[National surveillance of schistosomiasis morbidity in China, 2015-2019]

OBJECTIVE

To understand the morbidity due to Schistosoma japonicum in national schistosomiasis surveillance sites of China from 2015 to 2019, so as to provide insights into schistosomiasis control and elimination and provide the scientific evidence for formulating the new scheme for schistosomiasis surveillance in China.

METHODS

According to the requirements of National Scheme for Schistosomiasis Surveillance in China (2014 Edition), national schistosomiasis surveillance sites were assigned in all schistosomiasis-endemic counties (cities, districts) and the potential endemic counties (cities, districts) in the Three Gorges Reservoir areas, and S. japonicum infections were monitored in local residents, mobile populations and livestock according to different epidemic types. The sero-prevalence of S. japonicum infections, adjusted prevalence of human S. japonicum infections, characteristics of egg-positive individuals and prevalence of S. japonicum infections livestock were analyzed.

RESULTS

S. japonicum infections were monitored in 453 schistosomiasis-endemic counties (cities, districts) from 13 provinces (municipalities, autonomous regions) and 4 potential endemic counties (cities, districts) from the Three Gorges Reservoir areas in China from 2015 to 2019. During the 5-year period from 2015 to 2019, the sero-prevalence of S. japonicum infections reduced from 3.35% to 1.63% among local residents and from 1.15% to 0.75% among mobile populations, while the adjusted prevalence of infections reduced from 0.05% to 0 among local residents and from 0.20% to 0.001 03% among mobile populations. There were significant differences in the sero-prevalence of S. japonicum infections among local residents and mobile populations in terms of province, occupation and age (all P values < 0.05). A total of 132 egg-positives were identified during the 5-year period, including 97 local residents (inter-quartile range for ages, 47 to 61 years), and 35 mobile populations (inter-quartile range for ages, 26 to 48 years), and there was a significant difference in the age distribution between local residents and mobile populations (P < 0.05). There were totally 6 bovines (5 in 2015 and 1 in 2016) identified with S. japonicum infections in national schistosomiasis surveillance sites of China, with no S. japonicum infections detected in bovines from 2017 to 2019.

CONCLUSIONS

The prevalence of schistosomiasis is very low in China. Further surveillance including more mobile surveillance sites seems justified to identify the risk of schistosomiasis as soon as possible and interrupt the transmission route, so as to facilitate the elimination of schistosomiasis in China.

[National surveillance of Oncomelania hupensis in China, 2015-2019]

OBJECTIVE

To analyze the monitoring data of Oncomelania hupensis in the national schistosomiasis surveillance sites of China from 2015 to 2019, so as to understand the changes of Oncomelania snail status in the schistosomiasis-endemic areas of China and to provide the scientific evidence for Oncomelania snail control.

METHODS

According to the requirements of National Scheme for Schistosomiasis Surveillance in China (2014 Edition), national schistosomiasis surveillance sites were assigned in all schistosomiasis-endemic counties (cities, districts) and the potential endemic counties (cities, districts) in the Three Gorges Reservoir areas, and Oncomelania snail status was monitored according to different epidemic types. In endemic areas, Oncomelania snail survey was performed by means of systematic sampling and environmental sampling, and the occurrence of frames with Oncomelania snails and the prevalence of Schistosoma japonicum infections in Oncomelania snails were calculated, while in potential endemic areas, the risk of imported Oncomelania snails and Oncomelania snails in floating debris were monitored.

RESULTS

Oncomelania snail survey was performed covering an area of 116 834.16 hm² in the national schistosomiasis surveillance of China from 2015 to 2019, with 35 007.62 hm² Oncomelania snail habitats identified. A total of 6 908 292 frames were surveyed during the 5-year period, and there were 364 555 frames detected with Oncomelania snails, with a 5.28% mean occurrence of frames with Oncomelania snails. Among 997 508 living Oncomelania snails captured, no S. japonicum infections were detected, and loop-mediated isothermal amplification (LAMP) assay detected 18 positive mixed Oncomelania snail samples. During the period from 2015 to 2019, 147.20 hm² emerging Oncomelania snail habitats were identified, with an overall tendency towards a rise seen in the proportion of emerging Oncomelania snail habitats in plain regions with waterway networks (0.12% to 92.00%), a tendency towards a rise followed by decline seen in marshland and lake regions (0 to 96.72%), and a large fluctuation in hilly regions (0 to 88.49%). A total of 831.10 hm² re-emerging Oncomelania snail habitats were found in the national schistosomiasis surveillance sites of China from 2015 to 2019, with an overall tendency towards a rise seen in the proportion of re-emerging Oncomelania snail habitats in marshland and lake regions (16.05% to 79.66%), an overall tendency towards a decline seen in hilly regions (19.25% to 81.00%), and a minor fluctuation in plain regions with waterway networks (1.10% to 10.14%). During the 5-year period from 2015 to 2019, a total of 48 656 kg floating debris were captured in 4 surveillance sites in the Three Gorges Reservoir areas, and 2 204 snails were found, with no Oncomelania snails identified.

