Neutral particles pushed or pulled by laser pulses: erratum

We present an erratum to our Letter [Opt. Lett.41, 230 (2016)10.1364/OL.41.000230]. This erratum corrects three typing errors. The corrections have no influence on the results and conclusions of the original Letter.

[Pathogenic spectrum and laboratory indicators of fungal infections in the central nervous system]

Central nervous system (CNS) fungal infections are challenging and difficult to diagnose and treat. This article introduces the high risk factors, pathogen spectrum and laboratory indicators that cause CNS fungal infection. As patients with CNS fungal infections are often accompanied by immunodeficiency, it is especially necessary for clinical early detection, early prevention, and early diagnosis, and timely and effective implementation of optimized diagnosis and treatment programs to prevent further deterioration of the disease.

Small RNA and Degradome Sequencing Reveal Important MicroRNA Function in Nicotiana tabacum Response to Bemisia tabaci

MicroRNAs (miRNAs), a class of small non-coding regulatory RNAs, are key molecules in many biological and metabolic processes of plant growth, development and stress response via targeting mRNAs. The phloem-feeding insect whitefly Bemisia tabaci (Hemiptera, Aleyrodidae) is a serious pest that causes devastating harm to agricultural production worldwide. However, the function of host miRNAs in the response to whitefly infestation remains unclear. Here, we sequenced the small RNA and degradome of tobacco (Nicotiana tabacum L.), after and before infestation by B. tabaci. We identified 1291 miRNAs belonging to 138 miRNA families including 706 known miRNAs and 585 novel miRNAs. A total of 47 miRNAs were differentially expressed, of which 30 were upregulated and 17 were downregulated by whitefly exposure. Then, computational analysis showed that the target genes of differential miRNAs were involved in R gene regulation, plant innate immunity, plant pathogen defense, the plant hormone signal pathway and abiotic stress tolerance. Furthermore, degradome analysis demonstrated that 253 mRNAs were cleaved by 66 miRNAs. Among them, the targets cleaved by upregulated miR6025, miR160, miR171, miR166 and miR168 are consistent with our prediction, suggesting that pathogen-related miRNAs may function in plant defense against whitefly. Moreover, our results show that plant miRNA response and miRNA-mediated post-transcriptional regulation for phloem-feeding insect infestation are similar to pathogen invasion. Our study provides additional data to further elucidate how host plants respond and defend the phloem-feeding insects.

[Evaluation of eutrophication level changes in Baiyangdian Lake based on multiple biological groups]

Baiyangdian Lake is the largest shallow lake in the North China Plain. Due to the increases in upstream water consumption in recent decades, the amount of natural water entering the lake has decreased, resulting in a significant drop in the water level of Baiyangdian Lake. Severe eutrophication has occurred in Baiyangdian Lake owing to the discharge of domestic sewage around the sub-lakes. With the establishment of the Xiong'an New Area in 2017, the importance of environmental governance and protection of Baiyangdian Lake has been unprecedentedly increased. The implementation of ecological water supplement from upstream reservoirs and other basins has significantly increased water level of Baiyangdian Lake. Moreover, domestic sewage from surrounding rural areas was collected. In order to understand the current state of water quality in Baiyangdian Lake, and to evaluate the effects of the previous water replenishment and pollution control projects, we investigated water physicochemical variables and aquatic organisms of Baiyangdian Lake in August 2019. We evaluated water quality status of Baiyangdian Lake based on water quality, phytoplankton, zooplankton and macrozoobenthos, by comparing with the evaluation based on the survey data in 2010. In addition, submerged macrophytes were used to evaluate the water ecological status. The results showed that the water quality state of Baiyangdian Lake in 2019 was greatly improved compared with 2010. Among them, total phosphorus concentration decreased by 88.6%, total nitrogen concentration decreased by 83.9%, chlorophyll a concentration decreased by 47.8%, and the Seechi depth increased by 43.4%. The diversity of zooplankton and macrozoobenthos were significantly increased, the density of phytoplankton was significantly reduced, the dominant species of phytoplankton changed from a general highly eutrophic type to a eutrophic type, and the distribution of the clean-type submerged macrophytes was narrowed. The evaluation methods based on submerged macrophytes species and based on zooplankton diversity were not suitable for water quality evaluation in Baiyangdian Lake. In the early stage, the pollution source of Baiyangdian Lake was concentrated in the west, which led to lower water quality. Nowadays, due to the water replenishment from the west, north and south, the hydrodynamic conditions changed significantly. In the west, pollution control projects were carried out, and the spatial distribution of water quality in Baiyangdian Lake are showing a characteristics of homogenization.

