When inflammatory stressors dramatically change, disease phenotypes may transform between autoimmune hematopoietic failure and myeloid neoplasms

Aplastic anemia (AA) and hypoplastic myelodysplastic syndrome are paradigms of autoimmune hematopoietic failure (AHF). Myelodysplastic syndrome and acute myeloid leukemia are unequivocal myeloid neoplasms (MNs). Currently, AA is also known to be a clonal hematological disease. Genetic aberrations typically observed in MNs are detected in approximately one-third of AA patients. In AA patients harboring MN-related genetic aberrations, a poor response to immunosuppressive therapy (IST) and an increased risk of transformation to MNs occurring either naturally or after IST are predicted. Approximately 10%-15% of patients with severe AA transform the disease phenotype to MNs following IST, and in some patients, leukemic transformation emerges during or shortly after IST. Phenotypic transformations between AHF and MNs can occur reciprocally. A fraction of advanced MN patients experience an aplastic crisis during which leukemic blasts are repressed. The switch that shapes the disease phenotype is a change in the strength of extramedullary inflammation. Both AHF and MNs have an immune-active bone marrow (BM) environment (BME). In AHF patients, an inflamed BME can be evoked by infiltrated immune cells targeting neoplastic molecules, which contributes to the BM-specific autoimmune impairment. Autoimmune responses in AHF may represent an antileukemic mechanism, and inflammatory stressors strengthen antileukemic immunity, at least in a significant proportion of patients who have MN-related genetic aberrations. During active inflammatory episodes, normal and leukemic hematopoieses are suppressed, which leads to the occurrence of aplastic cytopenia and leukemic cell regression. The successful treatment of underlying infections mitigates inflammatory stress-related antileukemic activities and promotes the penetration of leukemic hematopoiesis. The effect of IST is similar to that of treating underlying infections. Investigating inflammatory stress-powered antileukemic immunity is highly important in theoretical studies and clinical practice, especially given the wide application of immune-activating agents and immune checkpoint inhibitors in the treatment of hematological neoplasms.

Preparation and Oil Adsorption of Cellulose-graft-poly(butyl acrylate-N,N'-methylene Bisacrylamide)

With the advancement of industrial economies, incidents involving spills of petroleum products have become increasingly frequent. The resulting pollutants pose significant threats to air, water, soil, plant and animal survival, as well as human health. In this study, microcrystalline cellulose served as the matrix and benzoyl peroxide (BPO) as the initiator, while butyl acrylate (BA) and N,N'-methylene bisacrylamide (MBA) were employed as graft monomers. Through free radical graft polymerization, cellulose-graft-poly(butyl acrylate-N,N'-methylene bisacrylamide) [Cell-g-P(BA-MBA)], possessing oil-adsorbing properties, was synthesized. The chemical structure, elemental composition, surface morphology and wetting properties of the graft polymerization products have been characterized, using infrared spectroscopy, elemental analysis, scanning electron microscopy and contact angle testing. The adsorption properties of Cell-g-P(BA-MBA) for various organic solvents and oils were then assessed. The experimental results demonstrated that Cell-g-P(BA-MBA) exhibited a maximum adsorption capacity of 37.55 g/g for trichloromethane. Adsorption kinetics experiments indicated a spontaneous and exothermic process involving physical adsorption, conforming to the Freundlich isotherm model. Furthermore, adsorption kinetics experiments revealed that Cell-g-P(BA-MBA) displayed favorable reuse and regeneration performance, maintaining its adsorption capacity essentially unchanged over fifteen adsorption-desorption cycles.

Rare presentation of double-clonal Waldenström macroglobulinemia with pulmonary embolism: A case report

Waldenström macroglobulinemia (WM) rarely leads to pulmonary embolism. Due to its low incidence, the underlying pathophysiology, prognosis, and optimal treatment remain largely unexplored and uninvestigated. In this study, a patient with a double-clonal WM, a rare subtype, presented with pulmonary embolism. The patient had a small number of plasma cells without morphological abnormalities, and an effective therapeutic response was observed. Nonetheless, the clinical prognosis requires a long-term follow-up.

