study were nutritional status including weight, BMI, albumin, and hemoglobin. This study has been approved by the Ethics Committee of the First Affiliated Hospital of the Fourth Military Medical University (Ethics Committee Approval Number: KY20222067-F-1).

RESULTS

A total of 60 patients were enrolled in this study. Patient characteristics were well balanced in both arms. Compared with RTM group, patients in H2H group had better nutritional status as below: body weight (62.33±4.37) vs (60.14±4.56) kg, P = 0.037; BMI (21.84±3.01) vs (19.70±2.95) kg/m2, P = 0.033; Alb (39.25±2.17) vs (37.02±2.69) g/L, P = 0.031; Hb (132.7±9.03) vs (125.3±9.28) g/L, P = 0.039. The incidence of grade 3-4 oral mucositis in H2H group was less than RTM group (26% vs. 70%, P = 0.038). The score of quality of life was higher in H2H group compared RTM group (85.60±3.40 vs. 73.48±3.61, P = 0.000). The rate of nursing satisfaction in H2H group was higher than RTM group. Pre- and post-intervention satisfaction was 73.33% and 96.67%, respectively (p = 0.011).

CONCLUSION

H2H standardized nutritional support management model improve nutritional status, quality of life and rate of nursing satisfaction in patients with HNC receiving CCRT.

Genome-wide analysis of the GRAS gene family in Liriodendron chinense reveals the putative function in abiotic stress and plant development

Introduction

GRAS genes encode plant-specific transcription factors that play essential roles in plant growth and development. However, the members and the function of the GRAS gene family have not been reported in Liriodendron chinense. L. chinense, a tree species in the Magnolia family that produces excellent timber for daily life and industry. In addition, it is a good relict species for plant evolution research.

Methods

Therefore, we conducted a genome-wide study of the LcGRAS gene family and identified 49 LcGRAS genes in L. chinense.

Results

We found that LcGRAS could be divided into 13 sub-groups, among which there is a unique branch named HAM-t. We carried out RNA sequencing analysis of the somatic embryos from L. chinense and found that LcGRAS genes are mainly expressed after heart-stage embryo development, suggesting that LcGRAS may have a function during somatic embryogenesis. We also investigated whether GRAS genes are responsive to stress by carrying out RNA sequencing (RNA-seq) analysis, and we found that the genes in the PAT subfamily were activated upon stress treatment, suggesting that these genes may help plants survive stressful environments. We found that PIF was downregulated and COR was upregulated after the transient overexpression of PATs, suggesting that PAT may be upstream regulators of cold stress.

Discussion

Collectively, LcGRAS genes are conserved and play essential roles in plant development and adaptation to abiotic stress.

[A case of occupational explosive deafness caused by non explosive strong noise]

Occupational explosive hearing loss is often caused by close exposure to blasting operations or the impact waves and strong pulse noise generated by explosions of flammable and explosive chemicals, pressure vessels, etc. in the workplace. This article analyzes the diagnosis of a case of occupational explosive hearing loss caused by non explosion, in order to improve the flexible application of diagnostic standards by occupational disease diagnosis physicians.

First Double-Differential Measurement of Kinematic Imbalance in Neutrino Interactions with the MicroBooNE Detector

We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.

Genome-wide identification of the NAC gene family and its functional analysis in Liriodendron