Magnetic-activated cell sorting of nonapoptotic spermatozoa with a high DNA fragmentation index improves the live birth rate and decreases transfer cycles of IVF/ICSI

The present study aimed to evaluate the clinical outcomes of magnetic-activated cell sorting (MACS) in sperm preparation for male subjects with a sperm DNA fragmentation index (DFI) ≥30%. A total of 86 patients who had undergone their first long-term long protocol were selected. The protocol involved in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, and the patients were divided into the MACS or control groups. The MACS group included sperm samples analyzed with MACS that were combined with density gradient centrifugation (DGC) and the swim-up (SU) technique (n = 39), and the control group included sperm samples prepared using standard techniques (DGC and SU; n = 41). No differences were noted with regard to basic clinical characteristics, number of oocytes retrieved, normal fertilization rate, cleavage rate, or transplantable embryo rate between the two groups in IVF/ICSI. In addition, the clinical pregnancy and implantation rates of the first embryo transfer cycles indicated no significant differences between the two groups. However, there was a tendency to improve the live birth rate (LBR) of the first embryo transfer cycle (63.2% vs 53.9%) and the cumulative LBR (79.5% vs 70.7%) in the MACS group compared with the control group. Moreover, the number of transferred embryos (mean ± standard deviation [s.d.]: 1.7 ± 0.7 vs 2.3 ± 1.6) and the transfer number of each retrieved cycle (mean ± s.d.: 1.2 ± 0.5 vs 1.6 ± 0.8) were significantly lower in the MACS group than those in the control group. Thus, the selection of nonapoptotic spermatozoa by MACS for higher sperm DFI could improve assisted reproductive clinical outcomes.

[Effect of splenectomy on the risk of hepatocellular carcinoma development among patients with liver cirrhosis and portal hypertension: a multi-institutional cohort study]

Objective: To identify whether splenectomy for treatment of hypersplenism has any impact on development of hepatocellular carcinoma(HCC) among patients with liver cirrhosis and hepatitis. Methods: Patients who underwent splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension between January 2008 and December 2012 were included from seven hospitals in China, whereas patients receiving medication treatments for liver cirrhosis and portal hypertension (non-splenectomy) at the same time period among the seven hospitals were included as control groups. In the splenectomy group, all the patients received open or laparoscopic splenectomy with or without pericardial devascularization. In contrast, patients in the control group were treated conservatively for liver cirrhosis and portal hypertension with medicines (non-splenectomy) with no invasive treatments, such as transjugular intrahepatic portosystemic shunt, splenectomy or liver transplantation before HCC development. All the patients were routinely screened for HCC development with abdominal ultrasound, liver function and alpha-fetoprotein every 3 to 6 months. To minimize the selection bias, propensity score matching (PSM) was used to match the baseline data of patients among splenectomy versus non-splenectomy groups. The Kaplan-Meier method was used to calculate the overall survival and cumulative incidence of HCC development, and the Log-rank test was used to compare the survival or disease rates between the two groups. Univariate and Cox proportional hazard regression models were used to analyze the potential risk factors associated with development of HCC. Results: A total of 871 patients with liver cirrhosis and hypertension were included synchronously from 7 tertiary hospitals. Among them, 407 patients had a history of splenectomy for hypersplenism (splenectomy group), whereas 464 patients who received medical treatment but not splenectomy (non-splenectomy group). After PSM,233 pairs of patients were matched in adjusted cohorts. The cumulative incidence of HCC diagnosis at 1,3,5 and 7 years were 1%,6%,7% and 15% in the splenectomy group, which was significantly lower than 1%,6%,15% and 23% in the non-splenectomy group (HR=0.53,95%CI:0.31 to 0.91,P=0.028). On multivariable analysis, splenectomy was independently associated with decreased risk of HCC development (HR=0.55,95%CI:0.32 to 0.95,P=0.031). The cumulative survival rates of all the patients at 1,3,5,and 7 years were 100%,97%,91%,86% in the splenectomy group,which was similar with that of 100%,97%,92%,84% in the non-splenectomy group (P=0.899). In total,49 patients (12.0%) among splenectomy group and 75 patients (16.2%) in non-splenectomy group developed HCC during the study period, respectively. Compared to patients in non-splenectomy group, patients who developed HCC after splenectomy were unlikely to receive curative resection for HCC (12.2% vs. 33.3%,χ²=7.029, P=0.008). Conclusion: Splenectomy for treatment of hypersplenism may decrease the risk of HCC development among patients with liver cirrhosis and portal hypertension.