Evaluation of the efficacy and feasibility of concurrent weekly docetaxel-nedaplatin and hypo-fractionated radiotherapy in atypical histologic subtypes of primary and metastatic mediastinal malignancies

Background

We aimed to evaluate the efficacy and feasibility of concurrent weekly docetaxel-nedaplatin and hypo-fractionated radiotherapy (hypo-RT) in atypical histologic subtypes of primary and metastatic mediastinal malignancies.

Methods

Fifty-four patients diagnosed with atypical primary or metastatic mediastinal malignancies were retrospectively reviewed. 30 patients received concurrent weekly docetaxel and nedaplatin and hypo-RT (CChRT group) and 24 patients had hypo-RT alone (hRT group). Overall response rate (ORR), in-field locoregional progression-free survival (LPFS) and toxicities were analyzed. The radiobiological effect was evaluated by the LQRGC/TCP model, incorporating four “R”s of radiobiology, Gompertzian tumor growth and radio-sensitizing effect of chemotherapeutic agent. The biologically effective doses (BEDs) were calculated.

Results

The median follow-up time was 29.2 months for all patients. The ORR was 86.7% in CChRT group, compared with 62.5% in hRT group (p=0.033). The 2-year in-field LPFS of CChRT and hRT group was 73.4% and 47.3%, respectively (p=0.003). There was no significant difference of any >=Grade 3 toxicities between the two groups (p=0.754). The mean total dose and mean BED by the LQRGC/TCP model in CChRT group were 58.2Gy and 72.34Gy, versus 52.6Gy and 67.25Gy in hRT group.

Conclusions

Concurrent weekly docetaxel-nedaplatin and hypo-RT achieved promising in-field LPFS and tolerable toxicities compared with hypo-RT alone in different histologic subtypes of primary and metastatic mediastinal malignancies.

[Mechanism of human airway epithelial cell injury induced by Candida albicans infection]

Objective: To investigate the immune mechanism of human airway epithelial cell injury induced by invasion of Candida albicans with different biofilm formation abilities. Methods: Twenty-five strains of Candida albicans isolated and cultured in General Hospital of Ningxia Medical University from June to December 2019 were selected, and quality control strain SC5314 was used as the standard strain. An in vitro model of Candida albicans biofilm was established, and the biofilm formation ability of different Candida albicans was detected by crystal violet staining and enzyme plate method. The absorbance value at 570 nm (A₅₇₀) was determined by enzyme plate method. A₅₇₀≥0.5, 0.25<A₅₇₀<0.5 and A₅₇₀≤0.25 indicated strong biofilm Candida albicans form (SBF), moderate biofilm Candida albicans form (DRF) and weak biofilm Candida albicans form (WBF), respectively. The gas-liquid phase culture model of human airway epithelial cells was isolated and established in vitro and divided into five groups, including blank control group (n=20), standard strain group (n=20), strong biofilm group (n=19), weak biofilm group (n=17) and fluconazole-resistant group (n=18).The morphology of the epithelial cells was observed by scanning electron microscope (SEM), and the expression of marker protein in the model was detected by immunofluorescence in vitro. The level of lactate dehydrogenase (LDH) in cells was detected by microplate method, and the secretion of β-defensin (hBD2), granulocyte macrophage colony stimulating factor(GM-CSF) and granulocyte colony-stimulating factor (G-CSF) was detected by enzyme-linked immunosorbent assay (ELISA). Results: The strong biofilm strains grew with interlacing mycelia, and very few yeast cells could be seen wrapped in them.SEM observed that the mycelia of epithelial cells in gas-liquid phase culture could actively invade epithelial cells, and the expression of acetylated tubulin and keratin in cilia were significantly reduced, while the expression of Ki67 was down-regulated.The LDH levels in the blank control group, standard strain group, strong biofilm group, weak biofilm group, and fluconazole-resistant group were (12.21±5.68), (46.35±6.35), (18.69±4.38), (12.56±3.69), and (13.48±4.28) U/L, respectively, with statistically significant differences (P<0.001). Compared with standard strain group, LDH level in strong biofilm group, weak biofilm group and fluconazole resistant group were significantly decreased (all P<0.01). The hBD2 levels of the five groups were (26.14±0.77), (56.18±0.83), (30.66±2.59), (29.22±0.48), (28.28±1.56) ng/L, respectively, with statistically significant differences(P<0.001). Compared with the blank control group, SC5314-treated epithelial cells induced an increase of intracellular hBD2 expression (P<0.001). The differences in the expression of GM-CSF and G-CSF between different groups were not statistically significant(all P>0.05). Conclusion: Strong biofilm Candida albican can inhibit cell proliferation, disrupt the integrity of epithelial cells and induce cell damage by down-regulating the expression of cell proliferation-related protein.