As one of the largest plant specific transcription factor families, NAC family members play an important role in plant growth, development and stress resistance. To investigate the function of NAC transcription factors during abiotic stress, as well as during somatic embryogenesis, we identified and characterized the NAC gene family in Liriodendron chinense. We found that most LcNAC members contain more than three exons, with a relatively conserved gene and motif structure, especially at the N-terminus. Interspecies collinearity analysis revealed a closer relationship between the L. chinense NACs and the P. trichocarpa NACs. We analyzed the expression of LcNAC in different tissues and under three abiotic stresses. We found that 12 genes were highly expressed during the ES3 and ES4 stages of somatic embryos, suggesting that they are involved in the development of somatic embryos. 6 LcNAC genes are highly expressed in flower organs. The expression pattern analysis of LcNACs based on transcriptome data and RT-qPCR obtained from L. chinense leaves indicated differential expression responses to drought, cold, and heat stress. Genes in the NAM subfamily expressed differently during abiotic stress, and LcNAC6/18/41/65 might be the key genes in response to abiotic stress. LcNAC6/18/41/65 were cloned and transiently transformed into Liriodendron protoplasts, where LcNAC18/65 was localized in cytoplasm and nucleus, and LcNAC6/41 was localized only in nucleus. Overall, our findings suggest a role of the NAC gene family during environmental stresses in L. chinense. This research provides a basis for further study of NAC genes in Liriodendron chinense.

Nonlocal Near-Field Radiative Heat Transfer by Transdimensional Plasmonics

Using transdimensional plasmonic materials (TDPM) within the framework of fluctuational electrodynamics, we demonstrate nonlocality in dielectric response alters near-field heat transfer at gap sizes on the order of hundreds of nanometers. Our theoretical study reveals that, opposite to the local model prediction, propagating waves can transport energy through the TDPM. However, energy transport by polaritons at shorter separations is reduced due to the metallic response of TDPM stronger than that predicted by the local model. Our experiments conducted for a configuration with a silica sphere and a doped silicon plate coated with an ultrathin layer of platinum as the TDPM show good agreement with the nonlocal near-field radiation theory. Our experimental work in conjunction with the nonlocal theory has important implications in thermophotovoltaic energy conversion, thermal management applications with metal coatings, and quantum-optical structures.

[Preliminary exploration of modified side overlap with fundoplication by Yamashita (mSOFY) anastomosis technique in laparoscopic proximal gastrectomy]

Objective: To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy. Methods: Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications. Results: Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion: mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

[In vitro activity of β-lactamase inhibitors avibanvctam and relebactam in combination with β-lactams against multidrug-resistant Mycobacterium tuberculosis and mutations of resistance genes]

Objective: To evaluate the activity of six β-lactams in combination with three β-lactamase inhibitors against mycobacterium tuberculosis(MTB) in vitro. Methods: A total of 105 multidrug-resistant tuberculosis (MDR-TB) strains from different regions of Henan province from January to September 2020 were included in this study. Drug activity of six β-lactams (biapenem, meropenem, imipenem, doripenem, ertapenem and tebipenem) alone or in combination with β-lactamase inhibitors (clavulanic acid, avibactam and relebactam) was examined by minimum inhibitory concentration method (MICs) against 105 clinical isolates. Mutations of blaC, ldtmt1 and ldtmt2 were analyzed by PCR and DNA sequencing. Chi-square test was used to compare the antimicrobial activities of different β-lactam drugs. Results: Out of the β-lactams used herein, tebipenem was the most effective against MDR-TB and had an MIC50 value of 8 mg/L(χ2=123.70,P=0.001). Besides, after the addition of β-lactamase inhibitors, the MICs of most β-lactam drugs were reduced more evidently in the presence of avibactam and relebactam compared to clavulanic acid.Especially, relebactam decreased both the MIC50 and MIC90 of telbipenem by 16-fold, and diluted the MIC of 23 (21.90%) and 41 (39.04%) isolatesby 32-fold and 16-fold.In addition, a total of 13.33% (14/105) of isolates harbored mutations in the blaC gene, with three different nucleotide substitutions: AGT333AGG, AAC638ACC and ATC786ATT. For the strains with Ser111Arg and Asn213Thr substitution in BlaC, the MIC values of the meropenem-clavulanate combination were reduced compared with a synonymous single nucleotide polymorphism (SNP) group. Conclusions: Both avibactam and relebactam had better synergistic effects on β-lactams than clavulanic acid. The combination of tebipenem and relebactam showed the most potent activity against MDR-TB isolates. In addition, the Ser111Arg and Asn213Thr substitution of BlaC may be associated with an increased susceptibility of MDR-TB isolates to meropenem in the presence of clavulanate.

