Kainic acid hyperphosphorylates tau via inflammasome activation in MAPT transgenic mice

The excitotoxicity induced by kainic acid (KA) is thought to contribute to the development of Alzheimer’s disease (AD); however, the mechanisms underlying this excitotoxicity remain unknown. In the current study, we investigated the dynamic changes in tau phosphorylation and their associations with the excitotoxicity induced by intraperitoneal injection of KA in the mouse brain. We found that KA-induced excitotoxicity led to sustained hyperphosphorylation of tau in MAPT transgenic (Tg) mice. By using cultured microglia and mouse brains, we showed that KA treatment specifically induced endoplasmic reticulum (ER) stress, which was characterized by activation of the major biomarkers of ER, such as ATF6, GRP78, and IRE1, and resulted in stimulation of inflammasomes. KA receptors (KARs), such as Girk1, were determined to be involved in this KA-induced ER stress. ER stress was also shown to activate inflammasomes by stimulating the expression of the two major components of inflammasomes, nucleotide binding oligomerization domain (NOD)-like receptor (NLR) protein 3 (NLRP3) and nuclear factor (NF)-κB, and eventually causing the production of interleukin-1β (IL-1β). Inhibition of NLRP3 or NF-κB by Bay11-7082 resulted in reduction of KA-induced IL-1β production. Our results also revealed the positive effects of IL-1β on tau phosphorylation, which was blocked by Bay11-7082. Notably, the results indicate that Bay11-7082 acts against KA-induced neuronal degeneration, tau phosphorylation, and memory defects via inflammasomes, which further highlight the protective role of Bay11-7082 in KA-induced neuronal defects.

[Analysis on the incidence of occupational pneumoconiosis of migrant workers in Shiyan city from 2013 to 2017]

Objective: To explore the incidence regularity and characteristics of pneumoconiosis among migrant workers in Shiyan city, and to provide a basis for making policies about pneumoconiosis prevention and treatment among migrant workers. Methods: In September 2018, 338 cases of pneumoconiosis among migrant workers and 354 cases of pneumoconiosis among non-migrant workers were collected between 2013 and 2017. The proportions of pneumoconiosis types, the age and seniority of onset workers, the severity grade of pneumoconiosis, the type of pneumoconiosis, the type of work and regional distribution, etc. were analyzed. Results: The age at onset of pneumoconiosisand the length of service of migrant workers and non-migrant workers in Shiyan city were significantly different (t=2.237, 3.208, P<0.05) . The proportion of pneumoconiosis stage was significantly different from that of non-migrant workers (χ(2)=47.897, P<0.05) , among migrant workers, the types of pneumoconiosis were mainly silicosis (308 cases, 91.1%) , coal worker's pneumoconiosis (29 cases, 8.6%) . The leading work types are rock drilling (115 cases, 34.0%) and blasting (105 cases, 31.1%) . The industry was mainly engaged in non-ferrous metal mining (205 cases, 60.7%) and coal (105 cases, 31.1%) . The area distribution involved each counties of Shiyan city, with Zhushan county (175 cases, 51.8%) and Yunxi county (125 cases, 37.0%) as the top two districts in number of cases. Of the cases of migrant workers, 89 cases (26.3%) had blood relationship with any others. There was no work-related injury insurance for migrant workers with pneumoconiosis. Conclusion: There is a high incidence of pneumoconiosis among migrant workers in Shiyan city, featured with the phenomenon of "late occurrence" and "family clustering", so it is urgent to strengthen the prevention and treatment of pneumoconiosis of migrant workers.

[Relative factors of transmural intestinal necrosis in acute superior mesenteric vein thrombosis]

Objective: To examine the relative factors of transmural intestinal necrosis (TIN) during multidisciplinary stepwise management facilitating the decision making in patients with acute superior mesenteric vein thrombosis (ASMVT). Methods: Clinical data of patients with ASMVT admitted to Department of General Surgery, Jinling Hospital from January 2009 to June 2017 were reviewed retrospectively. There were 52 males and 37 females, aging (45.9 ± 12.6) years (range: 20 to 69 years). According to the postoperative pathological results and follow-up, the patients were divided into TIN group (n=31) and non-TIN group (n=58, including 18 cases of intestinal stricture). The related factors were compared between ASMVT patients with TIN and patients without TIN by univariate analysis using t test, U test and χ(2) test accordingly, and factors with statistically significance were subsequently submitted to binary Logistic regression analysis. The predictive value and cut-off point of factors were evaluated by receiver operator characteristic (ROC) curve and area under the curve. Results: In univariate analysis, smoking, hypertension, peritonitis, white blood cell count,haemoglobin, international normalized ratio, blood albumin, thrombosis of superior mesenteric branches vein, free intraperitoneal fluid, decrease of bowel wall enhancement and pneumatosis intestinalis were TIN risk factors (all P<0.05). According to the binary Logistic regression analysis, white blood cell count (OR=1.093, 95%CI: 1.010 to 1.182, P=0.027), thrombosis of the superior mesenteric branches vein (OR=11.519, 95%CI: 1.906 to 69.615, P=0.008), pneumatosis intestinalis (OR=11.140, 95%CI: 2.360 to 52.585, P=0.002) were independent relative factors of TIN in patients with AMI, and the area under the ROC curve of the above factors and predictive model was 0.759 (95%CI: 0.647 to 0.871), 0.745 (95%CI: 0.641 to 0.848), 0.737 (95%CI: 0.621 to 0.854), 0.909 (95%CI: 0.847 to 0.971), respectively. The cutoff value of white blood cell count was 18.1 × 10(9)/L. Conclusion: White blood cell levels, superior mesenteric vein branch thrombosis and pneumatosis intestinalis are independent predictors of TIN in ASMVT.