[The incidence and causes of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia]

Objective: To observe the incidence of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia and to explore the risk factors for its occurrence. Methods: The data of patients suffered from Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia from June 2018 to May 2021 were retrospectively reviewed. The type of procedure, surgeon, age and gender were selected as matching factors, 4 patients without Tapia syndrome were selected as control group for each case. The radiological parameters including mandibular-vertebral distance, thyroid-vertebral distance, thyroid cartilage-vertebral distance, and C₂-C₇ lordotic Cobb angle were measured on lateral radiographs of the cervical spine. The above parameters were measured on neutral, over-flexion and over-extension radiographs. The difference between the Tapia group and the control group were analyzed. Results: There were 9 patients (0.37%) suffered from Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia in 2 431 patients, and it happened in 0.67 days (0-2 days) after the operation. There were 3 males and 6 females with a mean age of (61±5) years. The clinical manifestations was tongue extension deviation in 8 cases (88.9%), dysarthria in 6 cases (66.7%), dysphagia in 3 cases (33.3%), tongue stiffness in 3 cases (33.3%), hoarseness in voice and pharyngeal discomfort in 1 case (11.1%). All of the symptoms were relieved in all patients at 3 months postoperative follow-up. In neutral position, the mandibular-vertebral distance was (7.19±3.96) mm in the control group and it was (3.98±3.01) mm in Tapia group (P<0.05). From neutral position to hyperflexion position, the distance between mandible and vertebral body was reduced from 3.98 mm to 1.95 mm in the Tapia group and decreased for 51.0%, and it decreased from 7.19 mm for 31.8% to 4.90 mm in the control group. Conclusions: The incidence of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia is low. A smaller mandibular-vertebral distance on pre-operative cervical spine lateral view radiograph maybe a risk factor for Tapia syndrome after posterior cervical surgery under oral tracheal intubation general anesthesia.

[Diagnostic value of serum amyloid A and C-reactive protein for predicting acute aortic dissection]

