[A real-world study of 176 cases with aplastic anemia treated in outpatient]

Objective: To explore the diagnostic process and outcomes of patients with aplastic anemia (AA) who received outpatient treatment in a real-world setting. Methods: The diagnostic processes, treatment regimens, and outcomes of 176 patients with AA treated in outpatient centers from January 2018 to December 2019 were reviewed. Results: The median interval from the onset of symptoms to the first visit was 7 (5-120) months. Complaints during the first visit included bleeding (52.3% ) , anemia (51.7% ) , and infection (6.8% ) . For diagnosis, 168 patients (95.5% ) underwent bone marrow aspiration; however, only 22 of them (17.1% ) consented aspiration in multiple sites (sternum) . The completion rate of bone marrow biopsy was 85.1% (143/168) ; flow immunophenotype and karyotype analyses were performed on 59.5% (100/168) and 58.9% (99/168) of AA patients, respectively, and the culture of clonal forming units by bone marrow mononuclear cells was performed on 26.8% (45/168) of AA patients. The most preferred regimen was cyclosporine combined with androgen and levamisole (43.8% , 77 patients) , followed by cyclosporine combined with androgen (25.6% , 45 patients) . Cyclosporine alone was administered in 24 patients (13.6% ) and androgen alone in 16 patients (9.1% ) . Furthermore, 14 patients (7.9% ) did not consent to any drugs or only chose traditional Chinese medicine. The patients were divided according to the frequencies of follow-up: regular follow-up group (≥4 times/year, n=130) and irregular group (<4 times/year, n=46) . The former had a higher 6-month remission rate (52.5% vs 28.0% , P=0.005) , a greater high-quality remission rate in 12 months (40.7% vs 16.7% , P=0.027) , and a lower relapse rate in 24 months (4.4% vs 36.4% , P=0.001) . Conclusion: In real-world settings, bone marrow aspiration in multiple sites should be addressed in outpatient treatment for AA diagnostic work-up, including PNH clone screening, flow immunophenotype, chromosome karyotype analysis, and culture of clonal forming units. Patients with AA who follow regular visits were more likely to achieve high-quality remission and a lower relapse rate. Visits at least four times per year are recommended for AA patients undergoing outpatient treatment.

Profiling of donor-specific immune effector signatures in response to rituximab in a human whole blood loop assay using blood from CLL patients

Rituximab is widely used in the treatment of haematological malignancies, including chronic lymphocytic leukaemia (CLL), the most common leukaemia in adults. However, some patients, especially those with high tumour burden, develop cytokine release syndrome (CRS). It is likely that more patients will develop therapy-linked CRS in the future due to the implementation of other immunotherapies, such as CAR T-cell, for many malignancies. Current methods for CRS risk assessment are limited, hence there is a need to develop new methods. To better recapitulate an in vivo setting, we implemented a unique human whole blood "loop" system to study patient-specific immune responses to rituximab in blood derived from CLL patients. Upon rituximab infusion, both complement-dependent cytotoxicity (CDC) and antibody-dependent cellular cytotoxicity (ADCC) profiles were evident in CLL patient blood, coincident with CLL cell depletion. Whereas B cell depletion is induced in healthy persons in the blood loop, only patients display B cell depletion coupled with CRS. With the exception of one donor who lacked NK cells, all other five patients displayed variable B cell depletion along with CRS profile. Additionally, inhibition of CDC or ADCC via either inhibitors or antibody Fc modification resulted in skewing of the immune killing mechanism consistent with published literature. Herein we have shown that the human whole blood loop model can be applied using blood from a specific indication to build a disease-specific CRS and immune activation profiling ex vivo system. Other therapeutic antibodies used for other indications may benefit from antibody characterization in a similar setting.