[The status analysis of diagnosis and treatment of synchronous peritoneal carcinomatosis from colorectal cancer in China: a report of 1 003 cases in 16 domestic medical centers]

Objective: To analyze the status of domestic surgical treatment of synchronous peritoneal carcinomatosis from colorectal cancer in China. Methods: Clinicopathological data of patients who underwent surgery from October 2003 to October 2018 in 16 domestic medical centers was retrospectively analyzed. Excel database was created which covered 77 fields of 7 parts: baseline information of patients, laboratory tests, imaging tests, chemoradiotherapy information, intra-operative findings, postoperative pathology and follow-up data. The Wilcoxon rank-sum test was used for comparison of the measurement data between groups. The χ(2) test was used for comparison of the categorical data between groups. The survival curve was calculated by the Kaplan-Meier method. Results: Of the 1 003 patients, there were 575 male and 428 female patients with the age of (58.5±14.1) years (range: 18 to 92 years). In a total of 920 patients, the carcinoma of sigmoid colon was performed in 292 cases (31.8%) with the highest ratio. The proportion of patients with liver metastasis and lung metastasis were 27.9% (219/784) and 8.3% (64/769). Preoperative detection of carcino-embryonic antigen level was the most common method in China (87.74%, 880/1 003), and the positive rate was 64.5% (568/880). The correct rate of preoperative imaging tests was 40.7% (280/688). The ratio of peritoneal carcinomatosis index (PCI) scores between 0 and 10 was the highest (59.6%, 170/285). Two hundred and sixty-two (27.0%) patients were performed by totally laparoscopic operation in 971 patients. The resection of primary tumor was performed in 588 of the 817 patients (72.0%). In a total of 457 cases, 253 (55.4%) patients were performed cytoreduction which group scored completeness of cytoreduction (CCR) 0. The postoperative hyperthermic intraperitoneal chemotherapy was implemented in 70 of the 334 cases (21.0%). Among 1 003 cases, 562 cases (56.03%) had complete follow-up data and the median overall survival was 15 months. The primary tumor resection and the CCR scores were affected by the PCI scores. The patients underwent primary tumor resection (187/205 vs. 26/80, χ(2)=105.085, P=0.000) and the patients were performed cytoreduction which scored CCR 0 or CCR 1 (162/204 vs. 8/78, Z=-10.465, P=0.000) had significant difference between the groups of PCI<20 and ≥20. There was a close correlation between the surgical method and the CCR scores (Z=-3.246,P=0.001).When the maximum degree of tumor reduction was planned, most surgeons would choose laparotomy. The overall survival time was longer in patients with primary tumor resection (P=0.000). The median survival time was 18.6 months in the group of primary tumor resection. Conclusions: It is difficult to diagnose the synchronous peritoneal carcinomatosis from colorectal cancer before the operation. Primary tumor resection has an obvious effect to prolong the survival time. It is necessary to standardize the treatment of peritoneal metastasis.

The Regulatory Effects of CDKN1A on Relevant Genes in Kaposi's Sarcoma Cells

The cyclin-dependent kinase inhibitor 1A (CDKN1A) gene plays important roles in different types of cancer; however, its mechanism in Kaposi's Sarcoma (KS) is far less known. The aim of this study is to investigate the regulatory effects of CDKN1A on relevant genes in KS cells, and ultimately determine the role of CDKN1A in KS. In the study, the CDKN1A overexpression group, or siRNA group, was transfected into KS cells, respectively. Western-Blot (WB) and quantitative real-time polymerase chain reactions (q-PCR) were performed to detect the expression of cell cycle protein D1 (CyclinD1) and cell cycle protein E (CyclinE). Q-PCR was performed to determine the expression of kshv-mir-k12-1-5p. The results prove that CDKN1A negatively regulates the expression of CyclinD1, CyclinE, and kshv-mir-k1-2-1-5p. Therefore, CDKN1A may be involved in the formation and development of KS through the regulation of kshv-mir-k12-1-5p, CyclinD1, and CyclinE. CDKN1A may become a new choice for targeted therapy in KS.