[A study on the mediation effect of insulin use on diabetic retinopathy in a community population]

Objective: To explore the risk factors for diabetic retinopathy (DR) in patients with diabetes and the mediating effect of insulin use on the relationship between glycated hemoglobin (HbA1c) and DR. Methods: Cross-sectional study. Random cluster sampling was conducted using a random number table method. A total of 84 sampling points (including 2 pilot points) were selected from the registered population of patients with type 2 diabetes aged 50 years and above at the Disease Prevention and Control Center in Funing County, Jiangsu Province. Questionnaires and biochemical tests were performed to obtain information on the general characteristics of the participants, medical history, insulin use, and glycated hemoglobin (HbA1c) levels. Ocular examinations, including anterior segment and fundus examinations, were conducted. The participants were divided into two groups, DR (diabetic retinopathy) and non-DR, based on the presence or absence of retinal hemorrhages, hard exudates, cotton wool spots, neovascularization, preretinal or vitreous hemorrhage. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors for DR. The Karlson-Holm-Breen analysis method was used for mediation effect analysis. Results: A total of 2 067 diabetic patients were enrolled, of whom 1 965 completed the survey and 1 802 were included in the statistical analysis, resulting in a response rate of 87.2%. Among them, 660 patients were diagnosed with DR, with a detection rate of 36.63%. The results of multivariate analysis showed that diabetes duration (OR=1.166, 95%CI: 1.138-1.196), family history of diabetes (OR=1.325, 95%CI: 1.001-1.755), insulin therapy (OR=1.995, 95%CI: 1.434-2.777), HbA1c level (OR=1.513, 95%CI: 1.189-1.925), and alcohol consumption (OR=0.712, 95%CI: 0.514-0.985) were independent risk factors for DR. The mediating effect of insulin use accounted for 13.67% of the total effect of HbA1c on DR (P<0.001). Conclusions: The risk factors for DR in patients with diabetes include a history of insulin therapy, longer duration of diabetes, family history of diabetes, alcohol consumption, and high HbA1c levels. Insulin use increases the impact of HbA1c on DR and has a partial mediating effect on DR.

[Effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease: a multicenter study]

Objective: To investigate the effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease (IBD). Methods: A cross-sectional survey was conducted in 42 hospitals in 22 provinces (autonomous regions and municipalities directly under the central government) from September 2021 to May 2022. General clinical information and the use of biologics were obtained from adult patients diagnosed with IBD who voluntarily participated in the study. Psychological status was evaluated using the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Inflammatory Bowel Disease Questionnaire (IBDQ) assessment tools. Counts were analyzed via the Chi-square test, and datasets that were not normally distributed were analyzed via nonparametric tests. P<0.05 was considered statistically significant. Results: A total of 2 478 valid questionnaires were collected. The GAD-7 score of the biologics group was significantly lower than that of the non-use group [6 (2, 9) vs. 7 (3, 10), Z=-3.49, P<0.001]. IBDQ scores [183 (158, 204) vs. 178 (152, 198), Z=-4.11, P<0.001], intestinal symptom scores [61 (52, 67) vs. 58 (49, 65), Z=-5.41, P<0.001], systemic symptom scores [28 (24, 32) vs. 27 (23, 31), Z=-2.37, P=0.018], emotional ability scores [69 (58, 77) vs. 67 (56, 75), Z=-3.58, P<0.001] and social ability scores [26 (22, 29) vs. 25 (22, 29), Z=-2.52, P=0.012] in the biologics group were significantly higher than in the non-use group. GAD-7 scores [5 (2, 9) vs. 6 (3, 10), Z=-3.50, P<0.001] and PSQI scores [6 (4, 9) vs. 6 (4, 9), Z=-2.55, P=0.011] were significantly lower in the group using infliximab than in the group not using it. IBDQ scores were significantly higher in patients using vedolizumab than in those not using it [186 (159, 205) vs. 181 (155, 201), Z=-2.32, P=0.021] and were also significantly higher in the group treated with adalimumab than in the group not treated with adalimumab [187 (159, 209) vs. 181 (155, 201), Z=-2.16, P=0.030]. However, ustekinumab had no significant effect on any of the scores. Conclusion: The use of biologics is strongly associated with improvements in anxiety status and quality of life in IBD patients.