CONCLUSIONS

The areas of Oncomelania snail habitats tended to be stable in the national schistosomiasis surveillance sites of China during the period from 2015 to 2019, however, there was a gradual rise in the area of Oncomelania snail habitats year by year, and LAMP assay identified positive Oncomelania snail samples, suggesting Oncomelania snail control is far from optimistic in China.

A32 EMPAGLIFOZIN IMPROVES GASTROINTESTINAL INFLAMMATION IN A MOUSE MODEL OF COLITIS

Background

Empagliflozin (EMPA) is a highly selective sodium glucose cotransporter-2 (SGLT2) inhibitor and is increasingly being utilized as an antihyperglycemic agent in the management of type 2 diabetes. Interestingly, it has been demonstrated in human trials that EMPA treatment exerts potent cardioprotective effects by reducing cardiac inflammation independently of glycemic control. Further, EMPA has also been shown to suppress LPS-induced renal and systemic inflammation in an animal model. Based on these findings, we hypothesized that EMPA treatment may also be effective in reducing gut inflammation.

Aims

The aim of this study was to examine the effects of treatment with EMPA on gastrointestinal inflammation in an animal model of inflammatory bowel disease and to determine mechanistic insights regarding its direct effects on gut cytokine secretion.

Methods

Adult male and female IL-10-/- mice with established colitis were treated with a daily gavage of EMPA (10mg/kg; n=10) or vehicle (n=10) for 14 days. Disease activity was assessed by measurement of mouse weight, colonic weight and length, histological score, cytokine levels in colonic homogenate and lipocalin-2 levels in stool. To examine for possible direct effects of EMPA, colonic explants from wild-type (n=8) and IL-10-/- (n=8) mice were incubated with increasing doses of EMPA (0.1–5 µM) ± LPS (10µg/ml) for 2 hours and tissue levels of IL-1β and TNFα protein measured by ELISA.

Results

After 14 days EMPA treated IL-10-/- mice had a significant improvement in colonic inflammation as evidenced by decreased colonic weight to length ratio (p=0.019), decreased fecal lipocalin-2 (p=0.03), as well as decreased enterocyte injury (p=0.01), decreased lamina propria neutrophils (p=0.01) and decreased total histological score (p=0.006). EMPA treated mice also maintained their weight over the 14 days while untreated mice continued to lose weight (p=0.04). There were no significant differences in colonic homogenate levels of TNFα, IL-1β, or IL-6 or in blood glucose levels between EMPA-treated mice and controls. In addition, EMPA did not suppress levels of basal or LPS-induced TNFα and IL-1β in colonic explants from either wild-type or IL-10-/- mice suggesting that the beneficial effects in IL-10-/- mice were not due to direct effects of EMPA on colonic TNFα or IL-1β cytokine levels.

Conclusions

EMPA treatment dramatically improved histologic and fecal inflammatory markers and maintained body weight in adult IL-10-/- mice with established colitis. These findings suggest further investigations into the effects of EMPA in treating gut inflammation are warranted.