[Clinicopathological and molecular characteristics of Epstein-Barr virus associated gastric cancer: a single center large sample case investigation]

OBJECTIVE

Epstein-Barr virus associated gastric cancer (EBVaGC) is different from the traditional gastric cancer (Epstein-Barr virus non-associated gastric cancer, EBVnGC), and has unique clinicopathological features. This study investigated the largest single center cancer series so as to establish the clinicopathological and molecular characteristics of EBVaGC in China.

METHODS

A retrospective analysis was conducted on EBVaGC and EBVnGC patients diagnosed at Peking University Cancer Hospital from 2003 to 2018 by comparing their clinicopathological features and prognosis. The gastric cancer (GC) dataset of public database was analyzed to obtain differentially expressed genes. The expression of important genes and their association with prognosis of GC were verified in GC tissues from our hospital.

RESULTS

In this study, 3 241 GC patients were included, and a total of 163 EBVaGC (5.0%) patients were identified. Compared with EBVnGC, EBVaGC was higher in male and younger patients, and positively associated with remnant GC, poorly differentiated adenocarcinoma, and mixed type GC. EBVaGC was inversely related to lymph node metastasis. The 5-year survival rate of EBVnGC and EBVaGC was 59.6% and 63.2% respectively (P<0.05). In order to explore molecular features of EBVaGC, the Cancer Genome Atlas (TCGA) dataset was analyzed (n=240), and 7 404 significant differentially expressed genes were obtained, involving cell proliferation, apoptosis, invasion and metastasis. The down-regulated invasion/metastasis gene SALL4 and the up-regulated immune checkpoint gene PD-L1 were important molecular features of EBVaGC. Validation of these two genes in large GC series showed that the majority of the EBVaGC was SALL4 negative (1/92, 1.1%, lower than EBVnGC, 303/1 727, 17.5%), and that PD-L1 was mostly positive in EBVaGC (81/110, 73.6%, higher than EBVnGC, 649/2 350, 27.6%). GC patients with SALL4 negative and PD-L1 positive were often associated with better prognosis.

CONCLUSION

EBVaGC is a unique subtype of GC with less metastasis and a good prognosis. It also has a distinct molecular background. The down-regulation of invasion/metastasis gene SALL4 and up-regulation of immune checkpoint gene PD-L1 are important molecular features.

[Analysis of mental state of allergic rhinitis patients in Chengdu city by symptom check list 90 (SCL-90) scale]

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People's Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion: AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

A method for improving the accuracy of non-invasive prenatal screening by cell-free foetal DNA size selection

Background Non-invasive prenatal screening (NIPS) using cell-free foetal DNA (cfDNA) has been widely used for identifying common foetal aneuploidies (e.g. trisomy 21 (T21), trisomy (T18) and trisomy 13 (T13)) in clinical practice. The sensitivity and specificity of NIPS exceeds 99%, but the positive prediction value (PPV) is approximately 70% (combined T21, T18 and T13). Thus, some 30% of pregnant women who have positive NIPS results are eventually identified as normal by amniocentesis. These women therefore must undertake needless invasive tests and risk miscarrying healthy babies because of false positive NIPS results. Methods In order to achieve higher accuracy, we amended the standard NIPS (s-NIPS) protocol with an additional cfDNA size selecting step in agarose-electrophoresis. The advantage of the new method (named e-NIPS) was validated by comparing the results of e-NIPS and s-NIPS using 114 retrospective cases selected from 15,930 cases. Results Our results showed that the foetal cfDNA fraction can be enriched significantly by a size selection step. With this modification, all 98 negative cases and 9 of 11 false positive cases of s-NIPS were correctly identified by e-NIPS, resulting in an increased PPV from 71% to 77%. Additionally, a simulation test showed that e-NIPS is more reliable than s-NIPS, especially when the foetal cfDNA concentration and sequencing coverage are low. Conclusion cfDNA size selection is an important step in improving the accuracy of non-invasive prenatal screening for chromosomal abnormalities.