[Research progress on non-steady state noise-induced hearing loss]

Non-steady state noise has become the main type of workplace noise. Compared with steady state noise, non-steady state noise may cause more serious hearing loss. This paper reviews the new situation of occupational hearing loss caused by non-steady state noise exposure, the overview of international noise exposure assessment standards and new challenges, and the new evidence of non-steady state noise induced hearing loss, so as to provide the basis for the future research of non-steady state noise induced hearing loss.

MicroRNA-20a suppresses RANKL-modulated osteoclastogenesis and prevents bone erosion in mice with rheumatoid arthritis through the TLR4/p38 pathway

Abnormal osteoclast formation plays a significant part in rheumatoid arthritis (RA). As potent therapeutic biomarkers, microRNAs (miRNAs) have obtained increasing attention. Recently, treatment regimens regarding miRNAs have been implicated in skeletal diseases. The aim of this study is to assess the expression and function of miR-20a during osteoclast proliferation and differentiation and its correlation with bone erosion in RA mice. The expression of miR-20a was observed to be diminished in the ankle tissues of RA mice relative to that in normal controls evaluated by RT-qPCR. Hematoxylin and eosin staining, Safranin O-fast green staining, and tartrateresistant acid phosphatase staining were used to evaluate the effects of miR-20a on RA symptoms. The proliferation and differentiation of osteoclasts, and bone erosion were repressed by agomiR-20a injection. 3'UTR luciferase reporter assays were conducted to validate the putative binding between miR-20a and receptor activation of nuclear factor-κB ligand (RANKL). The protein expression and phosphorylation level of toll-like receptor4 (TLR4)/p38 pathway-related factors were detected by Western blot. miR-20a inhibited proliferation and differentiation potentials to osteoclasts partly through the TLR4/p38 pathway. The current work provides evidence that miR-20a hinders proliferation and differentiation of osteoclasts by targeting RANKL through the TLR4/p38 pathway.

[Allogeneic donor-derived CD19 CAR-T therapy of relapsed B-cell acute lmphoblastic leukemia after allogeneic hematopoietic stem cell transplantation]

目的

观察供者抗CD19嵌合抗原受体T细胞（CAR-T）（HI19α-4-1BB-ζ CAR-T）治疗急性B淋巴细胞白血病（B-ALL）异基因造血干细胞移植（allo-HSCT）后复发患者的疗效及安全性。

方法

对2017年7月至2020年5月期间9例allo-HSCT后复发B-ALL患者应用供者抗CD19 CAR-T细胞治疗，FCA方案（氟达拉滨+环磷酰胺+阿糖胞苷）预处理后回输供者CD3⁺T淋巴细胞，其中CAR-T细胞中位数1.79（0.86～3.53）×10⁶/kg，观察疗效和不良反应。

