[Mutational analysis of RNA splicing machinery genes SF3B1, U2AF1 and SRSF2 in 118 patients with myelodysplastic syndromes and related diseases]

目的

探讨RNA剪接体复合物编码基因SF3B1、U2AF1和SRSF2突变在MDS及相关疾病中的突变率、突变特点及临床意义。

方法

以118例MDS及相关疾病患者为研究对象，采用PCR扩增产物直接测序法分别检测SF3B1（K700E）、U2AF1（S34、Q157P）和SRSF2（P95）突变情况。

结果

118例MDS患者中，男76例，女42例，中位年龄53.5（13~84）岁。对全部患者均进行SF3B1（K700E）基因突变分析，SF3B1（K700E）的突变率为19.49%（118例中23例）。在突变的22例MDS患者中，14例环形铁粒幼红细胞（RS）比例≥15%，其中难治性贫血伴环状铁粒幼红细胞（RARS）7例、难治性血细胞减少伴有多系发育异常（RCMD）6例、难治性贫血（RA）1例。与未突变组相比，突变组患者的年龄偏大[58（32~78）岁对51（13~84）岁，z=−1.981，P=0.048]、PLT偏高[121（22~888）×10⁹/L对59（6~1 561）× 10⁹/L，z=−3.305，P=0.001]、骨髓原始细胞比例偏低[0.007（0~0.122）对0.017（0~0.268），z=−2.885，P=0.004]、RS比例偏高[0（0~64%）对0（0~58%），z=−4.664，P<0.001]，HGB偏低[63（40~95）g/L对77（34~144）g/L，z=−3.192，P=0.001]。对105例患者进行U2AF1（S34、Q157P）基因突变分析，突变率为21.90%（105例中23例）。突变组患者各临床特征与未突变组相比差异均无统计学意义。107例患者有SRSF2（P95）突变结果，8例突变，突变率为7.48%，突变组患者初诊时年龄偏高，中位年龄63（50~84）岁，其中难治性贫血伴有原始细胞增多-1（RAEB-1）4例，突变率为14.29%（28例中4例）；MDS转化的急性髓系白血病3例。1例患者同时出现SF3B1（K700E）和SRSF2（P95H）突变，2例患者同时出现SF3B1（K700E）和U2AF1（S34Y）突变。

结论

SF3B1、U2AF1和SRSF2剪接体复合物蛋白编码基因中，仅SF3B1基因突变与环状铁粒幼红细胞增多性贫血密切相关，是该亚型的主要致病基因。

Symmetrical acral keratoderma revisited: proposal for a new term, 'pigmented carpotarsal hyperkeratosis'

First reported from Taiwan mistakenly as acral acanthosis nigricans in 1991, pigmented carpotarsal hyperkeratosis or hyperkeratosis nigricans carpi et tarsi displays a peculiar distribution of velvety brown-grey hyperpigmented plaques symmetrically on the flexural side of the wrists and ankles and on the dorsal sides of the hands and feet. A marked epidermal hyperkeratosis with typically mild acanthosis and papillomatosis is observed in histology. Whitish maceration upon perspiration or water exposure, with exacerbation in summer but remission in winter, is common. The association with obesity, endocrine disorders, atopic dermatitis, ichthyosis or malignancy is unknown. Familial occurrence and hereditary patterns are ill-defined. There is preliminary evidence indicating a pathogenic role of missense mutation in the transcription factor 4 gene. Treatment is empirical, with good outcome with topical retinoids and keratolytic agents. Recurrence is common, and long-term prognosis is unclear. To be distinguished are acral acanthosis nigricans, palmoplantar keratoderma of the Nagashima type, palmoplantar keratoderma of the Bothnian type and aquagenic palmoplantar keratoderma. Most reported cases are from Southern China and are predominantly observed in men between the ages of 20 and 40 years. The currently used term 'symmetrical acral keratoderma' is non-specific and misleading and may lead to global unawareness, underreporting or misdiagnosis of this phenomenon. Further genetic and molecular studies are required to clarify its pathogenesis and relation to palmoplantar keratoderma.