Bioinformatics analysis of key biomarkers and pathways in KSHV infected endothelial cells

Kaposi sarcoma (KS) is an endothelial tumor etiologically related to Kaposi sarcoma herpesvirus (KSHV) infection. The aim of our study was to screen out candidate genes of KSHV infected endothelial cells and to elucidate the underlying molecular mechanisms by bioinformatics methods. Microarray datasets GSE16354 and GSE22522 were downloaded from Gene Expression Omnibus (GEO) database. the differentially expressed genes (DEGs) between endothelial cells and KSHV infected endothelial cells were identified. And then, functional enrichment analyses of gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis were performed. After that, Search Tool for the Retrieval of Interacting Genes (STRING) was used to investigate the potential protein-protein interaction (PPI) network between DEGs, Cytoscape software was used to visualize the interaction network of DEGs and to screen out the hub genes. A total of 113 DEGs and 11 hub genes were identified from the 2 datasets. GO enrichment analysis revealed that most of the DEGs were enrichen in regulation of cell proliferation, extracellular region part and sequence-specific DNA binding; KEGG pathway enrichments analysis displayed that DEGs were mostly enrichen in cell cycle, Jak-STAT signaling pathway, pathways in cancer, and Insulin signaling pathway. In conclusion, the present study identified a host of DEGs and hub genes in KSHV infected endothelial cells which may serve as potential key biomarkers and therapeutic targets, helping us to have a better understanding of the molecular mechanism of KS.

[Association between Lipoprotein(a) and the characteristics of left main coronary artery plaque in patients with stable angina pectoris]

Objective: To investigate the relationship between Lipoprotein (LP) (a) level and the characteristics of tissue components of left main coronary artery (LMCA) plaque. Methods: A total of 102 patients with stable angina pectoris who underwent percutaneous coronary intervention (PCI) in the People's Hospital of Henan Province from June 2010 to October 2016 were included. We performed intravascular ultrasound-virtual histology (IVUS-VH) to their LMCAs and evaluated the tissue characteristics, and the blood level of total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), ApoB, ApoA1, LP(a) were measured. According to the value of their LP(a) level they were divided into 2 groups (high LP(a) group (>300 mg/L) (n=35) and low LP(a) group (≤300 mg/L) (n=67)), then the relationship between the above lipid values and the tissue characteristics of the LMCA plaque in the patients were evaluated. Results: Patients with a high LP(a) had a larger percentage of fibrolipid volume and a smaller percentage fibrous volume compared to patients with a normal LP(a) (25%±5% vs 13%±6%, P<0.01 and 50%±8% vs 61%±9%, P<0.01). Using multivariate linear regression analysis after adjustment for the above-mentioned confounding factors, LP(a) had a significantly positive correlation with fibrolipid volume percentage (r=0.645, β=0.29, P<0.01), and had a negative correlation with fibrous volume percentage (r=-0.467, β=-0.32,P<0.01), suggesting that the LP(a) was associated with the vulnerability of the LMCA plaque. Conclusion: For the patients with stable angina pectoris, the LP(a) has a significantly positive correlation with the percentage of fibrolipid volume and a negative correlation with the percentage of fibrous volume, suggesting that the LP(a) could predict the vulnerability of the LMCA plaque.

[Application of multiplex PCR assay to study early multiple herpesviruses infection during HSCT]

目的

采用多重PCR方法分析造血干细胞移植（HSCT）患者多种疱疹病毒的感染状况，并探讨HSCT患者多种疱疹病毒感染与临床特征的相关性及其对移植并发症和预后的影响。

方法

以苏州大学附属第一医院血液科2017年2月至2017年8月行HSCT的90例患者为研究对象，收集预处理至移植后90 d内不同时间点的外周血标本共734份，Lab-Aid824核酸提取Mini试剂抽提DNA，应用多重PCR方法同时扩增8种人类疱疹病毒，分析多种疱疹病毒感染发生率及其与临床特征的相关性及对移植后并发症和预后的影响。

结果

至随访终点，中位随访时间为192（35~308）d。移植前疱疹病毒感染发生率为35.6%（32/90），其中1种疱疹病毒感染发生率为12.2%（11/90），多种病毒感染的发生率为23.3%（21/90）。移植后疱疹病毒感染发生率为77.8%（70/90），其中1种疱疹病毒感染发生率为20.0%（18/90），多种疱疹病毒感染的发生率为57.8%（52/90）。在多种疱疹病毒感染的患者中，2种病毒感染30例（57.7%），3种疱疹病毒感染18例（34.6%），不同时间点样本检测的4种疱疹病毒感染4例（7.7%）。移植后多种疱疹病毒感染中，HHV-6和HHV-7感染存在相关性（OR=13.880，Q=0.026），EBV和HHV-7感染也存在相关性（OR=0.093，Q=0.044）。25例患者移植后出现疱疹病毒感染相关临床表现，主要为出血性膀胱炎、间质性肺炎、肠炎、病毒性脑炎和不明原因发热。移植前HHV-1感染与年龄、HHV-2感染与发病时间、CMV感染与原发病为淋巴瘤具有一定的相关性。移植后EBV感染与HLA不全相合、供受者ABO血型不一致及Ⅱ~Ⅳ度急性GVHD呈正相关；多种疱疹病毒感染与HLA不全相合、非血缘供者及Ⅱ~Ⅳ度急性GVHD呈正相关。