结果

①输注CAR-T细胞后28～42 d，9例患者均获得MRD阴性的完全缓解。②所有患者发生细胞因子释放综合征（CRS），其中3级2例、2级4例、1级3例；4例患者出现免疫效应细胞相关的神经毒性（ICANS），2级1例、1级3例；1例患者发生急性Ⅳ度移植物抗宿主病（GVHD），上述不良反应经治疗均控制。③4例患者再次复发，中位复发时间为CAR-T细胞治疗后8.6（4.6～19.3）个月，2例化疗后病情进展死亡，1例接受二次移植14个月后复发死亡，1例接受CD22 CAR-T细胞治疗后完全缓解，现6例患者无病存活，植入分析为完全供者嵌合体，中位无白血病生存（LFS）期18.1个月，预期1年、2年LFS率分别为63.5％、50.8％。④中位随访25.1（6.9～36.7）个月，预期2年、2.5年总生存（OS）率分别为87.5％、52.5％。

结论

供者抗CD19 CAR-T细胞治疗allo-HSCT后复发的B-ALL的缓解率高，不良反应可耐受，半数患者可无病生存2年以上，长期疗效有待进一步观察。

[Application of ARIMA Model for Mid- and Long-term Forecasting of Ozone Concentration]

Ozone pollution has recently become a severe air quality issue in the Beijing-Tianjin-Hebei region. Due to the lack of a precursor emission inventory and complexity of physical and chemical mechanism of ozone generation, numerical modeling still exhibits significant deviations in ozone forecasting. Owing to its simplicity and low calculation costs, the time series analysis model can be effectively applied for ozone pollution forecasting. We conducted a time series analysis of ozone concentration at Shangdianzi, Baoding, and Tianjin sites. Both seasonal and dynamic ARIMA models were established to perform mid- and long-term ozone forecasting. The correlation coefficient R between the predicted and observed value can reach 0.951, and the RMSE is only 10.2 μg·m^-3 for the monthly average ozone prediction by the seasonal ARIMA model. The correlation coefficient R between the predicted and observed value increased from 0.296-0.455 to 0.670-0.748, and RMSE was effectively reduced for the 8-hour ozone average predicted by the dynamic ARIMA model.

[Venetoclax with low-dose cytarabine for patients with untreated acute myeloid leukemia ineligible for intensive chemotherapy: results from the Chinese cohort of a phase three randomized placebo-controlled trial]

Objective: To investigate the safety and efficacy of venetoclax with low-dose cytarabine (LDAC) in Chinese patients with acute myeloid leukemia (AML) who are unable to tolerate intensive induction chemotherapy. Methods: Adults ≥ 18 years with newly diagnosed AML who were ineligible for intensive chemotherapy were enrolled in this international, randomized, double-blind, placebo-controlled trial. Globally, patients (n=211) were randomized 2∶1 to either venetoclax with LDAC or placebo with LDAC in 28-d cycles, with LDAC on days 1-10. The primary endpoint was OS; the secondary endpoints included response rates, event-free survival, and adverse events. Results: A total of 15 Chinese patients were enrolled (venetoclax arm, n=9; placebo arm, n=6) . The median age was 72 years (range, 61-86) . For the primary analysis, the venetoclax arm provided a 38% reduction in death risk compared with the placebo[hazard ratio (HR) , 0.62 (95%CI 0.12-3.07) ]. An unplanned analysis with an additional 6 months of follow-up demonstrated a median OS of 9.0 months for venetoclax compared with 4.1 months for placebo. The complete remission (CR) rates with CR with incomplete blood count recovery (CRi) were 3/9 (33%) and 0/6 (0%) , respectively. The most common non-hematologic adverse effects (venetoclax vs placebo) were hypokalemia[5/9 (56%) vs 4/6 (67%) ], vomiting[4/9 (44%) vs 3/6 (50%) ], constipation[2/9 (22%) vs 4/6 (67%) ], and hypoalbuminemia[1/9 (11%) vs 4/6 (67%) ]. Conclusion: Venetoclax with LDAC demonstrated meaningful efficacy and a manageable safety profile in Chinese patients consistent with the observations from the global VIALE-C population, making it an important treatment option for patients with newly diagnosed AML who are otherwise ineligible for intensive chemotherapy.

