[Prognostic analysis of allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in complete remission in the era of tyrosine kinase inhibitors]

目的

探讨在酪氨酸激酶抑制剂（TKI）时代Ph染色体阳性急性淋巴细胞白血病（Ph⁺ALL）在完全缓解（CR）状态下行异基因造血干细胞移植（allo-HSCT）的预后和影响因素。

方法

回顾性分析2012年5月至2017年5月河北燕达陆道培医院收治的116例在CR状态下行allo-HSCT的Ph⁺ALL患者的预后及其影响因素。

结果

116例患者中男72例，女44例。中位年龄20（4～64）岁。同胞全相合移植21例，亲缘单倍型移植77例，非血缘移植18例。5年总生存（OS）率为73.2％（95％CI 63.8％～80.5％），其中诊断至移植间隔时间<180 d的亚组5年OS率为87.5％。5年无病生存（DFS）率为61.4％（95％CI 51.8％～69.7％）。5年细胞形态及分子学水平复发累积发生率为18.5％（95％CI 12.6％～27.3％）。5年移植相关死亡率（TRM）为19.9％（95％CI 13.8％～28.7％）。多因素分析显示，15～39岁（HR＝2.730，P＝0.044）、诊断至移植间隔时间≥180 d（HR＝4.534，P＝0.010）、发生Ⅲ～Ⅳ度急性移植物抗宿主病（aGVHD）（HR＝7.558，P＝0.000）是影响患者OS的不利因素；发生局限型慢性移植物抗宿主病（cGVHD）是影响患者OS的有利因素（HR＝0.300，P＝0.034）。而性别、起病时WBC（<30×10⁹/L，≥30×10⁹/L）、BCR-ABL融合基因类型、体细胞突变类型、移植前状态（CR₁，>CR₁）、移植前微小残留病（MRD）水平（MRD阴性，MRD阳性）、预处理方案（全身照射方案，白消安为基础方案）、预处理方案强度、移植类型、GVHD预防方案（环孢素A，他克莫司）、抗胸腺细胞免疫球蛋白的种类、巨细胞病毒和EB病毒血症的有无对OS的影响无统计学意义。

结论

TKI时代Ph⁺ALL在CR状态下行allo-HSCT时，影响生存的因素有年龄、诊断至移植间隔时间和发生重度aGVHD。

Ionic Liquid Gating Enhanced Photothermoelectric Conversion in Three-Dimensional Microporous Graphene

The photothermoelectric (PTE) effect can effectively convert light into electricity through photothermal and thermoelectric processes and has great potential applications in light energy harvesting and bandgap-independent photodetection. It is particularly applicable for the terahertz (THz) range featuring low photon energy but has not been well established due to lack of high-performance PTE materials in this range. Three-dimensional microporous graphene (3DMG) foam possesses ultrahigh THz absorptivity and outstanding photothermal conversion and can serve as a promising candidate. Here, enhancement of the THz PTE response of 3DMG foam by fine-tuning its thermoelectric properties using the ionic liquid electric double layer (EDL) technique was demonstrated. Continuous and reversible control of the Seebeck coefficient of 3DMG highlights the effectiveness of EDL gating in manipulating the electronic structures of such bulk and porous material. An approximate 1 order of magnitude enhancement in the Seebeck coefficient as well as the PTE responsivity was observed. In addition, a double-cell 3DMG EDL device with a p-n junction like channel configuration enabled further improvement of the photoresponse. This work opens a new avenue to optimize the PTE performance of 2D nanosheet-assembled 3D porous materials for highly efficient energy harvesting and detection of THz radiation.

Knockdown of cadherin genes decreases susceptibility of Chilo suppressalis larvae to Bacillus thuringiensis produced Crystal toxins

The striped rice stem borer, Chilo suppressalis Walker, is one of the most destructive rice pests in Asia. Insecticidal crystal proteins (Cry toxins) produced by Bacillus thuringiensis are widely used as biopesticides or in developing transgenic crops for pest management. In this study, we tested the involvement of two newly cloned C. suppressalis cadherins (CsCAD3 and CsCAD4) in the toxicity of Cry1Ab/Ac, Cry2Aa and Cry1Ca. Our results showed that CsCAD4 was expressed highest in the midgut, whereas CsCAD3 was expressed highest in the epidermis. The feeding of double-stranded RNA specific to CsCAD3 and CsCAD4 respectively significantly suppressed the expressions of target gene. The knockdown of CsCAD3 significantly reduced the mortality of larvae to Cry1Ab/Ac, whereas knockdown of CsCAD4 significantly decreased the larval susceptibility to Cry2Aa. In contrast, reduced expressions of CsCAD3 or CsCAD4 were not interacted with larval susceptibility to Cry1Ca. Our results suggest that CsCAD3 and CsCAD4 function in Cry toxin toxicity and these findings will help us to better understand the action mechanism of Cry toxins in C. suppressalis.