Effect of Glycation on Interlamellar Bonding of Arterial Elastin

BACKGROUND

Interlamellar bonding in the arterial wall is often compromised by cardiovascular diseases. However, several recent nationwide and hospital-based studies have uniformly reported reduced risk of thoracic aortic dissection in patients with diabetes. As one of the primary structural constituents in the arterial wall, elastin plays an important role in providing its interlamellar structural integrity.

OBJECTIVE

The purpose of this study is to examine the effects of glycation on the interlamellar bonding properties of arterial elastin.

METHODS

Purified elastin network was isolated from porcine descending thoracic aorta and incubated in 2 M glucose solution for 7, 14 or 21 days at 37 °C. Peeling and direct tension tests were performed to provide complimentary information on understanding the interlamellar layer separation properties of elastin network with glycation effect. Peeling tests were simulated using a cohesive zone model (CZM). Multiphoton imaging was used to visualize the interlamellar elastin fibers in samples subjected to peeling and direct tension.

RESULTS

Peeling and direct tension tests show that interlamellar energy release rate and strength both increases with the duration of glucose treatment. The traction at damage initiation estimated for the CZM agrees well with the interlamellar strength measurements from direct tension tests. Glycation was also found to increase the interlamellar failure strain of arterial elastin. Multiphoton imaging confirmed the contribution of radially running elastin fibers to resisting dissection.

CONCLUSIONS

Nonenzymatic glycation reduces the propensity of arterial elastin to dissection. This study also suggests that the CZM effectively describes the interlamellar bonding properties of arterial elastin.

LncRNA CASC15 functions as an oncogene by sponging miR-130b-3p in bladder cancer

OBJECTIVE

Recent studies have revealed that long noncoding RNAs (lncRNAs) are dysregulated in malignant tumors and participates in carcinogenesis. The purpose of our study was to uncover the mechanisms underlying lncRNA CASC15 in bladder cancer (BLCA).

PATIENTS AND METHODS

In this research, Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was performed to detect cancer susceptibility candidate 15 (CASC15) expression in BLCA samples and cells. Besides, the wound healing assay and transwell assay were performed in BLCA cells after CASC15 was knocked down. Furthermore, the bioinformatics analysis and dual-luciferase reporter assay were conducted to explore the target miRNA of CASC15, which was further verified through rescue experiments in BLCA cells.

RESULTS

CASC15 expression was upregulated in BLCA tissue samples. Moreover, CASC15 downregulated the miR-130b-3p expression and promoted cell migration and invasion in BLCA in vitro. The rescue experiments also revealed that the inhibitory effects by the silence of CASC15 could be reversed through the inhibition of miR-130b-3p.

CONCLUSIONS

Our study suggested a vital regulatory mechanism of CASC15 in BLCA, and the CASC15/miR-130b-3p axis might serve as a new therapeutic interventional target for BLCA patients.

RETRACTED: ORIENT-3: A randomized, open-label, phase III study of sintilimab versus docetaxel in previously treated advanced/metastatic squamous non-small cell lung cancer (sqNSCLC)

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article was retracted at the request of the authors. The authors of this abstract have advised that full agreement between authors and sponsors on publication of the abstract has not been reached and they are therefore unable to publish this data at present.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is associated with IRF7, BANK1 and TBX21 polymorphisms in two populations

BACKGROUND AND PURPOSE

Autoantibodies targeting the GluN1(NR1) subunit of the anti-N-methyl-D-aspartate receptor (NMDAR) cause encephalitis. Although it has been shown that anti-NMDAR encephalitis is associated with human leukocyte antigen (HLA) loci, susceptibility genes for the disease outside the HLA loci remain unidentified. In this study, we aimed to explore the association of anti-NMDAR encephalitis with non-HLA genes.

METHODS

Two Chinese anti-NMDAR encephalitis cohorts from Han populations were recruited for this study. The North Chinese case-control set consisted of 98 patients and 460 controls, while the South Chinese case-control set included 78 patients and 541 controls. All participants were genotyped for 28 single nucleotide polymorphisms that are associated with autoimmune disorders or infectious diseases.