Bevacizumab biosimilar candidate TAB008 compared to Avastin® in patients with locally advanced, metastatic EGFR wild-type non-squamous non-small cell lung cancer: a randomized, double-blind, multicenter study

BACKGROUND

Bevacizumab (Avastin®) is a monoclonal antibody targeting the vascular endothelial growth factor (VEGF). Used alone or in combination with chemotherapy and/or immunotherapy, Avastin® has shown promising efficacy in many cancers. This study compared the efficacy and safety of TAB008 with Avastin® sourced from the EU (bevacizumab-EU), in patients with non-squamous non-small cell lung cancer (nsNSCLC).

METHOD

In this randomized, double-blind, multicenter, phase III similarity study, treatment naïve for metastatic lung cancer., EGFR wild-type, locally advanced, metastatic, or recurrent non-squamous, non-small cell, lung cancer (nsNSCLC) patients were enrolled and randomized (1:1) into TAB008 or Avastin® groups. Patients received TAB008 or Avastin® 15 mg/kg intravenously plus paclitaxel/carboplatin for 4-6 cycles followed by TAB008 or Avastin® 7.5 mg/kg until disease progression, unacceptable toxicity or death. The primary endpoint compared the objective response rate (ORR) within 6 cycles as read by an independent radiological review committee (IRRC). Secondary endpoints compared disease control rate (DCR) Within 6 cycles, duration of response (DoR), progression-free survival (PFS), a year overall survival rate (OSR), overall survival (OS), safety, immunogenicity, and steady-state pharmacokinetics.

RESULTS

A total of 549 nsNSCLC patients were enrolled (277 in TAB008 group and 272 in Avastin® group). In the full analysis set, ORRs were 55.957% for TAB008 and 55.720% for Avastin®, and the ORR ratio was 1 (90% CI 0.89-1.14), well within the predefined equivalence margin of 0.75-1.33. No significant differences were found in DCR within 6 cycles (95.703% vs 95.367%, p = 0.8536), DoR (8.17 vs 7.3 months, p = 0.3526), PFS (9.10 vs. 7.97 months, p = 0.9457), 1 year overall survival rate (66.2% vs 68%, p = 0.6793), or OS (20.4 vs 17.6 months, p = 0.6549). Serious adverse events (SAEs) occurred in 37.55% (104/277) of patients in the TAB008 group and 34.32% (93/271) in the Avastin® group. Anti-drug antibodies were reported in 3 of 277 (1.08%) TAB008 patients, and 5 of 271 (1.85%) Avastin® patients, neutralizing antibody (Nab) was positive in 1 patient on Avastin®, which became negative upon follow-up. The steady-state trough concentrations (Cssmin) were 106.13 μg/mL in TAB008 group and 96.03 μg/mL in Avastin® groups, with the treatment group ratio of LS geometric means fully contained within the bioequivalence limits of 80.00-125.00% (90% CI was 101.74-120.05%).

CONCLUSIONS

TAB008 is similar to Avastin® in terms of efficacy, safety, and pharmacokinetic parameters, with comparable immunogenicity.

TRIAL REGISTRATION

ClinicalTrials.gov number; NCT05427305.