Funding Agencies

CAG, CIHR

[Endemic status of schistosomiasis in People's Republic of China in 2019]

This report presented the endemic status of schistosomiasis in the People's Republic of China at a national level in 2019, and analyzed the data collected from the national schistosomiasis prevention and control system and 455 national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai, Zhejiang, Fujian, Guangdong and Guangxi continued to consolidate the achievements of schistosomiasis elimination, Sichuan Province achieved transmission interruption, Jiangsu newly achieved the standard of transmission interruption and 5 provinces of Yunnan, Hubei, Anhui, Jiangxi and Hunan maintained transmission control by the end of 2019. There were 450 endemic counties (cities, districts) endemic for schistosomiasis, including 28 500 endemic villages covering 70 667 800 people at risk of infections. Among the 450 endemic counties (citis, districts), 66.89% (301/450), 28.44% (128/450) and 4.67% (21/450) kept the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2019, a total of 30 170 advanced schistosomiasis cases were documented in China. In 2019, a total of 12 090 712 individuals received inquiry examinations and 1 740 764 were positive; 5 158 369 individuals received serological tests and 89 753 were seropositive. A total of 327 475 individuals received stool examinations and 5 were positive, including one case of acute schistosomiasis. In 2019, snail survey was performed in 19 726 endemic villages in China and Oncomelania snails were found in 7 322 villages, accounting for 37.12% of all surveyed villages, with 6 villages with emerging snail habitats. Snail survey covered an area of 585 286.24 hm² and 174 270.42 hm² snail habitats were found, including emerging snail habitats of 64.20 hm²; however, no infected snails were identified. In 2019, a total of 605 965 bovines were raised in the schistosomiasis endemic areas of China, and 183 313 received serological examinations, with 1 176 positives detected, while 134 978 bovines received stool examinations, with 7 positives identified. In 2019, there were 28 557 patients with schistosomiasis receiving praziquantel chemotherapy, and expanded chemotherapy was given to 1 008 083 person-times; there were 7 bovines with schistosomiasis receiving praziquantel chemotherapy, and 296 053 herd-times expanded chemotherapy was given to bovines. In 2019, snail habitats at an area of 128 754.26 hm² were given chemical treatment, and the actual area of chemical treatment was 69 605.55 hm², while environmental improvements were performed in snail habitats covering an area of 2 847.00 hm². Data from the 455 national schistosomiasis surveillance sites of China showed that the mean Schistosoma japonicum infection rates were both zero in humans and bovines in 2019, and no infected snails were found. The results demonstrate that the overall endemic situation of schistosomiasis remains at a lower infection level in China; however, there is still a risk of schistosomiasis transmission. To achieve the target set in the National Thirteenth Five-Year Plan for Schistosomiasis Control and consolidate the achievements of schistosomiasis control, precision control on schistosomiasis still needs to be reinforced in China.

Surveillance-based evidence: elimination of schistosomiasis as a public health problem in the Peoples' Republic of China

BACKGROUND

A steady progress on schistosomiasis control in the Peoples' Republic of China (P.R. China) was achieved and broadened into the twelve-year medium and long term national plan (MLNP) which marled the implementation of an integrated control strategy across all endemic areas in P.R. China in 2004. To understand the endemic trends of schistosomiasis to assess the effectiveness of an integrated strategy, we conducted an analysis of schistosomiasis surveillance data spanned from 2005 to 2015.

METHODS

The schistosomiasis sentinel surveillance data from sentinel sites were collected and analyzed from 2005 to 2015. In these sentinel sites, residents aged 6 years or above were screened annually by indirect hemagglutination assay (IHA), while only antibody positives were followed by stool examination either Kato-katz method (KK) and/or hatching technique (HT). Domestic animals raised in sentinel sites were examined by HT for confirming the infection of schistosomes. Snail investigation was conducted each year through systematic sampling method combined with environmental sampling method. The snails collected from field were tested by microscopic dissection method. The infection rates of schistosomes in residents, domestic animals and snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. ANOVA analysis was used to examine the changes of the number of eggs per gram feces in population and Chi-square test was used to examine any change in proportions among groups.