NWChem: Past, present, and future

Specialized computational chemistry packages have permanently reshaped the landscape of chemical and materials science by providing tools to support and guide experimental efforts and for the prediction of atomistic and electronic properties. In this regard, electronic structure packages have played a special role by using first-principle-driven methodologies to model complex chemical and materials processes. Over the past few decades, the rapid development of computing technologies and the tremendous increase in computational power have offered a unique chance to study complex transformations using sophisticated and predictive many-body techniques that describe correlated behavior of electrons in molecular and condensed phase systems at different levels of theory. In enabling these simulations, novel parallel algorithms have been able to take advantage of computational resources to address the polynomial scaling of electronic structure methods. In this paper, we briefly review the NWChem computational chemistry suite, including its history, design principles, parallel tools, current capabilities, outreach, and outlook.

[Research on the effects of CPAP for OSA combined CHD long-term prognosis]

Objective:To investigate the effects of CPAP for obstructive sleep apnea（OSA） combined CHD（coronary heart disease） long-term prognosis. Method:One hundred and twenty cases of OSA combind CHD in gansu province people's hospital sleep center were randomly divided into two groups according to apnea hypopnea index（AHI）, group A（light, medium OSA and CHD） 60 cases, group B（severe OSA and CHD） 60 cases. Contrast analysis and comparison between two groups PSG（Polysomnography） parameters, and the differences between the degree of coronary artery lesions and CPAP therapy effect on coronary long-term prognosis. Result:Compared group B with A, AHI, BMI, LSaO2, Epworth sleepiness scale（ESS） score, the amino acid homocysteine, the prevalence of hypertension, type 2 diabetes, the prevalence of acute myocardial infarction（ami） and vascular lesions and SYNTAX score increased significantly（P<0.05）. The ejection fraction decreased significantly（P<0.05）. The BNP（Brain natriuretic peptide） and cTNT（cardiac troponin, cTn） concentration there was no significant difference between the two groups（P>0.05）. CPAP treatment（30.0±4.2） months later, Group B: CAPA + conventional treatment group, compared with the simple routine LSaO2, ejection fraction increased significantly（P<0.05）, AHI, cardiovascular adverse events, vascular lesions, SYNTAX score, the BNP and TNT concentration significantly reduced（P<0.05）; Group A: AHI, decreased significantly（P<0.05）, LSaO2increased significantly（P<0.05）, ejection fraction, cardiovascular adverse events, vascular lesions, SYNTAX score, there was no significant difference between the BNP and TNT concentration; Survival analysis showed that: Group A CPAP+conventional treatment group cumulative survival rate higher than the conventional treatment group, but there was no statistically significant difference（P=0.260）. Group B: CPAP+conventional treatment group total survival rate was significantly higher than that of the conventional treatment group（P<0.001）; Conclusion:With the increase of the severity of OSA, OSA merge CHD coronary artery pathological changes degree aggravating, CPAP therapeutic benefit the long-term prognosis of CHD.

LncRNA FER1L4 suppressed cancer cell growth and invasion in esophageal squamous cell carcinoma

OBJECTIVE

To investigate the regulatory effect of long non-coding ribonucleic acid (lncRNA) FER1L4 on biological behaviors of esophageal squamous cell carcinoma (ESCC) cells, such as proliferation and invasion.

PATIENTS AND METHODS

The expressions of FER1L4 were detected in 42 pairs of ESCC tissues and corresponding para-carcinoma tissues and 5 kinds of ESCC cell lines via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Polyethyleneimine (PEI) and liposomes were used for FER1L4 expression or interference elimination assays, respectively. The proliferation and invasion of ESCC cells were detected via MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide), apoptosis assay, cell cycle assay, and transwell chamber.

RESULTS

Results of qRT-PCR showed that, compared with that in normal tissues, FER1L4 was lowly expressed in ESCC tissues. Overexpression of FER1L4 could inhibit cell proliferation and invasion, promote apoptosis and increase the cell cycle distribution in G0/G1 phase. Knockout of FER1L4 could promote the proliferation and invasion of ESCC cells, inhibit apoptosis and decrease the cell cycle distribution in G0/G1 phase.