Objective: To explore the diagnostic value of serum amyloid A (SAA) and C-reactive protein (CRP) for predicting acute aortic dissection (AAD). Methods: One hundred and seventy-five AAD patients and 160 patients with acute coronary syndrome (disease control group) who were admitted to Cardio-cerebrovascular Disease Hospital of General Hospital of Ningxia Medical University from January 2018 to June 2020 were retrospectively selected. Meanwhile, 148 healthy subjects (healthy control group) who underwent physical examination were also enrolled. The latex-enhanced immunoturbidimetric assay and the latex immunoturbidimetric assay were used to determine the serum SAA and CRP levels of all subjects, and related clinical data were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to analyze the independent risk factors, and the receiver operating characteristic (ROC) curve was drawn to calculate the diagnostic value of SAA and CRP for predicting AAD. Results: The levels of SAA and CRP in the AAD patient group ((165.7±7.4) mg/L and (76.0±4.0)mg/L) were significantly higher than those of the healthy control group ((6.5±0.4) mg/L and (3.9±0.2) mg/L) and the disease control group ((27.2±1.3) mg/L and (9.4±3.2) mg/L), with significant differences (all P<0.05). Compared with patients less than 60 years, levels of SAA and CRP in AAD patients over 60 years old decreased ((150.6±12.7) mg/L and (73.9±7.3) mg/L), and there were significant differences (both P<0.05). Likewise, SAA levels in AAD patients with high-risk pain characteristics over 6 h increased compared to those with pain less than 6 h, and there was a significant difference (P<0.05). SAA was positively correlated with CRP (r=0.053 4, P<0.05). ROC analysis showed that SAA and CRP levels were independently related to the risk of AAD (P=0.001), and the ROC curve of SAA for predicting AAD showed that the area under the curve (AUC) of type A aortic dissection (TAAD) and type B aortic dissection (TBAD) were 0.997 and 0.995, respectively (both P<0.001). And the ROC curve of CRP for predicting AAD demonstrated that the AUC of TAAD and TBAD were 0.998 and 0.991, respectively (both P<0.001). The best cut-off values of SAA and CRP for predicting AAD were 175.17 mg/L and 72.96 mg/L, respectively. Conclusion: Increased levels of SAA and CRP have high predictive value for AAD, and SAA combined with CRP is expected to serve as a laboratory marker to assist the diagnosis of AAD.

Acquired aplastic anemia: Is bystander insult to autologous hematopoiesis driven by immune surveillance against malignant cells?

We previously reported a serendipitous finding from a patient with refractory severe aplastic anemia who had gotten an unexpected hematological response to treatment with gut-cleansing preparations (GCPs). This patient experienced three recurrences over the ensuing one year of intermittent GCP treatments, with each recurrence occurring 7-8 wk from a GCP. After his third recurrence, he was prescribed successive treatment with rifampicin, berberine, and monthly administered GCP for 4 mo, and he developed an erythroid proliferative neoplasma and an overwhelming enteropathy, and eventually died of septic shock. Laboratory investigations had validated the resolution of myelosuppression and the appearance of malignant clonal hematopoiesis. From the treatment process and laboratory investigations, it is reasonably inferred that the engagement of gut inflammation is critically required in sustaining the overall pathophysiology of acquired aplastic anemia probably by creating a chronic inflammatory state. Incorporation of rifampicin, berberine, and monthly GCP into cyclosporine can enhance the immunosuppressive effect. In a subgroup of acquired aplastic anemia patients whose pathogenesis is associated with genotoxic exposure, the suppressed normal hematopoiesis may result from the bystander insult that is mediated by the soluble inflammatory cytokines generated in response to the immunogenic products of damaged hematopoietic cells in the context of chronic inflammatory state and may offer a protective antineoplastic mechanism against malignant proliferation.

Severe hyperlipemia-induced pseudoerythrocytosis - Implication for misdiagnosis and blood transfusion: A case report and literature review

BACKGROUND

Severe hyperlipemia (SHLE) has an impact on the results of many kinds of laboratory tests. Complete blood count (CBC) examination by automated blood cell counter (ABCC) is a quick and convenient measurement for screening abnormalities of blood cells that are triggered by various pathogenic insults in disease diagnosis and for monitoring changes in the treatment of existing hematological conditions. However, CBC results are frequently affected by many intrinsic and extrinsic factors from blood samples, such as in the setting of hypergammaglobulinemia and certain anticoagulants. SHLE could also affect CBC results.