RESULTS

A total of 148 902 residents from sentinel sites attended this study and 631 676 blood samples were examined by IHA test during the 11 covered years. The annual average antibody positive rates presented a significant decrease trends, from 17.48% (95% CI: 17.20-17.75%) in 2005 to 5.93% (95% CI: 5.71-6.15%) (χ2 = 8890.47, P < 0.001) in 2015. During 2005-2015, the average infection rate of schistosomes in residents declined from 2.07% (95% CI: 1.96-2.17%) to 0.13% (95% CI: 0.09-0.16%), accompanied by significant decrease of infection intensity in population. In 2015, the stool positives were only found in farmers, fishermen and boatmen with infection rate of 0.16% (95% CI: 0.11-0.20%), 0.17% (95% CI: 0-0.50%) respectively. The infection rate of schistosomes in domestic animals dropped from 9.42% (538/5711, 95% CI: 8.66-10.18%) to 0.08% (2/2360, 95% CI: 0-0.20%) from 2005 to 2015. Infections were found in eight species of domestic animals at the beginning of surveillance while only two cattle were infected in 2015. Totally 98 ha of new snail habitats were found, while 94.90% (93/98) distributed in lake and marshland regions. The percentage of frames with snails decreased from 16.96% (56 884/33 5391, 95% CI: 16.83-17.09%) in 2005 to 4.28% (18 121/423 755, 95% CI: 4.22-4.34%) in 2014, with a slightly increase in 2015. Meanwhile, the infection rate of schistosomes in snails was decreased from 0.26% (663/256 531, 95% CI: 0.24-0.28%) to zero during 2005-2015.

CONCLUSIONS

The infection rate of schistosomes declined significantly, providing evidence that the goal of the MLNP was achieved. Elimination of schistosomiasis as a public health problem defined as WHO was also reached in P.R. China nationwide. Surveillance-response system should be improved and strengthened to realize the final goal of schistosomiasis elimination.

MetaGeneHunt for protein domain annotation in short-read metagenomes

The annotation of short-reads metagenomes is an essential process to understand the functional potential of sequenced microbial communities. Annotation techniques based solely on the identification of local matches tend to confound local sequence similarity and overall protein homology and thus don't mirror the complex multidomain architecture and the shuffling of functional domains in many protein families. Here, we present MetaGeneHunt to identify specific protein domains and to normalize the hit-counts based on the domain length. We used MetaGeneHunt to investigate the potential for carbohydrate processing in the mouse gastrointestinal tract. We sampled, sequenced, and analyzed the microbial communities associated with the bolus in the stomach, intestine, cecum, and colon of five captive mice. Focusing on Glycoside Hydrolases (GHs) we found that, across samples, 58.3% of the 4,726,023 short-read sequences matching with a GH domain-containing protein were located outside the domain of interest. Next, before comparing the samples, the counts of localized hits matching the domains of interest were normalized to account for the corresponding domain length. Microbial communities in the intestine and cecum displayed characteristic GH profiles matching distinct microbial assemblages. Conversely, the stomach and colon were associated with structurally and functionally more diverse and variable microbial communities. Across samples, despite fluctuations, changes in the functional potential for carbohydrate processing correlated with changes in community composition. Overall MetaGeneHunt is a new way to quickly and precisely identify discrete protein domains in sequenced metagenomes processed with MG-RAST. In addition, using the sister program "GeneHunt" to create custom Reference Annotation Table, MetaGeneHunt provides an unprecedented way to (re)investigate the precise distribution of any protein domain in short-reads metagenomes.

[Endemic status of schistosomiasis in People's Republic of China in 2018]

This report presented the endemic status of schistosomiasis in the People's Republic of China at a national level in 2018, and analyzed the data collected from the national schistosomiasis prevention and control system and 453 national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, 5 provinces (municipality and autonomous region), including Shanghai, Zhejiang, Fujian, Guangdong and Guangxi, continued to consolidate the achievements of schistosomiasis elimination, Sichuan Province achieved transmission interruption and 6 provinces of Yunnan, Jiangsu, Hubei, Anhui, Jiangxi and Hunan achieved transmission control by the end of 2018. There were 450 endemic counties (cities, districts) covering 260 million people, specifically including 28 456 endemic villages covering 70.059 7 million people at risk of infection. Among the 450 endemic counties (cities, districts), 58.44% (263/450), 27.56% (124/450) and 14.00% (63/450) reached the criteria of elimination, transmission interruption and transmission control, respectively. By the end of 2018, a total of 29 214 advanced schistosomiasis cases were documented in China. In 2018, a total of 11.127 6 million individuals received inquiry examinations and 2.062 9 million were positive; 7.191 4 million individuals received serological tests and 138.5 thousand of them were positive, 532.2 thousand individuals received stool examinations and 8 were positive in China. In 2018, snail survey was performed in 19 821 endemic villages and Oncomehania snails were found in 7 321 villages, accounting for 36.94% of all surveyed villages, with 3 newly detected villages with snails in China. Snail survey covered an area of 590 241.01 hm² and 168 319.41 hm² snail habitats were found, including emerging snail habitats of 61.28 hm²; however, no infected snails were identified. In 2018, a total of 646 823 bovines were raised in the schistosomiasis endemic areas of China, and 225 258 received serological examinations, with 2 638 positives detected, while 164 803 bovines received stool examinations, with 2 positives identified. In 2018, there were 90 388 patients with schistosomiasis receiving praziquantel chemotherapy, and expanded chemotherapy was given to 1 490 594 person-times; there were two bovines with schistosomiasis receiving praziquantel chemotherapy, and expanded chemotherapy was given to 352 577 bovine-times; chemical treatment was conducted in an area of 141 660.87 hm², including an actual mollusciciding area of 75 308.26 hm², and environmental improvements were performed in an area of 4 738.37 hm² in China. Data from the 453 national schistosomiasis surveillance sites of China showed that the mean Schistosoma japonicum infection rates were 0.001 5% and zero in humans and bovines in 2018, respectively, and no infected snails were found. The results demonstrate that the endemic situation of schistosomiasis appears a tendency towards a continuous decline in China; however, there is still a risk of schistosomiasis transmission, and challenges remain in achieving the target set in the Thirteenth Five-Year National Plan for Schistosomiasis Control in 2020 in some regions.