CONCLUSIONS

FER1L4 is involved in the occurrence and development of ESCC and plays a key role as a tumor suppressor gene in ESCC.

In vitro interaction of various antibiotic combinations recommended by Chinese consensus statement against carbapenems-resistant Pseudomonas aeruginosa

Pseudomonas aeruginosa is related to nosocomial infections, and it tends to become resistant during or after antimicrobial treatment. The ability to develop carbapenems resistance makes it difficult to treat. P. aeruginosa infections are often associated with high mortality, morbidity and treatment costs. A group of Chinese experts drafted a consensus for treatment of extensively drug-resistant Gram-negative bacilli (XDR-GNB) including extensively drug-resistant P. aeruginosa (XDR-PA). In this study, we studied the antibacterial activities of different antibiotic combinations against six carbapenems-resistant P. aeruginosa (CRPA) strains in vitro, and the results indicated that the combination of ceftazidime with cefoperazone-sulbatam was the best combination with excellent synergistic rate (100%). Besides, some combinations exhibited better effects than using antibiotics alone, reducing the MICs of both drugs significantly, such as ceftazidime/piperacillin-tazobactam and ceftazidime/aztreonam etc. However, there are also some combinations that showed no additional or synergistic effects, suggesting that not all combinations recommended by the guideline have the same effect against resistant P. aeruginosa. Our study screened out some effective combinations against six CRPA strains which might help to prevent the spread of antibiotic resistance through improving antibiotic effectiveness. SIGNIFICANCE AND IMPACT OF THE STUDY: This study measured the synergistic interactions between various antibiotics in vitro recommended by Chinese consensus statement against carbapenems-resistant Pseudomonas aeruginosa. The results of this study provide valuable evidence that some combinations may be a promising option for clinical treatment.

The midgut V-ATPase subunit A gene is associated with toxicity to crystal 2Aa and crystal 1Ca-expressing transgenic rice in Chilo suppressalis

Insecticidal crystal (Cry) proteins produced by the bacterium Bacillus thuringiensis (Bt) are toxic to a diverse range of insects. Transgenic rice expressing Cry1A, Cry2A and Cry1C toxins have been developed that are lethal to Chilo suppressalis, a devastating insect pest of rice in China. Identifying the mechanisms underlying the interactions of Cry toxins with susceptible hosts will improve both our understanding of Cry protein toxicology and long-term efficacy of Bt crops. In this study, we tested the hypothesis that V-ATPase subunit A contributes to the action of Cry1Ab/1Ac, Cry2Aa and Cry1Ca toxins in C. suppressalis. The full-length V-ATPase subunit A transcript was initially cloned from the C. suppressalis larval midgut and then used to generate double-stranded RNA (dsRNA)-producing bacteria. Toxicity assays using transgenic rice lines TT51 (Cry1Ab and Cry1Ac fusion genes), T2A-1 (Cry2Aa), and T1C-19 (Cry1Ca) in conjunction with V-ATPase subunit A dsRNA-treated C. suppressalis larvae revealed significantly reduced larval susceptibility to T2A-1 and T1C-19 transgenic rice, but not to TT51 rice. These results suggest that the V-ATPase subunit A plays a crucial role in mediating Cry2Aa and Cry1Ca toxicity in C. suppressalis. These findings will have significant implications on the development of future resistance management tools.

[Analysis of the overweight and obesity effects on pulmonary function in OSA patients]