CASE SUMMARY

A 33-year-old Chinese male presented with painful foot numbness and abdominal pain. He was initially misdiagnosed as having a myeloproliferative neoplasm (MPN) because of the marked abnormalities in CBC examination by the ABCC. Morphological evaluation of the bone marrow smears and biopsy showed no evidence of MPN. Gene mutations in Breakpoint cluster regions-Abelson murine leukemia viral oncogene homologue 1 (BCR-ABL1), Janus kinase 2 (JAK2), calreticulin (CALR), myeloproliferative leukemia virus (MPL), and colony-stimulating factor 3 receptor (CSF3R) were negative. Having noticed the thick chylomicron layer on blood samples and the dramatically fluctuating CBC results, we speculated that the fat droplets formed by shaking the blood samples in the setting of SHLE were mistakenly identified as blood cells due to the limited parameters of ABCC. Therefore, we removed a large part of the chylomicron layer and then reexamined the CBC, and the CBC results, as we expected, differed significantly from that of the sample before the chylomicron layer was removed. These significant differences had been validated by the subsequently repeated laboratory tests by measuring dual blood samples that the chylomicron layer was removed in one sample and was not in another, and comparing the CBC results. Computerized tomography reexamination of the upper abdomen revealed an exudative lesion surrounding his pancreas. After intensive consultation, definitive diagnosis was made as recurrent pancreatitis, hyperlipemia and pseudoerythrocytosis.

CONCLUSION

SHLE may become a potential cause of misdiagnosis of hyperlipemia-related diseases as MPNs and the resultant mistreatment. It may also lead to the misinterpretation of transfusion indications in patients with hematological disorders who critically need blood transfusion for supportive treatment.

Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature

BACKGROUND

Cumulative evidence suggests that the aberrant immune responses in acquired aplastic anemia (AA) are sustained by active chronic infections in genetically susceptible individuals. Recently, the constant source to trigger and sustain the pathophysiology has been proposed to come from the altered gut microbiota and chronic intestinal inflammation. In this case, our serendipitous finding provides convincing evidence that the persistently dysregulated autoimmunity may be generated, at least in a significant proposition of AA patients, by the altered gut microbiota and compromised intestinal epithelium.

CASE SUMMARY

A 30-year-old Chinese male patient with refractory severe AA experienced a 3-month-long febrile episode, and his fever was refractory to many kinds of injected broad-spectrum antibiotics. When presenting with abdominal cramps, he was prescribed oral mannitol and gentamycin to get rid of the gut infection. This treatment resulted in a quick resolution of the fever. Unanticipatedly, it also produced an excellent hematological response. He had undergone three episodes of recurrence within the one-year treatment, with each recurrence occurring 7-8 wk from the gastrointestinal inflammation eliminating preparations. However, subsequent treatments were able to produce subsequent remissions and consecutive treatments were successful in achieving durative hematological improvements, strongly indicating an etiological association between chronic gut inflammation and the development of AA. Interestingly, comorbid diseases superimposed on this patient (namely, psychiatric disorders, hypertension, insulin resistance, and renal dysfunction) were ameliorated together with the hematological improvements.

CONCLUSION

Chronic gut inflammation may be responsible for AA pathogenesis. The comorbidities and AA may share a common etiological association.

Antidepressant Drugs Correct the Imbalance Between proBDNF/p75NTR/Sortilin and Mature BDNF/TrkB in the Brain of Mice with Chronic Stress