Natural history of serum HBV-RNA in chronic HBV infection

Virus-like particles encapsulating HBV-RNA represent a serum biomarker for assessing viral replication activity in clinical practice. However, baseline levels of serum HBV-RNA and their associations with viral replicative intermediates and liver disease in phases of chronic hepatitis B remain unknown. In this cross-sectional study, 102 patients were categorized into immune-tolerant (IT), HBeAg-positive immune active (HBeAg+IA), inactive carrier (IC) and HBeAg-negative immune active (HBeAg-IA) phases. HBV-RNA in serum samples and in 66 paired liver biopsies were quantified and correlated with serum ALT levels, histopathological scores and the levels of other viral replicative intermediates. Mean levels of serum HBV-RNA differed among phases, with the highest levels among IT (6.78 ± 0.83 log₁₀ copies mL^-1 ) patients, followed by HBeAg+IA (5.73 ± 1.16 log₁₀ copies mL^-1 ), HBeAg-IA (4.52 ± 1.25 log₁₀ copies mL^-1 ) and IC (2.96 ± 0.40 log₁₀ copies mL^-1 ) patients. Serum HBV-RNA levels correlated with HBV DNA in all phases, although correlations with other viral replicative intermediates weakened or disappeared when cases were stratified into phases. Distinct compositions of viral products were found among phases: the ratio of HBsAg to serum HBV-RNA was highest in IC patients, while the ratio of serum HBV-RNA to intrahepatic HBV-RNA and the ratio of intrahepatic HBV-DNA to intrahepatic HBV-RNA were significantly higher in IT patients. In conclusion, baseline levels of HBV-RNA and the composition of viral replicative intermediates differ significantly across the natural course of chronic HBV infection. These findings shed light on the nature of viral replication and pathogenesis of disease among different phases of chronic HBV infection.

Incident Direction Independent Wave Propagation and Unidirectional Lasing

We propose an incident direction independent wave propagation generated by properly assembling different unidirectional destructive interferences (UDIs), which is a consequence of the appropriate match between synthetic magnetic fluxes and the incident wave vector. Single-direction lasing at spectral singularity is feasible without introducing nonlinearity. UDI allows unidirectional lasing and unidirectional perfect absorption; when they are combined in a parity-time-symmetric manner, the spectral singularities vanish with bounded reflections and transmissions. Furthermore, the simultaneous unidirectional lasing and perfect absorption for incidences from opposite directions is created. Our findings provide insights into light control and may shed light on the explorations of desirable functionality in fundamental research and practical applications.

Maximal distant entanglement in Kitaev tube

We study the Kitaev model on a finite-size square lattice with periodic boundary conditions in one direction and open boundary conditions in the other. Based on the fact that the Majorana representation of Kitaev model is equivalent to a brick wall model under the condition t = Δ = μ, this system is shown to support perfect Majorana bound states which is in strong localization limit. By introducing edge-mode fermionic operator and pseudo-spin representation, we find that such edge modes are always associated with maximal entanglement between two edges of the tube, which is independent of the size of the system.

Clinical efficacy of sequential therapy with voriconazole on COPD patients in acute phase with pulmonary aspergillosis and effects on cytokines and pulmonary functions

OBJECTIVE

To explore the clinical efficacy of sequential therapy with voriconazole on chronic obstructive pulmonary disease (COPD) patients in acute phase with pulmonary aspergillosis and its effects on cytokines and pulmonary functions.

PATIENTS AND METHODS

A total of 110 COPD patients in acute phase with pulmonary aspergillosis who were admitted to the hospital between February 2015 and November 2016 were enrolled. We divided them randomly into two groups, i.e., the control group (n = 55) and the treatment group (n = 55). Patients in the control group took itraconazole capsules orally (200 mg/time, twice per day for three days followed by once per day). Patients in treatment group underwent sequential treatment with voriconazole through intravenous infusion at a dose of 5 mg/kg/time twice a day for 3 days followed by a dose of 4 mg/kg/time, twice a day for 8 days. Then, patients took voriconazole orally at a dose of 150 mL/time, twice a day for 6 days. Patients in two groups received the treatment for a total of 14 days. After treatment, we evaluated the levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and IL-8. The total lung capacity (TLC), diffusing capacity of the lung for carbon monoxide (DLco), and arterial oxygen saturation (SaO2), were measured as well.