RESULTS

In two independent case-control sets, we identified significant associations of anti-NMDAR encephalitis with IRF7 rs1131665 (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.99-5.63; P < 0.000001, P^adjusted  = 0.00004), BANK1 rs4522865 (OR 1.44, 95% CI 1.15-1.82; P = 0.0017, P^adjusted  = 0.0149), and TBX21 rs17244587 (OR 2.03, 95% CI 1.35-3.05; P = 0.00051, P^adjusted  = 0.0066). Furthermore, analysis of the three polymorphisms with clinical features of the disease revealed that the IRF7 rs1131665 was associated with tumor status.

CONCLUSION

The present study has for the first time identified non-HLA susceptibility genes for anti-NMDAR encephalitis. The association of IRF7, BANK1 and TBX21 with anti-NMDAR encephalitis suggests that B-cell activation, Th1 responses, virus infection and the type I interferon signaling pathway are involved in the pathogenesis of the disease.

Effect of meat temperature on moisture loss, water properties, and protein profiles of broiler pectoralis major with the woody breast condition

The objective of this study was to investigate the influence of meat temperature on moisture loss, muscle water properties, and protein profiles in broiler pectoralis major with the severe woody breast (WB) condition. Broiler breast samples were collected from a commercial plant and sorted into normal, WB, and pale, soft, and exudative (PSE). Temperature treatments included 23°C, 40°C, 53°C, 57°C, 68°C, and 90°C based on denaturation of major muscle protein types during heating. Moisture loss was estimated with weight changes, water properties were measured with time-domain nuclear magnetic resonance measurements, and protein profiles were determined with SDS electrophoresis gel. There were no differences in moisture loss between 3 groups at meat temperature 23°C, 40°C, and 57°C. Moisture loss of WB samples was greater than normal and PSE at either 68°C or 90°C; however, it was the least at 53°C. Only close changing trend was noted between the intramyofibrillar water (T₂₁) reduction and moisture loss. The extramyofibrillar (T₂₂) water content and reduction in WB meat during heating were consistent greater, and electrophoretic profiles differed among 3 muscle conditions. Data suggest that greater reductions in intramyofibrillar and extramyofibrillar water are responsible for the increased moisture loss in WB meat at higher temperature.

Diagnostic accuracy of computed tomography colonography in patients at high risk for colorectal cancer: a meta-analysis

AIM

The aim was to explore the diagnostic value of computed tomographic colonography (CTC) compared with conventional colonoscopy in individuals at high risk for colorectal cancer.

METHOD

PubMed, Embase, the Cochrane Library and the Web of Science were searched by two independent reviewers for potentially eligible studies published up to 31 October 2018 that were based on a per-patient analysis. stata, meta-disc and revman were used to perform this meta-analysis. A random-effect model was used, and a subgroup analysis was conducted to explore the sources of heterogeneity.

RESULTS

A total of 14 full-text articles, involving 3578 patients, were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the area under the summary receiver operating characteristic curve of CTC for detecting polyps ≥ 6 mm were 0.87 (95% CI 0.83-0.90), 0.90 (95% CI 0.86-0.93), 9.08 (95% CI 6.28-13.13), 0.14 (95% CI 0.11-0.18) and 0.94 (95% CI 0.92-0.96), respectively. For polyps ≥ 10 mm, the pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of CTC were 0.91 (95% CI 0.86-0.94), 0.98 (95% CI 0.95-0.99), 40.36 (95% CI 19.16-85.03), 0.90 (95% CI 0.06-0.14) and 0.98 (95% CI 0.96-0.99), respectively.

CONCLUSION

In this meta-analysis, CTC had high diagnostic accuracy for detecting polyps ≥ 6 mm and ≥ 10 mm in patients at high risk of developing colorectal cancer and it had a higher sensitivity and specificity for detecting polyps ≥ 10 mm than polyps ≥ 6 mm. However, the results should be used cautiously due to the significant heterogeneity.