结论

HSCT前后存在多种疱疹病毒感染，HLA不全相合、非血缘供者和Ⅱ~Ⅳ度急性GVHD与移植后多种疱疹病毒感染存在一定的相关性。

[Immune reconstruct regularity profile of KIR2DL1 and KIR3DL1 in unrelated-donor allogeneic hematopoietic stem cell transplantation]

Objective: To investigate the immune reconstruct regularity profile of KIR2DL1 and KIR3DL1 in unrelated-donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) with KIR-AA genotype. Method: 75 donor-recipient pairs were performed by KIR genotying using PCR-SSP, and all donors were identified with KIR-AA genotype. Dynamic detections (including unrelated-donor on the day of transplantation and the recipient each month post allo-HSCT) of the expression of KIR2DL1/3DL1 on NK cell and mRNA level were performed in 291 cases using flow cytometry (FCM) and real-time fluorescent quantitation PCR (RT-qPCR) . Result: ①The median expression of KIR2DL1 in unrelated-donor on transplant's day was 21.60%, the median expression of KIR2DL1 in recipient 1M, 2M, 3M and 3-6M after transplantation were 7.40%, 12.00%, 16.92%, 17.64% respectively. The median expression of KIR2DL1 in unrelated-donor on transplant's day was 265.14 copies/10 000abl copies, the median expression of KIR2DL1 in recipient 1M, 2M, 3M, 3-6M, 6-9M, 9-12M after transplantation were 332.17, 438.31, 723.25, 414.17, 180.76 and 234.67 copies/10 000abl copies respectively. The median expression of KIR2DL1 on NK cells and mRNA level gradually increased at all time points after transplantation, and reached the highest expression at 3 months after transplantation. But mRNA expression levels increased earlier than NK cell membrane proteins. ②The median expression of KIR3DL1 in unrelated-donors on transplant's day was 18.56%, the median expression of KIR3DL1 in recipient 1M, 2M, 3M, 3-6M after transplantation were 23.83%, 22.57%, 23.02%, 21.60% respectively. The median expression of KIR3DL1 in unrelated-donor on transplant's day was 572.29 copies/10 000abl copies, the median expression of KIR3DL1 in recipient 1M, 2M, 3M, 3-6M, 6-9M, 9-12M after transplantation were 1 233.74, 1 140.42, 876.73, 1 057.07, 739.02 and 514.43 copies/10 000abl copies respectively. The median expression of KIR3DL1 on NK cells and mRNA level were higher than donors at 1 month after transplantation, and stable expression at all time points after transplantation, so mRNA and NK cell membrane proteins expression increased at the same time. Conclusion: The immune reconstruct regularity of KIR2DL1 and KIR3DL1 gene were different, which provided an experimental basis for selecting the best time to detect the expressions of KIR2DL1 and 3DL1 after transplantation.

[Clinical analysis of 7 patients with Epstein-Barr virus encephalitis after allogeneic hematopoietic stem cell transplantation]

Objective: To summarize the clinical features, treatment and prognosis of patients with Epstein Barr virus (EBV) encephalitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of 7 patients with EBV encephalitis who had undergone allo-HSCT in the First Affiliated Hospital of Soochow University from January 2012 to December 2015 were reviewed. Results: The incidence of EBV encephalitis was 0.70% (7/998) , and the median time was 63 (10-136) d after allo-HSCT. Seven patients had fever and mental disorder, of whom 4 cases of brain MRI were positive. Two patients received HLA-matched unrelated transplantation, while other 5 ones received haploidentical allo-HSCT. In conditioning regimen process, 7 patients were combined with anti-thymocyte globulin (ATG) to prevent graft versus host disease (GVHD) , of whom 6 patients had grade Ⅱ-Ⅳ acute GVHD. All patients of EBV-DNA were negative in CSF after taking anti-virus agent Rituximab. Until the last follow-up, a total of 3 patients died, 2 died of leukemia recurrence, 1 EBV encephalitis progression. Conclusion: Once suspected EBV encephalitis after allo-HSCT, brain MRI and EBV-DNA in CSF should be detected, which could improve early diagnosis of EBV encephalitis. The usage of Rituximab was effective and well tolerated.