The Correlation between Atrial Fibrillation and Prognosis and Hemorrhagic Transformation

Objective: Atrial fibrillation (AF) is the recognized risk factor for hemorrhagic transformation (HT) in thrombolysis patients with acute ischemic stroke (AIS). But the impact of AF on prognosis is still controversial. In our study, we aimed to assess the relationship between AF and HT and prognosis. Methods: We assessed 184 patients diagnosed with AIS and received thrombolysis from January 2016 to October 2017. Based on the imaging results during hospitalization, the patients were divided into HT and non-HT groups in which the HT was containing 40 patients. According to the modified Rankin Scale (mRS), we divided the patients into favorable prognosis (mRS score of 0–2) and the poor (mRS score >2) after 3 and 6 months of follow-up. Our analysis included demographics, onset to treatment time, initial blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) score, HT, anticoagulants, AF, smoking, and other past history. Results: At baseline, there was a significant difference (p < 0.05) between the HT and non-HT groups in the level of age, hyperlipidemia, AF, NIHSS, and the application of anticoagulants. After 3 and 6 months of follow-up, we found that only NIHSS (OR3 month 1.421, 95% CI 1.280–1.578, p < 0.001, and OR6 month 1.326, 95% CI 1.217–1.445, p < 0.001) was associated with prognosis instead of AF, HT, and anticoagulants. Meanwhile, patients with AF tended to be older, higher NIHSS score and less hyperlipidemia (p < 0.05). Conclusion: The present study indicated that there is no significant correlation between AF and prognosis, although there is some indeed related with HT. That was, the prognosis with AF had a similar response trend compared with the non-AF.

Antibacterial Effects of Phytic Acid against Foodborne Pathogens and Investigation of Its Mode of Action

This study investigated the antimicrobial mechanism of phytic acid (PA) and its antibacterial effects in combination with ethanol. The MIC of PA on Escherichia coli ATCC 11229, Staphylococcus aureus ATCC 6538P, Bacillus subtilis ATCC 6633, and Salmonella Typhimurium CICC 27483 were 0.24, 0.20, 0.26, and 0.28% (w/w), respectively. E. coli ATCC 11229 and S. aureus ATCC 6538P were selected to investigate the mechanism of PA by analyzing its effects at 1/2MIC and at MIC on the cell morphology, intracellular ATP, and cell membrane integrity. Environmental scanning electron microscope images revealed that PA was able to change the cell morphology and disrupt the intercellular adhesion. PA retarded bacterial growth and caused cell membrane dysfunction, which was accompanied by decreased intracellular ATP concentrations. Flow cytometry analysis further revealed that almost all the bacterial cells were damaged after treatment with PA at its MIC for 2 h. Moreover, PA has a synergistic antimicrobial ability when used in combination with ethanol. These results suggested that PA is effective in inhibiting growth of foodborne pathogens mainly by the mechanism of cell membrane damage and to provide a theoretical basis for the development of natural antimicrobial agents in the food industry.