In situ growth of CeO2 on g-C3N4 nanosheets toward a spherical g-C3N4/CeO2 nanozyme with enhanced peroxidase-like catalysis: a selective colorimetric analysis strategy for mercury(II )

Cerium dioxide (CeO2) nanocatalysts were initially grown in situ on 2D graphitic carbon nitride (g-C3N4) nanosheets to yield the nanocomposites g-C3N4/CeO2 with a spherical structure for the catalysis-based colorimetric analysis of Hg2+ ions in blood and wastewater. As the synergetic introduction of g-C3N4 nanosheets might promote the electron transfer in CeO2, the resulting g-C3N4/CeO2 nanozyme was found to present greatly enhanced catalytic activity, as demonstrated by the steady-state kinetic studies, which is nearly 4-fold higher than that of pure CeO2. Moreover, the g-C3N4/CeO2 nanozymes would aggregate in the presence of Hg2+ ions due to the strong interaction between Hg2+ and the nitrogen of g-C3N4, leading to a decrease of catalysis rationally depending on the Hg2+ ion concentration. A colorimetric analysis strategy is therefore developed for the selective detection of Hg2+ ions separately in the complex samples of blood and wastewater, showing a linear concentration range from 0.50 nM to 800 nM with the LOD of 0.23 nM as exemplified for Hg2+ ions in blood. Also, the recovery tests indicated that the developed colorimetric method can allow for the accurate analysis of Hg2+ ions in wastewater and blood. Such a route for the fabrication of composite nanozymes by growing catalytic nanomaterials on conductive 2D substrates may be extended to the design of other kinds of nanozymes with enhanced catalytic performances for developing catalysis-based detection platforms.

IGF-1R/β-catenin signaling axis is implicated in streptozotocin exacerbating bone impairment in ovariectomized rats

OBJECTIVE

The aim of this study was to investigate the role of the insulin-like growth factor-1 receptor (IGF-1R)/β-catenin signaling axis in bone impairment induced by hyperglycemia in ovariectomized rats.

METHODS

Rats were divided into four groups. The sham group received sham operation and a single intraperitoneal administration of vehicle. The ovariectomy (OVX) group was subjected to bilateral OVX and vehicle injection. The streptozotocin (STZ) group received sham operation and a single STZ injection to induce hyperglycemia. The OVX + STZ group received bilateral OVX and a single STZ injection. Dual-energy X-ray absorptiometry measurement, bone biomechanics test, micro-computed tomography scan, and hematoxylin-eosin staining were performed to evaluate bone alteration in this model. The expression of relevant signals including IGF-1R, glycogen synthase kinase-3β (GSK-3β), and β-catenin were examined by quantitative real-time polymerase chain reaction and western blot.

RESULTS

The OVX, STZ, and OVX + STZ groups induced bone loss, attenuated bone strength, and impaired microarchitecture compared with the sham group, respectively. Compared with OVX, more serious bone damage was found in the OVX + STZ group, which showed enhanced phosphorylation of IGF-1R, GSK-3β, and β-catenin.

CONCLUSION

OVX plus STZ induced more serious bone impairment than OVX alone, which involves the IGF-1R/β-catenin signaling axis in the pathogenesis. This may provide a potential target for treatment of postmenopausal diabetic osteoporosis.

Correlation study on β2-adrenergic receptor gene polymorphisms and asthma susceptibility: evidence based on 57 case-control studies

OBJECTIVE

Previous studies have indicated that β2-adrenergic receptor (ADRB2) genetic polymorphism is related to the risk of asthma, but the results still have some controversy and uncertainty. To this end, the meta-analysis was performed, including all studies that can be used to assess the correlation between ADRB2 polymorphism and asthma susceptibility.