[Dasatinib combined with multi-agent chemotherapy regimen in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia: a prospective study from a single center]

目的

评价达沙替尼联合多药化疗方案在Ph染色体阳性急性淋巴细胞白血病（Ph⁺ ALL）患者中的疗效及安全性。

方法

前瞻性、单臂、开放的临床研究。2016年1月至2018年4月中国医学科学院血液病医院收治的30例初诊成人Ph⁺ ALL患者入组。采用多药化疗方案，标准诱导化疗为期4周，自诱导化疗第8天开始口服达沙替尼（商品名依尼舒，正大天晴药业集团股份有限公司产品）100 mg/d，持续应用至整体治疗结束。有条件和意愿进行移植者，可进行异基因造血干细胞移植或自体造血干细胞移植。

结果

所有30例患者在诱导治疗4周后均达到血液学完全缓解（HCR），累积完全分子学反应（MCR）率为70.0％（21/30）。中位随访时间为37.8（32.0～46.6）个月。3年总生存（OS）率为68.1％，3年无血液学复发生存（HRFS）率为61.6％。63.3％的患者在治疗3个月时达到主要分子学反应（MMR）（其中有43.3％患者达到MCR）。6个月时60.0％的患者达到MCR，达到MCR的患者具有更好的OS（P＝0.004）、HRFS（P＝0.049）和EFS（P＝0.001）。15例（50.0％）患者在第1次HCR期内进行移植，移植组患者HRFS（P＝0.030）和EFS（P＝0.010）优于化疗组。

结论

达沙替尼联合多药化疗方案治疗初诊Ph⁺ALL安全有效。

临床试验注册

ClinicalTrials.gov，NCT02523976。

[Clinical value of emergency endovascular embolization in the interventional treatment for oral hemorrhage caused by carcinoma]

To evaluate the clinical value of emergency endovascular embolization in the interventional treatment for oral hemorrhage caused by carcinoma, 32 patients with oral hemorrhage caused by carcinoma, who received emergency endovascular embolization due to unsatisfactory hemostatic effect of conventional conservative treatment in the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2019, were included in this study and their clinical data, laboratory data and imaging information were retrospectively analyzed. There were 16 males and 16 females, aged (60.6±13.6) years (34-88 years). Technical successful rate of emergency endovascular embolization, immediate successful rate of controlling hemorrhage, blood pressure before and after operation, hemoglobin before and after operation, postoperative complications and recurrence rate of oral hemorrhage were statistically analyzed. Results showed that technical successful rate of operation and immediate successful rate of controlling oral hemorrhage are both 100% (32/32). Recurrent oral hemorrhage occurred in 4 patients (13%). The hemorrhagic shock symptoms of all patients were significantly improved after interventional therapy. After operation, local swelling happened in 34% (11/32) patients and intermittent local pain happened in 22% (7/32) within 24 hours; the swelling and the pain gradually disappeared from 2nd to 5th days. Mild complications of transient fever happened in 9% (3/32) patients and disappeared spontaneously in the short term. No serious complications such as blindness, cerebrovascular accident or central nervous system disturbance occurred in all patients after operations. During the whole follow-up period (1 to 12 months), a total of 8 patients died. The causes of death were progression and metastasis of carcinoma (n=4), heart failure (n=2), severe pneumonia (n=1) and respiratory failure caused by recurrent oral hemorrhage (n=1). Owing to the remarkable short-term curative effect, repeatable operation, low recurrence rate of oral hemorrhage and low incidence of complications, emergency endovascular embolization can be used in the clinical therapy and application of oral hemorrhage caused by carcinoma.