[Clinical analysis of myeloid neoplasms with t (3;21) (q26;q22)]

目的

探讨伴有t（3;21）（q26;q22）髓系肿瘤的临床特征。

方法

回顾性分析2011年1月至2018年3月北京大学人民医院收治的19例伴有t（3;21）（q26;q22）血液恶性肿瘤患者的临床资料，并汇总文献报道的有详细生存资料的48例患者，采用Kaplan-Meier法进行生存分析。

结果

19例患者中男15例，女4例，中位年龄36（22~68）岁，包括原发急性髓系白血病（AML）4例，骨髓增生异常综合征（MDS）4例，MDS转化的AML3例，慢性髓性白血病（CML）急变8例。19例患者染色体核型均可见t（3;21）（q26;q22），其中13例伴有附加异常。19例中9例进行AML1-MDS1融合基因检测均阳性。9例患者有随访资料，6例接受化疗的患者中4例无效，2例获得完全缓解。随访期内除1例MDS患者因随访期短（6个月）仍存活，其余8例均死亡，中位生存时间为6（4.5~22）个月。汇总文献生存分析结果显示伴有t（3;21）（q26;q22）的髓系肿瘤患者整体预后差，中位生存时间为7个月，尤以AML/治疗相关的AML预后最差，移植和非移植组中位生存时间分别为20.9和4.7个月，差异有统计学意义（P<0.001）。

结论

t（3;21）（q26;q22）是罕见的重现性染色体异常，主要见于髓系血液肿瘤，临床预后差，建议尽早进行造血干细胞移植。

Variations in carbon source-sink relationships in subalpine fir across elevational gradients

Cold-adapted trees display acclimation in both carbon source and carbon sink capacity to low-temperature stress at their upper elevational range limits. Hence a balanced carbon source-sink capacity might be required for their persistence and survival at the elevational tree limits. The present study examined the spatial dynamics of carbon source-sink relationship in subalpine fir (Abies fargesii) trees along elevational gradients in the northern slope of the temperate region and in the southern slope of the subtropics in terms of climate in the Qinling Mountain range, north-central China. The results showed that non-structural carbohydrate (NSC) concentrations in both the source and sink tissues increased with the increase in elevation. The ratio of carbon source-sink displayed a consistent decreasing trend with the increase in elevation and during growing season, showing that it was lowest at a ratio of 2.93 in the northern slope and at a ratio of 2.61 in the southern slope at the upper distribution elevations in the late growing season. Such variations of carbon source-sink ratio might be attributable to the balance between carbon source and sink activities, which changed seasonally across the elevational distribution range. We concluded that a ratio of carbon source-sink of at least 2.6 might be essential for subalpine fir trees to persist at their upper range limits. Therefore, a sufficient source-sink ratio and a balanced source-sink relationship might be required for subalpine fir trees to survive and develop at their upper elevational distribution limits.

Aqueous leaching of lithium from simulated pyrometallurgical slag by sodium sulfate roasting

In the pyrometallurgical treatment for spent lithium-ion batteries (LIBs), lithium is generally present in slag with Al, Ca and Si and is hard to be further treated. In this study, lithium was recovered from a simulated pyrometallurgical slag (pyro-slag) via sodium roasting and water leaching. The thermodynamic process for the reactions between slag and additives such as NaCl, NaNO₃ and Na₂SO₄ were simulated during roasting by the HSC software, where Na₂SO₄ possessed stronger chemical reactivity. The optimal conditions for roasting were experimentally determined to be 800 °C for 60 min and an Na₂SO₄/Li molar ratio of 3 : 1, followed by water leaching at 70 °C for 80 min using a liquid-to-solid (L/S) mass ratio of 30 : 1. This yielded a maximum of 93.62% lithium recovery. The mechanism by which insoluble lithium in slag was transformed into soluble lithium by salt roasting was proposed using the analysis of XRD and EDS spectra, in which ion exchange occurred between Na⁺ and Li⁺ at a certain temperature.

An effective method for the recovery of lithium from the slag formed by treating spent lithium-ion batteries.

[Transformation from promyelocytic leukemia with t (15; 17) ( q22; q21) to acute monocytic leukemia with t (11; 17) (q23; q21) in a case]

OBJECTIVE

To report on a case of therapy-related acute monocytic leukemia(t-AML) with t(11;17) (q23;q21)/MLL-AF17q after successful treatment for acute promyelocytic leukemia(APL) with t(15;17) (q22;q21)/PML-RARα.