Objective:To investigate the overweight and obesity effects on pulmonary function in OSA patients.Method:Randomly selected 90 cases OSA patients who were treated January 2017 to December 2017. On the basis of BMI were divided into three groups, the normal OSA group(A,30 cases), overweight OSA group(B,30 cases) and obesity OSA group(C,30 cases). Comparative analysis between groups of age, AHI, lowest arterial saturation oxygen(LSaO₂), the longest apnea time(LAD) and pulmonary function indicators include: a second volume(FEV1),forced vital capacity(FVC), FEV1/FVC,the chase volume(MVV), per minute resting ventilation(MV), peak expiratory flow velocity(PEF),tidal volume(VT), the residual gas volume(RV), functional residual capacity(FRC) and expiratory reserve volume volume(ERV), total lung volume(TLC) vital capacity(VC), deep inspiratory capacity(IC), RV/TLC. Result:Compared group C with B and A, B and A, AHI increased significantly(P<0.01); compared group C with B and A, LSaO₂ significantly reduced(P<0.01); compared group C with A, LAD is prolonged(P<0.05).Compared group C with A, MVV, MV, TLC and IC increased significantly(P<0.05), FRC, ERV significantly reduced(P<0.05); compared C with B, MVV, MV and TLC increased significantly(P<0.05). Compared group B with A,MVV,MV,MEF75,ERV and IC increased significantly(P<0.05); AHI and VT,RV,TLC and FRC has significant positive correlation(P<0.05), and VT, MVV and FEV1/FVC has significant negative correlation(P<0.05);LAD with BMI,VC,FVC,FEV1,MEF50,PEF and MVV is a significant positive correlation(P<0.05).FEV1/FVC, IC is the independence of overweight and obesity OSA severe impact factor. Conclusion:With the increasing of BMI, not only increase the severity of OSA, and further damage to the pulmonary function; the OSA severity of overweight and obesity are closely associated with multiple pulmonary function index; FEV1% FVC, IC for overweight and obesity independent factor influencing the severity of OSA. Pulmonary function can be used as overweight and obesity auxiliary to assess the severity of OSA patients.

[Influence of directed restrictive fluid management strategy on patients with serious burns complicated by severe inhalation injury]

Objective: To explore the influence of directed restrictive fluid management strategy (RFMS) on patients with serious burns complicated by severe inhalation injury. Methods: Sixteen patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2014 to December 2017, meeting the inclusion criteria and treated with RFMS, were enrolled in directed treatment group. Thirty-four patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2012 to December 2017, meeting the inclusion criteria and without RFMS, were enrolled in routine treatment group. Medical records of patients in 2 groups were retrospectively analyzed. Within post injury day 2, mean arterial pressure (MAP), central venous pressure (CVP), extravascular lung water index (ELWI), global end-diastolic volume index, and pulmonary vascular permeability index of patients in directed treatment group were monitored by pulse contour cardiac output monitoring technology, while MAP and CVP of patients in routine treatment group were monitored by routine method. On post injury day 3 to 7, patients in 2 groups were treated with routine fluid supplement therapy of our Department to maintain hemodynamic stability, and patients in directed treatment group were treated according to RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2). On post injury day 3 to 7, total fluid intake, total fluid output, and total fluid difference between fluid intake and output within 24 h, value of blood lactic acid, and oxygenation index of patients in 2 groups were recorded. Occurrence of acute respiratory distress syndrome (ARDS) on post injury day 3 to 7 and 8 to 28, mechanical ventilation time within post injury day 28, and occurrence of death of patients in 2 groups were counted. Data were processed with chi-square test, t test, and analysis of variance for repeated measurement. Results: The total fluid intakes within 24 h of patients in directed treatment group were close to those in routine treatment group on post injury day 3, 4, 5, 6, 7 (t=-0.835, -1.618, -2.463, -1.244, -2.552, P>0.05). The total fluid outputs and total fluid differences between fluid intake and output within 24 h of patients in 2 groups on post injury day 3 were close (t=0.931, -2.274, P>0.05). The total fluid outputs within 24 h of patients in directed treatment group were significantly higher than those in routine treatment group on post injury day 4, 5, 6, 7 (t=2.645, 2.352, 1.847, 1.152, P<0.05). The total fluid differences between fluid intake and output within 24 h of patients in directed treatment group were (2 928±768), (2 028±1 001), (2 186±815), and (2 071±963) mL, significantly lower than (4 455±960), (3 434±819), (3 233±1 022), and (3 453±829) mL in routine treatment group (t=-4.331, -3.882, -3.211, -4.024, P<0.05). The values of blood lactic acid of patients in directed treatment group and routine treatment group on post injury day 3, 4, 5, 6, 7 were close (t=0.847, 1.221, 0.994, 1.873, 1.948, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 3 and 4 were (298±78) and (324±85) mmHg (1 mmHg=0.133 kPa ), which were close to (270±110) and (291±90) mmHg in routine treatment group (t=-1.574, 2.011, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 5, 6, 7 were (372±88), (369±65), and (377±39) mmHg, significantly higher than (302±103), (313±89), and (336±78) mmHg in routine treatment group (t=3.657, 3.223, 2.441, P<0.05). On post injury day 3, 4, 5, 6, 7, patients with ARDS in directed treatment group were less than those in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.105, P>0.05). On post injury day 8 to 28, patients with ARDS in directed treatment group were significantly less than those in routine treatment group (χ(2)=0.827, P<0.05). The mechanical ventilation time within post injury day 28 of patients in directed treatment group was apparently shorter than that in routine treatment group (t=-2.895, P<0.05). Death of patients in directed treatment group within post injury day 28 was less than that in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.002, P>0.05). Conclusions: Under the circumstance of hemodynamics stability, RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2) on post injury day 3 to 7 is an useful strategy, which can reduce occurrence rate of ADRS and shorten mechanical ventilation time of patients with serious burns complicated by severe inhalation injury at late stage of burns.