Depression is a worldwide problem with a great social and economic burden in many countries. In our previous research, we found that the expression of proBDNF/p75NTR/sortilin is upregulated in patients with major depressive disorder. In addition, the treatment of proBDNF antibodies reversed both the depressive behaviors and the reduced BDNF mRNA detected in our rodent chronic stress models. Antidepressant drugs are usually only effective in a subpopulation of patients with major depression with a delayed time window of 2-4 weeks to exert their efficacy. The mechanism underlying such delayed response is not known. In this study, we hypothesize that antidepressant drugs exert their therapeutic effect by modulating proBDNF/p75NTR and mature BDNF/TrkB signaling pathways. To test the hypothesis, C57 mice were randomly divided into normal control, chronic unpredictable mild stress (CUMS), vehicle (VEH), fluoxetine (FLU), and clozapine (CLO) groups. Behavioral tests (sucrose preference, open field, and tail suspension tests) were performed before and after 4 weeks of CUMS. The gene and protein expression of proBDNF, the neurotrophin receptor (p75NTR), sortilin, and TrkB in the cortex and hippocampus were examined. At the protein level, CUMS induced a significant increase in proBDNF, p75NTR, and sortilin production while the TrkB protein level was found to be lower in the cortex and hippocampus compared with the control group. Consistently, at the mRNA level, p75NTR expression increased with reduced BDNF/TrkB mRNA in both cortex and hippocampus, while sortilin increased only in the hippocampus after CUMS. FLU and CLO treatments of CUMS mice reversed all protein and mRNA expression of the biomarkers in both cortex and hippocampus, except for sortilin mRNA in the cortex and proBDNF in the hippocampus, respectively. This study further confirms that the imbalance between proBDNF/p75NTR/sortilin and mBDNF/TrkB production is important in the pathogenesis of depression. It is likely that antidepressant FLU and antipsychotic CLO exert their antidepressant-like effect correcting the imbalance between proBDNF/p75NTR/sortilin and mBDNF/TrkB.

Efficacy and safety of basic fibroblast growth factor in the treatment of burns: Protocol for a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

To systematically evaluate the efficacy and safety of basic fibroblast growth factor (bFGF) in the treatment of burns and to provide evidence-based medical information for clinicians to choose the appropriate treatment measures for burns.

METHODS

Seven databases, including PubMed, the Cochrane Library, Embase, the Chinese Biomedical Literature Database, the Wanfang Database, the China National Knowledge Infrastructure Internet, and the Chongqing Chongqing Weipu Chinese Science and Technology Journal Full-text Database (VIP), were searched by computer. Randomized controlled trials on bFGF in the treatment of burns were collected, and the search was conducted by using a combination of subject terms (MeSH) and free words. The search time limit was from the establishment of each database until January 2019. Two researchers independently screened the literature and extracted the data. According to the evaluation criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions version 5.3.0, they conducted a rigorous bias risk assessment for the included studies, and Stata 12.0 software was used for meta-analysis.

RESULTS

System evaluation and meta-analysis were carried out strictly in accordance with the requirements of the Cochrane Handbook for Systematic Reviews of Interventions version 5.3.0 on meta-analysis and provided a high-quality evaluation of the efficacy and safety of bFGF in the treatment of burns.

CONCLUSION

This study provided conclusions from evidence-based medicine and a scientific basis for the efficacy and safety of bFGF in the clinical treatment of burns.

ETHICS AND DISSEMINATION

This study was not a clinical trial and therefore did not require ethical approval. The results of this study will be published in an SCI academic journal related to this study in the form of a public publication.

PROSPERO REGISTRATION NUMBER

CRD42019124778.

Factors Influencing Rust (Melampsora apocyni) Intensity on Cultivated and Wild Apocynum venetum in Altay Prefecture, China

Rust (Melampsora apocyni) on Apocynum venetum is the major constraint to the commercial development of this medicinal herb. To determine the factors influencing rust intensity (maximum disease index [DI_max]), rust was investigated from 2011 to 2015 in both cultivated and wild A. venetum plants. Partial least squares path modeling (PLS-PM) was used to analyze the paths and extent of the factors related to pathogen, environment, and host that affect rust intensity. DI_max exhibited considerable variations across years and study sites, with variations linked to various factors fostering disease development. PLS-PM explained 80.0 and 70.1% of variations in DI_max in cultivated and wild plants, respectively. Precipitation was the key factor determining DI_max in both cultivated and wild plants (path coefficient [PC] = 0.313 and 0.544, respectively). In addition, the topsoil water content in cultivated plants and the total vegetation coverage in wild plants were also critical determinants of DI_max via their effects on the microclimatic factor (contribution coefficients [CC] = 0.681 and 0.989, respectively; PC = 0.831 and 0.231, respectively). In both cultivated and wild plants, host factors were mainly dominated by A. venetum density (CC = 0.989 and 0.894, respectively), and their effect on DI_max via the microclimatic factor (PC = 0.841 and 0.862, respectively) exceeded that via the inoculum factor (PC = 0.705 and 0.130, respectively). However, the indirect effects led to DI_max variation, while the dilution effect on host (CC = 0.154) from weed in wild plants led to the indirect effect size in wild plants of 0.200, which was lower than -0.699 in cultivated plants.