METHODS

A MICM method (bone marrow morphology(M), immunophenotype(I), cytogenetics(C), and molecular biology(M)) was used for the diagnosis and classification of the disease at the time of onset and transformation.

RESULTS

The patient was initially identified with typical morphology and immunophenotype of APL. She has carried t(15;17)(q22;q21) and PML-RARα fusion gene but was without t(11;17)(q23;q21) or MLL gene abnormalities. After 13 months of successful treatment, she has transformed to AML with typical morphology and immunophenotype. t(11;17)(q23;q21) and MLL-AF17q fusion gene were detected in her bone marrow sample, while no PLZF-RARα fusion gene was detected by real-time quantitative reverse-transcription PCR(RQ-PCR) and fluorescence in situ hybridization(FISH).

CONCLUSION

t-AML is a serious complication after successful treatment of APL. t(11;17)(q23;q21) is not specific for the diagnosis of variant APL and can also be detected in t-AML. RQ-PCR and FISH are essential for the diagnosis of such patients.

Anti-viral therapy is associated with improved survival but is underutilised in patients with hepatitis B virus-related hepatocellular carcinoma: real-world east and west experience

BACKGROUND

Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) worldwide. It remains incompletely understood in the real world how anti-viral therapy affects survival after HCC diagnosis.

METHODS

This was an international multicentre cohort study of 2518 HBV-related HCC cases diagnosed between 2000 and 2015. Cox proportional hazards models were utilised to estimate hazard ratios (HR) with 95% (CI) for anti-viral therapy and cirrhosis on patients' risk of death.

RESULTS

Approximately, 48% of patients received anti-viral therapy at any time, but only 17% were on therapy at HCC diagnosis (38% at US centres, 11% at Asian centres). Anti-viral therapy would have been indicated for >60% of the patients not on anti-viral therapy based on American criteria. Patients with cirrhosis had lower 5-year survival (34% vs 46%; P < 0.001) while patients receiving anti-viral therapy had increased 5-year survival compared to untreated patients (42% vs 25% with cirrhosis and 58% vs 36% without cirrhosis; P < 0.001 for both). Similar findings were seen for other patient subgroups by cancer stages and cancer treatment types. Anti-viral therapy was associated with a decrease in risk of death, whether started before or after HCC diagnosis (adjusted HR 0.62 and 0.79, respectively; P < 0.001).

CONCLUSIONS

Anti-viral therapy improved overall survival in patients with HBV-related HCC across cancer stages and treatment types but was underutilised at both US and Asia centres. Expanded use of anti-viral therapy in HBV-related HCC and better linkage-to-care for HBV patients are needed.

[Comparative study of cytogenetic response evaluated by conventional banding analysis and fluorescence in situ hybridization in chronic myeloid leukemia patients during tyrosine kinase inhibitor treatment]

Objective: To compare the cytogenetic response detected by conventional banding analysis (CBA) and fluorescence in situ hybridization (FISH) and to explore the correlation between the cytogenetic and molecular response in chronic myeloid leukemia (CML) patients during tyrosine kinase inhibitor (TKI) treatment. Methods: CBA, FISH and real-time quantitative reverse transcriptase polymerase chain reaction (RQ-PCR) methods were performed to detect the cytogenetic and molecular response simultaneously in 504 bone marrow samples from 367 CML patients who received TKI treatment. Results: Among 504 samples, 344 were detected to reach complete cytogenetic response (CCyR) by CBA, while 297 samples reached CCyR by FISH which were considered to carry BCR-ABL positive cells<1%. When the results of CBA, FISH and RQ-PCR were compared in 493 samples at the same time, it showed that in 337 samples with CBA-CCyR, 273 (81.0%) reached FISH-CCyR and 289 (85.8%) were BCR-ABL(IS) (International Scale, IS) ≤1% by RQ-PCR, compared to 9.0 (261/290) were BCR-ABL(IS) ≤1% among 290 samples with FISH-CCyR. There was no significant difference in the median value of BCR-ABL(IS) between samples in CBA-CCyR and FISH-CCyR (0.21% vs 0.13%, z=-1.875, P=0.061) . Furthermore, when the samples were divided into three groups according to BCR-ABL positive cells (0,>0~<1%, 1%~5%) by FISH, the statistical difference was observed, the proportion of samples with BCR-ABL(IS) ≤1% in the three groups were 94.1%, 57.6% and 27.7% respectively (χ(2)=43.499, P<0.001; χ(2)=9.734, P=0.003) , while the median value of BCR-ABL(IS) were 0.10%, 0.64% and 1.80% respectively (z=-5.864, P<0.001; z=-4.787, P<0.001) . Conclusion: FISH results were in good concordance with CBA in identify samples in CCyR, FISH was more sensitive and had better correlation with RQ-PCR results than CBA, but how to define FISH-CCyR need further study.