[The effect of different diagnostic standards on the diagnosis of suspected occupational noise-induced deafness]

Objective: To explore the effect of different diagnostic criteria on occupational noise-induced deafness (Onid) , and to provide theoretical basis for the revision of ONID diagnostic criteria. Methods: From January 2016 to January 2018, the physical examination results of noise-exposed workers during occupational health examination in Qingyuan Occupational Disease Prevention and Treatment Hospital were retrospectively investigated in September 2019, with Gbz 49-2014《diagnosis of occupational noise deafness》as the study object, 471 workers suspected of Onid were weighted with different combinations of high frequency hearing threshold, and the better ear weight was calculated, compared with the diagnostic criteria of 2007 and 2014, the degree of hearing loss was evaluated. SPSS 22.0 was used for statistical analysis, χ(2) test was used for counting data, and non-parametric test was used for measuring bias data. Results: The average age of 471 subjects was (40.32±7.01) years, and the average age of exposure to noise was (7.11±3.44) years. On the basis of the 2007 edition diagnostic standard, the suspected ONID diagnostic rate of different high frequency auditory threshold was increased by 16.35% and 30.15% at 3.0 kHz, 6.0 kHz increased by 20.17%, 3.0 kHz+4.0 kHz increased by 22.29%, 3.0 kHz+6.0 kHz increased by 17.20%, 4.0 kHz+6.0 kHz increased by 25.27%, the differences were statistically significant (P<0.05) , the frequency of 3.0 kHz+4.0 kHz+6.0 kHz increased by 22.29%. Using the 2014 edition diagnostic standard, the diagnostic rate of Onid was reduced by 30.15% and 13.80%, 6 kHz is 9.98% lower, 3.0 kHz+4.0 kHz is 7.86% lower, 3.0 kHz+6.0 kHz is 12.95% lower, 4.0 kHz+6.0 is 4.88% lower, the high frequency of 3.0 kHz+4.0 kHz+6.0 kHz decreased by 7.86%, the differences were statistically significant (P<0.05) . Conclusion: The diagnosis rate of suspected Onid is increased by weighting different high frequency hearing threshold, in which the weighted 4kHz high frequency has the greatest influence on the result, and the weighted 3 kHz high frequency has the least.

[Preparation of a novel tri-specific T cell engager targeting CD19 antigen and its anti-leukemia effect exploration]

Objective: To prepare a novel tri-specific T cell engager (19TriTE) targeting CD19 antigen, and to investigate its immunotherapeutic effect on CD19-positive hematological malignancies. Methods: 19TriTE was constructed by molecular cloning technology and successfully expressed through the eukaryotic expressing system. The effects of 19TriTE on the proliferation and activation of T cells, as well as the specific cytotoxicity against CD19 positive tumor cell lines were verified. Results: ①19TriTE expressing plasmid was constructed and successfully expressed through the eukaryotic expressing system. ②19TriTE can specifically bind to T cells and Nalm6 cells, with equilibrium dissociation constants of 19.21 nmol/L and 11.67 nmol/L, respectively. ③The expression rates of CD69 positive T cells and CD25 positive T cells were 35.4% and 49.8% respectively, when 2 nmol/L 19TriTE were added in the co-culture system, which were significantly higher than those in the control group. ④19TriTE can significantly promote the proliferation of T cells. The absolute count of T cells expanded from the initial one million to 74 million with an 74 fold increase at the concentration of 1 nmol/L on day 12. ⑤19TriTE can significantly mediate T cells killing of CD19 positive target cells in a dose-dependent manner. At the concentration of 10 nmol/L, the target cells lysis reached 50%. ⑥Degranulation experiment verified that 19TriTE can activate T cells in the presence of CD19 positive target cells, and the activation of T cells positively correlated with the dose of 19TriTE. ⑦When 19TriTE fusion protein co-cultured with T cells and target cells overexpression RFP and luciferase genes respectively, 19TriTE can notably mediate T cells killing of CD19 positive target cells through fluorescent microscope or bioluminescence imaging technology. Conclusion: In this study, we successfully constructed and expressed 19TriTE fusion protein and verified that it can effectively activate T cells and promote their proliferation in vitro. At the same time, it can bind to CD19 positive target cells and T cells, as well as enhance T cells anti-leukemia effect in vitro, providing the foundation for further clinical research.

Analysis of peripherally inserted central catheter-related complications: a retrospective cohort study of 2,974 children with blood diseases in a single center of China

BACKGROUND

Although the peripherally inserted central catheter (PICC) has been widely utilized, there is still a lack of large sample size-based relevant risk factor investigation for the children with blood diseases in a single center of China.