[Distribution of donor-specific aKIR after unrelated allogeneic hematopoietic stem cell transplantation]

目的

分析非血缘异基因造血干细胞移植（allo-HSCT）后可供检测的供者特异性激活性杀伤细胞免疫球蛋白样受体（aKIR）基因的分布、比例及在临床中的应用价值。

方法

采用序列特异性引物聚合酶链反应（PCR-SSP）方法，回顾性分析216对供受者KIR基因分型，探讨可供检测的供者特异性aKIR的临床价值。

结果

在216例患者接受非血缘HSCT后可检测到供者特异性KIR基因为53.7%（116/216），在供受者KIR基因型不合中占78.3%（112/143），在供受者KIR基因型相合中占5.5%（4/73）。116例患者可检测到供者特异性KIR，99.1%（115/116）为aKIR基因。55对供受者KIR基因型为Bx-AA，可分别检测Bx1基因型中KIR3DS1、KIR2DL5A、KIR2DS5、KIR2DS1；Bx2基因型中KIR3DS1、KIR2DL5A、KIR2DS3、KIR2DS1；Bx3基因型中KIR2DS2、KIR2DL2；Bx4基因型中KIR2DS2、KIR2DL2、KIR3DS1、KIR2DL5A、KIR2DS5、KIR2DS1。44对供受者AA-AB不合中，有16对可检测供者特异性的KIR2DS4（FUL）基因。在143对供受者KIR基因型不合中，可检测供者特异性KIR基因频率由高到低分别为KIR2DS1（35.7%）、KIR3DS1（32.9%）、KIR2DS5（29.4%）、KIR2DS4（FUL）（25.9%）、KIR2DL2（25.2%）、KIR2DS2（24.5%）、KIR2DS3（21.7%）、KIR3DL1（8.4%）。

结论

非血缘allo-HSCT后可检测的供者特异性aKIR基因主要分布在供受者KIR基因型不合中，且因供受者KIR基因型不同而有差异，但在频率较高的KIR-AA、Bx1、Bx2、Bx3、Bx4中有供者特异性较高的aKIR，其为研究aKIR基因对移植预后的影响奠定了实验基础。

[Exogenous lipid pneumonia with hyperpyrexia: a case report]

Lipoid pneumonia (LP) is an uncommon form of pneumonia that is characterized by the presence of intra-alveolar lipid and lipid-laden macrophages on microscopy. It categorized as exogenous lipoid pneumonia (ExLP) and endogenous lipoid pneumonia (EnLP). Exogenous lipoid pneumonia caused by inhalation of liposuction substances (animal fat, vegetable oil, or mineral oil), mostly, in adult cases, they were medicines for constipation or rhinopharyngitis. Most of these patients showed mild clinical manifestations, and chronic medical condition. There were reports of lipoid pneumonia being successfully treated with corticosteroids, immunoglobulins and whole lung lavage. We report a case of exogenous lipoid pneumonia characterized by high fever and acute medical condition. A 77-year-old woman with hypertension and diabetes mellitus, accepted paraffin oil treatment for "incomplete intestinal obstruction", then, an accident of aspiration happened, as she went through the history of coughing while eating, followed by persistent hyperthermia and increases of white blood cells (WBC). Chest CT showed progressive ground-glass opacities, accompanied with fusion of consolidation, her sputum etiological examination was negative, and the therapy of broad-spectrum antibiotic was invalid. The patient was subjected to bronchofibroscopy with bronchoalveolar lavage (BAL). The bronchoalveolar lavage fluid (BALF) appeared colorless and transparent, and did not show a milky appearence. Total cell count of the BALF was 2.0×10⁹ cell/mL, including 7.2% macrophages and 92.8% neutrophils. Cultures of the BALF were negative for bacterial, fungal, and mycobacterial pathogens. The BALF cytologic findings showed vacuolated lipid-laden macrophages (Oil Red O staining). These findings revealed exogenous lipoid pneumonia. There were reports of lipoid pneumonia being successfully treated with corticosteroids, immunoglobulins, and whole-lung lavage. So this patient was treated with methylprednisolone 120 mg/d for 3 days and 80 mg/d for 6 days, at the same time, immunoglobulins was given to infusion, but the daily peak temperature of the patients fluctuated between 38 and 39 degrees. Then, whole lung lavage was performed 28 days after admission. Unfortunately, acute pulmonary edema occurred during the operation, as the tracheal intubation problems, and 6 days later, the patient died at last. The clinical manifestations of exogenous lipid pneumonia vary greatly, from asymptomatic to life-threatening symptoms, and as febrile low fever is the main manifestation, but hyperthermia may also be the remarkable presentation.

[Various choices of reconstructing the left subclavicular artery to extend the proximal landing zone thoracic endovascular aortic repair]

Thoracic endovascular aortic repair (TEVAR) has become the preferred treatment for Stanford type B aortic dissection. Covered the left subclavian artery (LSA) directly may cause corresponding complications in Stanford type B aortic dissection with unfavourable proximal landing zone. TEVAR can be successfully implemented by reconstructing LSA to expand the proximal landing zone. Currently, the methods of reconstructing LSA mainly include hybridization technology (carotid-subclavian artery transposition), chimney technology (including branch stent technology) and fenestration (or slot technology), etc. These techniques are all valid for aortic dissection that needs to reconstructing LSA. The choices and applications of these techniques should follow the individualized principles.