Bioinformatics-based design of a fusion vaccine with CTLA-4 variable region to combat Brucella

Brucellosis has become a global zoonotic disease, seriously endangering the health of people all over the world. Vaccination is an effective strategy for protection against Brucella infection in livestock in developed countries. However, current vaccines are pathogenic to humans and pregnant animals, which limits their use. Therefore, it is very important to improve the safety and immune protection of Brucella vaccine. In this study, different bioinformatics approaches were carried out to predict the physicochemical properties, T/B epitope, and tertiary structure of Omp2b and Omp31. Then, these two proteins were sequentially linked, and the Cytotoxic T lymphocyte associated antigen-4 (CTLA-4) variable region was fused to the N-terminal of the epitope sequence. In addition, molecular docking was performed to show that the structure of the fusion protein vaccine had strong affinity with B7 (B7-1, B7-2). This study showed that the designed vaccine containing CTLA-4 had high potency against Brucella, which could provide a reference for the future development of efficient brucellosis vaccines.

PYL Family Genes from Liriodendron chinense Positively Respond to Multiple Stresses

The phytohormone abscisic acid (ABA) plays important roles in response to abiotic and biotic stresses in plants. Pyrabactin resistance 1-like (PYR/PYL) proteins are well-known as ABA receptors, which are responsible for ABA signal transduction. Nevertheless, the characteristics of PYL genes from Liriodendron chinense, an endangered timber tree, remain unclear in coping with various stresses. In this study, five PYLs were identified from the genome of Liriodendron chinense by sequence alignment and conserved motif analysis, which revealed that these LcPYLs contain a conserved gate and latch motif for ABA binding. The LcPYL promoters possess a series of cis-acting elements involved in response to various hormone and abiotic stresses. Moreover, the transcriptome data of Liriodendron hybrid leaves reveal that LcPYL genes specifically transcript under different abiotic stresses; Lchi11622 transcription was induced by drought and cold treatment, and Lchi01385 and Lchi16997 transcription was upregulated under cold and hot stress, respectively. Meanwhile, the LcPYLs with high expression levels shown in the transcriptomes were also found to be upregulated in whole plants treated with the same stresses tested by qPCR. Moreover, under biotic stress caused by scale insect and whitefly, Liriodendron hybrid leaves exhibited a distinct phenotype including disease spots that are dark green in the middle and yellow on the margin; the qPCR results showed that the relative expression levels of Lchi13641 and Lchi11622 in infected leaves were upregulated by 1.76 and 3.75 folds relative to normal leaves, respectively. The subcellular localizations of these stress-responsive LcPYLs were also identified in protoplasts of Liriodendron hybrid. These results provide a foundation to elucidate the function of PYLs from this elite tree species and assist in understanding the molecular mechanism of Liriodendron hybrid in dealing with abiotic and biotic stresses. In future research, the detailed biological function of LcPYLs and the genetic redundancy between LcPYLs can be explored by gene overexpression and knockout based on this study.

[IL-8 Links NF-κB and Wnt/β-Catenin Pathways in Persistent Inflammatory Response Induced by Chronic Helicobacter pylori Infection]

Helicobacter pylori (H. pylori) infection can cause persistent inflammatory response in human gastric mucosal epithelial cells, which may result in the occurrence of cancer. However, the underlying mechanism of carcinogenesis has not been elucidated yet. Herein, we established the models of chronic H. pylori infection in GES-1 cells and C57BL/6J mice. Interleukin 8 (IL-8) level was detected by ELISA. The expression of NF-κB p65, IL-8, Wnt2 and β-catenin mRNA and proteins was evaluated by real-time PCR, Western blotting, immunofluorescence staining, and immunohistochemistry. The infection of H. pylori in mice was evaluated by rapid urease test, H&E staining and Warthin-Starry silver staining. The morphological changes of gastric mucosa were observed by electron microscopy. Our results showed that in H. pylori infected gastric mucosal cells along with activation of NF-κB signaling pathway and increase of IL-8 level, the expression of Wnt2 was also increased significantly, which preliminarily indicates that IL-8 can positively regulate the expression of Wnt2. Studies in chronic H. pylori infected C57BL/6J mice models showed that there was an increased incidence of premalignant lesions in the gastric mucosa tissue. Through comparing changes of gastric mucosal cell ultrastructure and analyzing the relationship between NF-κB signaling pathway and Wnt2 expression, we found that H. pylori infection activated NF-κB signal pathways, and the massive release of IL-8 was positively correlated with the high expression of Wnt2 protein. Subsequently, the activated Wnt/β-catenin signal pathways may be involved in the malignant transformation of gastric mucosal cells. Collectively, H. pylori chronic infection may continuously lead to persistent inflammatory response: activate NF-κB pathway, promote IL-8 release and thereby activate Wnt/β-catenin pathway. IL-8 probably plays an important role of a linker in coupling these two signal pathways.