[Two cases of small cell neuroendocrine carcinoma of nose and paranasal sinuses]

The main symptoms were nasal obstruction and epistaxis. Nasal endoscope examination showed a pinkish mass in nasal cavity. CT and MRI scan revealed a large mass in nasal cavity, extending into the anterior cranial fossa. Pathological examinations confirmed as small cell neuroendocrine carcinoma.

Prognostic significance of placenta growth factor expression in patients with multiple cancers: a meta-analysis

BACKGROUND

Placenta growth factor (PLGF) is a member of the vascular endothelial growth factor (VEGF) family which is associated with the progression and metastasis of cancer. However, whether it can be used to predict prognosis in multiple cancer is still inconsistent.

METHODS

A meta-analysis was performed by searching electronic databases updated to December 2014. Eligible studies which evaluated the relationship between PLGF expression level and survival of patients with multiple cancers were conducted. Overall survival (OS), progression-free survival (PFS), hazard ratio (HR), and 95% confidence intervals (CI) were calculated.

RESULTS

Nineteen studies with a variety of cancers were included for the meta-analysis. Combined HR suggested that high expression of PLGF significantly associated with a poor OS (HR=1.69, 95% CI, 1.32-2.16), and PFS (HR=1.8, 95% CI, 1.33-2.44) in patients with different cancers. Moreover, a subgroup analysis based on cancer type demonstrated that high expression level of PLGF predict poor OS in both digestive system carcinoma (HR=1.63, 95% CI, 1.21-2.19; I(2)=80.7%, P<0.001) and respiratory system tumor (HR=1.75, 95% CI, 1.28-2.41; I(2)=0.0%, P=0.394). For PFS, the similar result was found in respiratory system tumor (HR=1.64, 95% CI, 1.23-2.19; I(2)=0.0%, P=0.807), but not in digestive system carcinoma (HR=1.81, 95% CI, 0.93-3.52; I(2)=80.2%, P<0.001).

CONCLUSION

Our meta-analysis demonstrates that PLGF might be regarded as a poor prognostic fact for multiple cancers. More large-scale and well-designed studies are still needed to strengthen our findings.

Effect of 5-aza-2'-deoxycytidine combined with trichostatin A on RPMI-8226 cell proliferation, apoptosis and DLC-1 gene expression

This study was aimed to investigate the effects of the DNA methylation inhibitor 5-aza-2'-deoxycytidine (5-Aza-CdR) and histone deacetylase inhibitor trichostatin A (TSA) on DLC-1 gene transcription regulation and molecular biological behaviours in the human multiple myeloma RPMI-8226 cells. The cells were treated respectively with 5-Aza-CdR and TSA alone, or the both combination; the cell proliferation and apoptosis, DLC-1 expression, the protein expression of Ras homolog family member A (RhoA) and Ras-related C3 botulinum toxin substrate 1 (Rac1) were examined by CCK-8 method, RT-PCR and ELISA, respectively. The results showed that the 5-Aza-CdR and TSA had cell growth inhibitory and apoptosis-inducing effects in dose-dependent manner (P < 0.05). Compared with a single drug (5-Aza-CdR or TSA alone), the effects were significantly enhanced after treatment with the combination of 5-Aza-CdR and TSA (P < 0.05). DLC-1 was weakly expressed in the control group; the treatment with 5-Aza-CdR alone enhanced its re-expression dose-dependently (P < 0.05). Compared with 5-Aza-CdR alone, 5-Aza-CdR plus TSA enhanced DLC-1 re-expression significantly.Compared with the control, 5-Aza-CdR and TSA significantly decreased RhoA and Rac1 protein expression (P < 0.05). It is concluded that 5-Aza-CdR and TSA can effectively reverse DLC-1 expression of RPMI-8226 cells; TSA has a synergistic effect on its re-expression. 5-Aza-CdR and TSA have significant cell growth inhibitory and apoptosis-inducing effects on RPMI-8226 cells. These effects may be related to the inhibition of Rho/Rho kinase signalling pathway.