MATERIALS AND METHODS

The related papers on ADRB2 polymorphisms and asthma were systematically reviewed in databases of PubMed, EMBASE, Cochrane Library, and WanFang, Odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were measured. The sensitivity analysis and publication bias were evaluated to investigate the correlation.

RESULTS

This meta-analysis included 57 papers in total involving 11,157 cases and 12,281 controls. Results illustrated that the C79G variant genotypes owned a reduced effect on asthma susceptibility (G vs. C: OR=0.94, p=0.037). In the age stratification analysis, C79G polymorphism owned a reduced effect on asthma risk for children (GG vs. CC: OR=0.69, p=0.002; GG vs. CC+CG: OR=0.65, p<0.001). Furthermore, in the ethnic stratification analysis, the C79G variant genotypes also owned a reduced effect on asthma in Asians (GG vs. CC: OR=0.80, p=0.027; GG vs. CC+CG: OR=0.81, p=0.02). Besides, for A46G polymorphism, the ethnic stratification analysis demonstrated that the A46G variant owned an increased effect on asthma susceptibility among Caucasians (G vs. A: OR=1.15, p=0.043). For C491T polymorphism, a considerable reduced effect was found between C491T and asthma susceptibility for children (CT vs. CC: OR=0.70, p=0.03). In the ethnic stratification analysis, the effect was also considerable in the Caucasian subjects.

CONCLUSIONS

The present meta-analysis demonstrated that C79G and C491T polymorphism may be a defensive factor for asthma, while A46G polymorphism may be a risk factor for asthma among the Caucasian population.

Muscle water properties in raw intact broiler breast fillets with the woody breast condition

The purpose of this study was to investigate the relationships between muscle water properties, water-holding capacity (WHC), and woody breast (WB) severity in intact raw broiler breast fillets. Broiler pectoralis major deboned at 3 h postmortem was collected from a commercial plant and categorized as normal (NORM), moderate WB, or severe WB (SEV). Meat drip loss was calculated based on weight loss during overnight storage at 4°C. Water properties of the intact fillets were determined with time domain nuclear magnetic resonance and the T2 relaxation times were determined using an inverse Laplace algorithm (CONTIN). Three T2 water components, hydration water (T2b), intra-myofibrillar water (T21), and extra-myofibrillar water (T22), were identified. With increasing WB severity, the time constant of each water component and the relative content of T22 (P22) increased while the relative areas of T2b and T21 (P2b and P21, respectively) decreased. Spearman correlation analysis showed that there were significant correlations between the WB condition score and either the time constant or normalized area for each T2 component. T22 normalized areas (A22) were most strongly correlated with the WB score (r = 0.75); however, the weakest correlation was found between the WB score and T21 areas (A21). Pearson correlation analysis revealed that the strongest correlation (r = 0.64) was found between A22 and drip loss; however, there was no correlation between A21 and drip loss. Within the NORM group, drip loss was significantly correlated to the time constants for both T2b and T21. Within the SEV group, only A22 was significantly correlated to drip loss. These data indicate that the WB condition has a significant impact on the distribution of water within the intact muscle tissue. The content of extra-myofibrillar water in broiler breast fillets may be a key factor responsible for the poor WHC measurements in WB meat.

Quantitative structure-property relationship of distribution coefficients of organic compounds

The n-octanol/buffer solution distribution coefficient (or n-octanol/water partition coefficient) is of critical importance for measuring lipophilicity of drug candidates. After 4885 molecular descriptor generation, 15 molecular descriptors were selected to develop quantitative structure-property relationship (QSPR) models for distribution coefficients at pH 7.4 (log D _7.4) of a large data set consisting of 1043 organic compounds, which was divided into a training set (600 compounds) and a test set (443 compounds). Support vector machine (SVM) based on genetic algorithm was used to develop a model for log D _7.4 that has coefficient of determination r ² of 0.919 for the training set and 0.893 for the test set. The results suggest that the SVM model is accurate in predicting log D _7.4.