Vitamin D receptor gene polymorphism, serum 25-hydroxyvitamin D levels, and risk of vitiligo: A meta-analysis

OBJECTIVES

To explore the relationship among the vitamin D receptor (VDR) gene polymorphisms, serum 25-hydroxyvitamin D levels, and vitiligo.

METHODS

Databases including PubMed, Cochrane Library, Ovid, Web of Science, CNKI, SinoMed, and Wanfang Data were systematically searched. The association was assessed using odds ratios (ORs), standard mean difference (SMD), and 95% confidence intervals (CIs). The statistical tests were performed using Review Manager 5.3.3.

RESULTS

We identified a total of 17 studies. The relationship between VDR gene polymorphisms (BsmI, ApaI, TaqI, and FokI), serum 25 (OH)D levels, and incidence of vitiligo was investigated. The results of this meta-analysis showed that the dominant genetic model (CC+AC vs AA, P = .007, OR = 1.41, 95% CI = 1.10-1.80), recessive genetic model (CC vs AC+AA, P = .01, OR = 4.10, 95% CI = 1.36-12.35), and allelic contrast model (C vs A, P = .005, OR = 1.87, 95% CI = 1.21-2.90) of VDR Apal locus increased the risk of vitiligo, and BsmI, TaqI, and FokI loci and the risk of vitiligo have no obvious correlation. Serum 25 (OH)D deficiency was positively associated with the incidence of vitiligo (P < .0001, SMD = -0.94, 95% CI = -1.39, -0.48).

CONCLUSION

This meta-analysis revealed that VDR Apal polymorphism increased the susceptibility risk of vitiligo, and there is a positive correlation between serum 25 (OH)D deficiency and the incidence of vitiligo.

Differential expression of intestinal ion transporters and water channel aquaporins in young piglets challenged with enterotoxigenic Escherichia coli K88

The study was to determine whether the expression of genes involved in intestinal water and ion transport would be affected by enterotoxigenic (ETEC) K88 both in vitro and in vivo. First, 36 male piglets (4 d old) were randomly allotted to either the control or the ETEC K88 group. Each group had 6 replicates with 3 piglets per replicate. All piglets were fed with the same diets for 17 d. On d 15, piglets in the ETEC K88 group were challenged with ETEC K88 (serotype O149:K91:K88ac) at 1 × 10 cfu per pig, whereas those in the control group received the same volume of sterile PBS. After being challenged with ETEC K88 for 72 h (d 18), 1 piglet from each replicate was selected for slaughter to collect samples from the jejunum, ileum, and colon. The mRNA expression and protein abundance of cystic fibrosis transmembrane conductance regulator (CFTR) in the ileum and colon were increased compared with that in the control group ( < 0.05). Furthermore, the mRNA expression of () in the ileum and colon was increased by ETEC K88 challenge ( < 0.05), whereas in the jejunum, both its mRNA and protein expression were increased by ETEC K88 treatment ( < 0.05). Additionally, an established porcine intestinal epithelial cell line (IPEC-J2) was used to investigate the effect and possible mechanism of ETEC K88 on expression of water channel aquaporins (AQP) and ion transporters. Cells (1.17 × 10 per well) were grown in 6-well plates and treated with ETEC K88 at a multiplicity of infection of 50:1 for 3 h. The mRNA expression of , , and () in IPEC-J2 cells was reduced after ETEC K88 treatment ( < 0.05). Further analyses using western blotting also demonstrated that ETEC K88 decreased the protein expression of AQP3, AQP9, and AQP11 in IPEC-J2 cells ( < 0.05). Moreover, the phosphorylation levels of protein kinase A (PKA) and cyclic adenosine monophosphate (cAMP)-response element binding protein (CREB) were decreased by ETEC K88 challenge ( < 0.05). The results indicate that ETEC K88 challenge induced differential expression of intestinal ion transporters and AQP in young piglets, probably by regulation of the cAMP-PKA signaling pathway. This study might provide new insights about the importance of fluid homeostasis in control of ETEC-induced diarrhea in young piglets.