[Application of CD138 Immunomagnetic Sorting Myeloma Cells Combined with Fluorescence in Situ Hybridization for Detecting Cytogenetic Abnormalities of Multiple Myeloma]

OBJECTIVE

To investigate the efficiency of direct fluorescence in situ hybridization (D-FISH) versus FISH on CD138 immunomagnetic sorting myeloma cells (MACS-FISH) to detect the cytogenetic abnormalities of multiple myeloma.

METHODS

Thirty-one patients with multiple myeloma (MM) were detected by D-FISH and MACS-FISH, using 5 probes, including 1q21, D13S319, RB1, IgH, P53. The IgH rearrangement positive patients were further examined by 3 IgH rearrangement subtype FISH probes including IgH/FGFR3, IgH/MAF and IgH/CCND1.

RESULTS

Metaphase karyotyping revealed cytogenetic abnormalities in 5 cases (16.1%), clonal aberrations were detected in 13 cases(41.9%) by D-FISH, while 25 case(80.6%) with clonal aberrations by MACS-FISH. The results between these 2 FISH methods were significantly different (P=0.042). The detection frequency of clonal aberration by each probes of D-FISH was 22.6%,25.8%,29%,38.7% and 9.7% respectively for 1q21 amplification, D13S319 deletion,RB1 deletion, IgH rearrangement and P53 deletion, compared with 48.4%,45.2%,48.4%,67.7% and 16.1% respectively by MACS-FISH. The 2 FISH methods were well consistent when the percentage of plasma cells was ≥20% in bone marrow smears. When the percentage of plasma cells was<20% in bone marrow smears, the difference between these 2 methods was very statistically significant (P=0.00).

CONCLUSION

MACS-FISH can obviously improve the detection efficiency of cytogenetic abnormalities in patients with MM. Conventional cytogenetics combined with MACS-FISH is an ideal efficient method to detect the cytogenetic abnormalities in MM patients, and should be applied widely, especially for those patients with the plasma cells <20% in bone marrow smears.

High-quality CsPbBr3 perovskite nanocrystals for quantum dot light-emitting diodes

We synthesized luminescent CsPbBr₃ nanocrystals with a high quantum yield and realized patterning and color-purity light-emitting diode applications.

Task-Based Regularization Design for Detection of Intracranial Hemorrhage in Cone-Beam CT

Prompt and reliable detection of acute intracranial hemorrhage (ICH) is critical to treatment of a number of neurological disorders. Cone-beam CT (CBCT) systems are potentially suitable for detecting ICH (contrast 40-80 HU, size down to 1 mm) at the point of care but face major challenges in image quality requirements. Statistical reconstruction demonstrates improved noise-resolution tradeoffs in CBCT head imaging, but its capability in improving image quality with respect to the task of ICH detection remains to be fully investigated. Moreover, statistical reconstruction typically exhibits nonuniform spatial resolution and noise characteristics, leading to spatially varying detectability of ICH for a conventional penalty. In this work, we propose a spatially varying penalty design that maximizes detectability of ICH at each location throughout the image. We leverage theoretical analysis of spatial resolution and noise for a penalized weighted least-squares (PWLS) estimator, and employ a task-based imaging performance descriptor in terms of detectability index using a nonprewhitening observer model. Performance prediction was validated using a 3D anthropomorphic head phantom. The proposed penalty achieved superior detectability throughout the head and improved detectability in regions adjacent to the skull base by ~10% compared to a conventional uniform penalty. PWLS reconstruction with the proposed penalty demonstrated excellent visualization of simulated ICH in different regions of the head and provides further support for development of dedicated CBCT head scanning at the point-of-care in the neuro ICU and OR.