[A case of Oliver-McFarlane syndrome caused by PNPLA6 gene mutation]

Oliver-McFarlane syndrome is a rare genetic disorder characterized by long eyelashes, choroidoretinal atrophy, and multiple pituitary hormone deficiencies. The patient in this case is a 29-year-old female who has suffered from night blindness, low vision, and long eyelashes since childhood. Through genetic sequencing, she was diagnosed with compound heterozygous variaton in the PNPLA6 gene, indicating Oliver-McFarlane syndrome based on her comprehensive clinical presentation.

First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40}  cm^{2}/Ar, where statistical and systematic uncertainties are combined.

Genome-Wide Identification and Abiotic-Stress-Responsive Expression of CKX Gene Family in Liriodendron chinense

Liriodendron chinense is a tree species of the Magnoliaceae family, an ancient relict plant mainly used for landscaping and timber production due to its excellent material properties and ornamental value. The cytokinin oxidase/dehydrogenase (CKX) enzyme regulates cytokinin levels and plays an important role in plant growth, development, and resistance. However, too-high or too-low temperatures or soil drought can limit the growth of L. chinense, representing a key issue for research. Here, we identified the CKX gene family in the L. chinense genome and examined its transcriptional responses to cold, drought, and heat stresses. A total of five LcCKX genes, distributed on four chromosomes and divided into three phylogenetic groups, were identified across the whole L. chinense genome. Further analysis showed that multiple hormone- and stress-responsive cis-acting elements are located in the promoter regions of LcCKXs, indicating a potential role of these LcCKXs in plant growth, development, and response to environmental stresses. Based on existing transcriptome data, LcCKXs, especially LcCKX5, were found to transcriptionally respond to cold, heat, and drought stresses. Furthermore, quantitative reverse-transcription PCR (qRT-PCR) showed that LcCKX5 responds to drought stress in an ABA-dependent manner in stems and leaves and in an ABA-independent manner in roots. These results lay a foundation for functional research on LcCKX genes in the resistance breeding of the rare and endangered tree species of L. chinense.

Characterization of the Liriodendron chinense Pentatricopeptide Repeat (PPR) Gene Family and Its Role in Osmotic Stress Response

The Pentatricopeptide repeat (PPR) superfamily is a large gene family in plants that regulates organelle RNA metabolism, which is important for plant growth and development. However, a genome-wide analysis of the PPR gene family and its response to abiotic stress has not been reported for the relict woody plant Liriodendron chinense. In this paper, we identified 650 PPR genes from the L. chinense genome. A phylogenetic analysis showed that the LcPPR genes could roughly be divided into the P and PLS subfamilies. We found that 598 LcPPR genes were widely distributed across 19 chromosomes. An intraspecies synteny analysis indicated that duplicated genes from segmental duplication contributed to the expansion of the LcPPR gene family in the L. chinense genome. In addition, we verified the relative expression of Lchi03277, Lchi06624, Lchi18566, and Lchi23489 in the roots, stems, and leaves and found that all four genes had the highest expression in the leaves. By simulating a drought treatment and quantitative reverse transcription PCR (qRT-PCR) analysis, we confirmed the drought-responsive transcriptional changes in four LcPPR genes, two of which responded to drought stress independent of endogenous ABA biosynthesis. Thus, our study provides a comprehensive analysis of the L. chinense PPR gene family. It contributes to research into their roles in this valuable tree species' growth, development, and stress resistance.