[Clinical features and gene mutation analysis of patients with Niemann-Pick disease type C]

Objective: To analyze the clinical manifestations, therapeutic efficacy, prognosis and characteristics of NPC1 mutation in Chinese patients with Niemann-Pick disease type C(NPC). Methods: Ten unrelated Chinese NPC patients were diagnosed by NPC1 mutation analysis from July 2013 to February 2017 in Beijing Tian Tan Hospital of Capital Medical University. Clinical data of 10 cases were analyzed retrospectively which included clinical manifestations, laboratory results and NPC1 gene mutation features, and a series of follow-up were carried out about therapeutic efficacy and prognosis. Results: Ten patients suffering from NPC included 5 males and 5 females, aged from 42 days to 14 years when they presented to Tian Tan Hospital. According to their age of neurological onset, 4 were in early infantile period, 2 in late infantile period, 2 in juvenile periods, and the other 2 cases in neonatal period. They all presented with splenomegaly, 5 of 10 accompanied with hepatomegaly. Two cases of neonatal subtype presented mainly with delayed neonatal cholestatic jaundice and hepatosplenomegaly, accompanied with decreased muscle tone and slight psychomotor retardation. The other 8 cases presented with severe neurological involvement, such as progressive encephalopathy, ataxia and language impairment, 4 with dystonia, 3 with decreased muscle tension, 5 with vertical supranuclear gaze palsy, 5 with gelastic cataplexy, and 4 with epilepsy. Eight of 9 cases presented with foam cells in their bone marrow. Head MRI showed diffuse cerebral atrophy in 8 cases, thin corpus callosum in 2 cases, and brain white matter abnormal signals in 2 cases. Among 10 cases, 18 different mutations of NPC1 allelic genes were identified including 11 reported mutations, 3 novel missense mutations: c. 3683T>C (p.Met1128Thr), c.1926G>C (p.Met642Iie) and c. 3006C>G (p.Phe1002Leu), 2 novel nonsense mutation: c. 1142G>A(p.Trp381Ter ) and c. 3229C>T(p.Arg1077Ter), 1 novel minimal deletion mutation: c. 1385-1386del, and 1 novel intron mutation: c. 1757+ 5G>A. In 5 cases, the symptom of gelastic cataplexy was alleviated by imipramine, and the convulsion was relieved by valproate in 2 cases, by carbamazepine in 1 case at the beginning of seizure. During the 25 (3-66) months of follow-up, 4 cases died, the others' neurological symptoms were deteriorated progressively. Conclusions: The NPC1 gene mutation were high heterozygous in this group, and 7 novel mutations enriched the gene mutation spectrum of NPC1. The neurological manifestations were complicated in patients with NPC, and the symptomatology would be different according to their onset age of neurological symptoms. There might be effective symptomatic treatment for gelastic cataplexy by imipramine and for convulsion by valproate or carbamazepine.

MicroRNA-126-3p suppresses cell proliferation by targeting PIK3R2 in Kaposi's sarcoma cells

Kaposi's sarcoma is a highly vascular tumor of lymphatic endothelial origin. Many deregulated miRNAs, including miR-126-3p, have been identified in Kaposi's sarcoma tissues. miR-126-3p is the most highly endothelial-specific miRNA that regulates vascular integrity and angiogenesis. In this study, we aimed to determine the effect of miR-126-3p on Kaposi's sarcoma cells through transfection of a miRNA mimic and inhibitor. Moreover, we searched the target gene (PIK3R2) of miR-126-3p using bioinformatics software and further verified PIK3R2 using luciferase reporter assays, Real-time quantitative PCR (qRT-PCR) and western blot. The results demonstrated that miR-126-3p inhibited cell proliferation, arrested cell cycle progression, induced cell apoptosis, and inhibited cell invasion of SLK cells. The bioinformatics analysis and luciferase reporter assay revealed that PIK3R2 mRNA is a direct target of miR-126-3p. Moreover, the level of expression of the PIK3R2 gene was downregulated in SLK cells transfected with miR-126-3p siRNAs. Therefore, our data demonstrated that miR-126-3p is a tumor suppressor miRNA that acts by targeting PIK3R2 in Kaposi's sarcoma cells. These findings contribute to our understanding of the molecular mechanisms underlying Kaposi's sarcoma.

WSe2 few layers with enzyme mimic activity for high-sensitive and high-selective visual detection of glucose

As one of the transition metal dichalcogenide materials, WSe₂ in the form of a few layers (nanosheets) have received much attention due to their unique physical, optical and electrical properties. Herein, we demonstrate that WSe₂ nanosheets possess intrinsic enzyme mimic activity. Under acidic conditions, they exhibit pronounced peroxidase-like property. The Michaelis-Menten kinetics indicate that the catalytic activity of WSe₂ nanosheets is comparable to that of horseradish peroxidase. Based on the color reaction, a platform of WSe₂ nanosheets was constructed to detect glucose concentration and it showed high sensitivity and high selectivity, which means that WSe₂ nanosheets with peroxidase-like property can be used to develop a highly sensitive and selective colorimetric method for glucose detection. Moreover, due to the electron-transferring and antioxidant properties of WSe₂ few layers, the peroxidase-like catalysis is proposed. These findings pave the way for further application of WSe₂ nanosheets in nano-biomedicine.