RESULTS

The total effectiveness rates of the treatment group and the control group were 83.63% and 61.82%. The differences had statistical significance (p < 0.01). After treatment, the incidence of chest pain, cough, sputum-coughing, hemoptysis, cyanosis, and dyspnea in the treatment group was significantly fewer than that in the control group (p < 0.05). TCL, DLco, and SaO2 in the two groups were significantly ameliorated by treatment (p < 0.05). The amelioration in the treatment group was more prominent than that in the control group (p < 0.05). The levels of TNF-α, IL-8, and IL-6 in the two groups were decreased dramatically by the treatments. The decrease in the treatment group was significantly lower than those in the control group (p < 0.05). Occurrence of adverse reactions in treatment group and control group were 8.33% and 6.25%, respectively; (p > 0.05).

CONCLUSIONS

Sequential therapy with voriconazole exhibits promising clinical efficacy in COPD patients in acute phase with pulmonary aspergillosis. The treatment ameliorated the clinical symptoms and vital signs of patients significantly. It also improved the pulmonary functions and inhibited the inflammatory responses of patients with evident clinical efficacy.

Dissection of a circulating CD3+ CD20+ T cell subpopulation in patients with psoriasis

CD3⁺ CD20⁺ T cells are a population of CD3⁺ T cells that express CD20 and identified in healthy donors and autoimmune diseases. However, the nature and role of these cells in patients with psoriasis remain unclear. In this study, we aimed to investigate the level, phenotype, functional and clinical relevance of CD3⁺ CD20⁺ T cells in the peripheral blood of patients with psoriasis. We found that a small subset of CD3⁺ T cells expressed CD20 molecule in the peripheral blood of patients with psoriasis, and their levels were similar to those in healthy donors. Circulating CD3⁺ CD20⁺ T cells in patients with psoriasis were enriched in CD4⁺ cells and displayed an activated effector phenotype, as these cells contained fewer CD45RA⁺ -naive and CCR7⁺ cells with increased activity than those of CD3⁺ T cells lacking CD20. In addition, compared with healthy donors, circulating CD3⁺ CD20⁺ T cells in patients with psoriasis produced more cytokines, interleukin (IL)-17A, tumour necrosis factor (TNF)-α and IL-21, but not IL-4 and IFN-γ. Furthermore, a significantly positive correlation was found between the levels of IL-17A, TNF-α and IL-21-production CD3⁺ CD20⁺ T cells with Psoriasis Area and Severity Index scores. Our findings suggest that CD3⁺ CD20⁺ T cells may play a role in the pathogenesis of psoriasis.

[Effects of ovalbumin exposure during pregnancy of mice on the ovalbumin re-exposure in adult progeny]

Objective: To observe the immunoreaction of offspring mice by ovalbumin (OVA) re-exposure after their mothers exposed to OVA during pregnancy. Method: A prospective controlled study was conducted to observe mice after repeated OVA exposures at 6-8 weeks.Their mothers were exposed to OVA during different stages of pregnancy.The symptoms were recorded and scored.The levels of OVA-specific IgE in serum, interferon-γ(IFN-γ) and interleukin-4(IL-4) in supernatant of spleen primary lymphocytes in vitro were measured by ELISA.The results were analyzed by single factor analysis of variance or rank sum test. Result: All the mice in each group had acute diarrhea.The diarrhea happened earliest (2 days) and most severe in the late pregnancy group (early pregnancy group 7.0±1.0; middle pregnancy group: 7.1±1.1; late pregnancy group: 9.9±2.2, P<0.01). The levels of absorbance of OVA-specific IgE in the pregnancy groups were higher than those of the control group.The absorbance of OVA-specific IgE in late pregnancy group was the highest (control: 0.27±0.06; early pregnancy group: 0.51±0.13; middle pregnancy group: 0.50±0.09; late pregnancy group: 0.63±0.13, P<0.01). There was no significant change in IFN-γ expression in cultured supernatant of spleen lymphocytes in each group (control: (133±7) pg/ml; early pregnancy group: (133±4) pg/ml; middle pregnancy group: (134±6) pg/ml; late pregnancy group: (132±4) pg/ml, all P value >0.05). The expression of IL-4 in the experimental groups was higher than that in the control group, especially in late pregnancy group(control: (25.3±2.4) pg/ml; early pregnancy group: (32.4±4.4) pg/ml; middle pregnancy group: (35.0±5.4) pg/ml; late pregnancy group: (47.1±5.8) pg/ml; P value all<0.01). Conclusion: The allergic reaction of the OVA re-exposure progeny whose mothers were exposed to OVA in the late pregnancy period was most severe, suggesting that late pregnancy period might be the high risk stage of intrauterine sensitization, or"window period".