Compressible Highly Stable 3D Porous MXene/GO Foam with a Tunable High-Performance Stealth Property in the Terahertz Band

In this work, a three-dimensional (3D) porous MXene/GO foam (MGOF) was successfully synthesized and exhibited an excellent terahertz stealth property covering a whole measurement frequency of 0.2-2.0 THz. This is due to the ingenious assembly of two functional two-dimensional materials that have different advantages. The multiscale micro-nanostructure constructed with the 3D porous MGOF can effectively increase the terahertz scattering and refraction. Furthermore, MXene sheets with high conductivity can enhance the responsiveness to the terahertz wave. By adjusting the content of MXene in the MGOF, it exhibits a maximum reflection loss (RL) of 37 dB with a 100% qualified frequency bandwidth (RL > 10 dB), which is the most outstanding result in the available reference. In addition, the optimal average terahertz RL values of MGOF were up to 30.6 dB, which is 100% higher than the best data presented in previous work. Benefitting from an ultralow density, a high RL value, and a wide bandwidth, the maximum specific average terahertz absorption performance can reach 4.6 × 10⁴ dB g^-1 cm³, which is more than 4000 times that of other materials. In addition, the regulation of the terahertz absorption property through microstructure and morphology control is reported for the first time.

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Background

Psoriasis is a chronic skin disorder that manifests as epidermal keratinocyte hyperplasia.

Objectives

We examined the effect of oxymatrine treatment on cell proliferation and apoptosis in skin lesions of psoriasis.

Patients and methods

Patients with severe plaque psoriasis were treated with oxymatrine or with acitretin. The skin lesions were stained with proliferating cell nuclear antigen (PCNA), Ki‐67 and Bcl‐2, as well as examined by terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labelling (TUNEL). We performed correlations of the Psoriasis Area and Severity Index (PASI) and the proliferation and apoptosis index.

Results

Oxymatrine significantly reduced the psoriasis lesions as demonstrated by the reduced PASI score after treatment [6·91; 95% confidence interval (CI) 5·00–8·81, P < 0·001]. In the oxymatrine group, the mitotic index was 26·15 (95% CI 24·80–27·49) before oxymatrine treatment, decreasing to 14·52 (95% CI 13·82–15·25; P < 0·001) after treatment, but remained higher than the normal group (6·24; 95% CI 5·87–6·61, P < 0·001). Oxymatrine also inhibited the proliferation of epidermal cells in the skin lesion as indicated by the reduced proliferation index after treatment (P < 0·01). In addition, oxymatrine treatment reduced cellular apoptosis as shown by increased Bcl‐2 expression and a decrease in TUNEL‐positive cells. The PASI score was positively correlated with mitotic index, proliferation index and apoptotic index (TUNEL), but negatively correlated with Bcl‐2 expression.

Conclusions

Oxymatrine treatment reduced proliferation but inhibited apoptosis of cells in the skin lesion. The balance between cell proliferation and turnover may contribute to the significant alleviation of psoriasis by oxymatrine.

What's already known about this topic?

Psoriasis manifests as epidermal keratinocyte hyperplasia with proliferation, keratinocyte maturation and turnover rates.

Current drugs for psoriasis may inhibit cell proliferation but could not adjust the balance of cell division, differentiation and apoptosis.

What does this study add?

We studied the efficacy of oxymatrine in the treatment of psoriasis and analysed the correlation of skin lesions, proliferation and apoptosis index before and after oxymatrine treatment.

What is the translational message?

Our study has demonstrated that oxymatrine is effective in the treatment of severe plaque psoriasis.

It has comparable efficacy with acitretin.

Because acitretin treatment was sometimes associated with metabolic abnormalities, our study suggests oxymatrine therapy as an alternative treatment for psoriasis in the context of acitretin allergy or adverse reactions.

https://www.bjdonline.com/article/oxymatrine-therapy-inhibited-epidermal-cell-proliferation-and-apoptosis-in-severe-plaque-psoriasis/

Linked Comment: https://doi.org/10.1111/bjd.18299.