METHODS

We performed a retrospective cohort study through including a total of 2,974 cases aged 0-18 years with blood diseases and PICC insertion. Success rates of different PICC operation techniques were compared. Targeting the common PICC-related complications, we performed the univariate and multivariate logistic regression analyses. Then, based on the screened risk factors, the prediction modeling analysis of binary logistic regression was conducted.

RESULTS

The "B-ultrasound plus Seldinger technology" showed a higher success rate of PICC placement than the "non-assistive blind insertion". The catheter type was closely linked to the occurrence of catheter occlusion. The age, insertion site, and catheter type might be the risk factors of phlebitis, while the insertion site, operation season, and catheter type might be associated with catheter fracture. Furthermore, based on these risk factors, we established the nomogram prediction models of phlebitis, rash occurrence, and catheter fracture, respectively, which shows a good predictive ability and a moderate level of predictive accuracy.

CONCLUSIONS

Our findings first shed new light on the preoperative estimation of the risk factors of PICCrelated complications for the children with blood diseases in China.

[Investigation and clinical analysis of a family with germline CEBPA mutations in acute myeloid leukemia]

目的

探讨伴CEBPA基因突变的家族性急性髓系白血病（AML）的临床特征、病因及转归，提高对家族性白血病的认识。

方法

调查一个伴CEBPA基因突变AML家系患者的发病年龄、临床特征、转归及预后并绘制家系谱。对先证者采集骨髓及口腔黏膜细胞，与先证者有血缘关系的亲属，采集外周血，通过基因测序技术检测基因突变。

结果

该家系共有10人诊断为AML，其中男4例，女6例，中位年龄9（3～48）岁。10例患者中，6例死亡，其中4例未进行治疗，1例患者化疗后生存3年复发死亡，1例采取中药及支持治疗生存2年后死亡。4例患者生存，1例接受化疗患者生存达15年，3例患者接受化疗联合造血干细胞移植，至随访截止，生存时间分别为6、9、28个月。对先证者及8名与先证者有血缘关系的亲属进行基因测序，发现5例存在胚系CEBPA TAD p.G36Afs*124突变，其中4例确诊为AML，1例随访至今未发病。

结论

伴CEBPA基因突变的家族性AML多在儿童及青壮年期发病，具有完全或接近完全的外显率，通过积极治疗，大多预后良好。

[Expert consensus for diagnosis and treatment of thrombocytopenia in China]

Thrombocytopenia is the main clinical manifestation or common complication of multiple diseases, but there is still a lack of systematic understanding of pathogenesis, underlying diseases and treatment strategies of thrombocytopenia. Based on evidence-based medicine, this consensus summarizes seven aspects related to thrombocytopenia, including definition, epidemiology, pathogenesis, clinical manifestations, laboratory examination, diagnosis and treatment. This consensus provides an important reference for the diagnosis and treatment of thrombocytopenia.

MiR-20a Promotes kidney injury in sepsis rats through autophagy

The aim of this work was to study the effects of micro ribonucleic acid (miR)-20a on acute kidney injury (AKI) in sepsis rats and its key molecular mechanism. Sprague-Dawley rats were randomly divided into healthy rat group (H group, n=3), sham group (S group, n=3), sepsis rat group (D group, n=3), sepsis rat + negative control transfection group (N group, n=3) and sepsis rat + miR-20a inhibitor transfection group (M group, n=3). At 6 h, 12 h and 24 h, serum creatinine (Scr) and blood urea nitrogen (BUN) were detected, the changes in miR-20a expression in kidney tissues were determined via reverse transcription-polymerase chain reaction (RT-PCR), the expression of autophagy marker protein microtubule-associated protein 1 light chain 3 (LC3) was measured via Western blotting, and the inflammatory cell infiltration in kidney tissues was detected using hematoxylin-eosin (HE) staining. There was no obvious change in each index in S group compared with H group. D group, N group and M group had higher levels of Scr, BUN and LC3 in kidney tissues than S group. The levels of Scr, BUN and LC3 in kidney tissues were lower in M group than those in N group. MiR-20a may cause AKI in sepsis rats via activating autophagy.