Abdominal wall reconstruction following resection of large abdominal aggressive neoplasms using tensor fascia lata flap with or without mesh reinforcement

PURPOSE

Abdominal wall defects caused by neoplasms with large extended resection defects remain a challenging problem. Autologous flaps, meshes, and component separation techniques are effective in reconstructing these defects. We retrospectively reviewed and assessed the success of reconstruction using tensor fascia lata flap with or without meshes.

METHODS

18 patients with abdominal wall neoplasms were identified during the period from 2007 to 2016. A retrospective review of office charts and hospital records was performed.

RESULTS

A total of 18 patients received corresponding treatment according to the degree of defects, with a mean age of 53.89 ± 14.56 years old, a mean body mass index (BMI) of 22.89 ± 4.09 kg/m², and a mean American Society of Anesthesiologist (ASA) score of 2.18 ± 0.75. Operative details included the mean defect size (303.44 ± 175.67 cm²), the mean mesh size (265.92 ± 227.99 cm²), and the mean operative time (382.33 ± 180.38 min). Postoperative wound complications were identified in 7 (39%) patients, including incisional infection, edema and thrombus. Neoplasm recurrence was observed in 2 (13%) primary neoplasms patients. No hernias were present in any patient.

CONCLUSIONS

Abdominal wall defects caused by neoplasms should be repaired by autologous flaps combined with or without mesh reinforcement. Most type I defects should be primary sutured; type II or III defects should be repaired well by flaps, with or without mesh; if the incision is infected or contaminated, biological mesh or flaps are the best choice.

Bergamottin, a natural furanocoumarin abundantly present in grapefruit juice, suppresses the invasiveness of human glioma cells via inactivation of Rac1 signaling

The aim of the present study was to explore the effect of bergamottin, a natural furanocoumarin obtained from grapefruit juice, on the invasiveness of human glioma cells. The results revealed that treatment with bergamottin for 48 h significantly inhibited wound-healing migration and Matrigel invasion of human glioma cells, compared with untreated cells (P<0.05). Bergamottin treatment caused a significant decrease in the expression and secretion of matrix metalloproteinase (MMP)-9 in glioma cells compared with untreated cells (P<0.05). A Rac1-GTP pull-down assay demonstrated that bergamottin-treated glioma cells had a significantly decreased level of active Rac1-GTP compared with untreated cells (P<0.05). However, bergamottin had no significant effect on cell division cycle 42 activity. Expression of constitutively activated Rac1 almost completely restored the migration and invasion of bergamottin-treated glioma cells. In addition, bergamottin-induced downregulation of MMP-9 was prevented by exogenous activated Rac1. The results of the present study demonstrated that bergamottin exhibits anti-invasive activity in human glioma cells through the inactivation of Rac1 and downregulation of MMP-9.

Topological gapless phase in Kitaev model on square lattice

We study the topological feature of gapless states in the fermionic Kitaev model on a square lattice. There are two types of gapless states which are topologically trivial and nontrivial. We show that the topological gapless phase lives in a wide two-dimensional parameter region and are characterized by two vertices of an auxiliary vector field de-fined in the two-dimensional momentum space, with opposite winding numbers. The isolated band touching points, as the topological defects of the field, move, emerge, and disappear as the parameters vary. The band gap starts to open only at the merg-ing points, associated with topologically trivial gapless states. The symmetry protect-ing the topological gapless phase and the robustness under perturbations are also discussed.

Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males

BACKGROUND

Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries.

METHODS

A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity.

RESULTS

Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders.

CONCLUSIONS

Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.