[Analysis of the epidemic characteristics of fever and thrombocytopenia syndrome in Henan province, 2007 - 2011]

OBJECTIVE

To analyze the epidemiological characteristics of fever thrombocytopenia and leukopenia syndrome (FTLS) in Henan province, China in 2007 - 2011.

METHODS

Data from specific surveillance system for FTLS in Henan and Information Management System of Chinese Center for Disease Control and Prevention were used to collect the information of the cases.Descriptive epidemiological methods were used to analyze the surveillance data during 2007 - 2011. Patients' sera were collected to detect new bunyavirus using fluorescent RT-PCR and virus isolation.

RESULTS

During 2007 - 2011, 1021 FTLS cases were reported in Henan province. The fatality rate was 2.25%with 23 deaths. The cases reported in Xinyang city were 1007, accounting for 98.75%.Cases were mainly occurred between April and October, accounting for 96.47% (985/1021). Epidemic peak was May to July, accounting for 59.16% (604/1021). The second peak occurred in September, accounting for 12.05% (123/1021). The age of the cases ranged from 1 to 88 years old with the median age of 59. Sex ratio (male:female) was 1:1.50 (408:613). In all cases, 93.73% (957/1021) were farmers. In 465 patients' sera, the positive rate of new bunyavirus was 69.25% (322/465) using fluorescent RT-PCR. In 164 patients' sera, 67 strains of new bunyavirus were isolated with isolation rate of 40.85% (67/164).

CONCLUSION

FTLS in Henan province is caused mainly by the new bunyavirus and has certain regional and seasonal characteristics. Most cases are female older farmers.

Nanosecond field-induced quenching of the luminescence from Er-doped silicon nanocrystals

Er-doped Si-rich SiO2 gate oxide layers containing silicon nanocrystals are prepared by implantation of Si+ and Er+ into SiO2 thin films. The photoluminescence from both Si nanocrystals around 700-850 nm and Er3+ ions at 1.54 microm is strongly quenched by applying electric field in the Si-rich oxide layer. The quenching time and the recovery time of the photoluminescence from Si nanocrystals are less than 50 ns under pulsed field modulation. The quenching rate of the luminescence increases with increasing the density and reducing the size of the silicon nanocrystals. Our results indicate that the fast quenching process originates from the quantum confined Stark effect and enhanced exciton ionization by carrier tunneling between the silicon nanocrystals under the high electric field.

[Cloning and expression analysis of ZFP207 encoding a TFA-type zinc finger protein in rice]

The zinc finer proteins consist of a large transcription factor family involved in plant development and responses to environmental stresses. In this paper, a TFA-type zinc finger protein gene ZFP207 (GenBank assession number AK063147.1) was cloned from rice variety Jiucaiqing by RT-PCR approach. This gene contains an open reading frame (ORF) of 567 bp, which encodes a peptide of 188 amino acid residues. The isoelectric point (pI) of the protein is 9.67, and its molecular weight is 20.72 kDa. Bioinformatic analysis showed that the ZFP207 protein comprises a typical TFA-type zinc finger domain and an EAR-motif at its C-terminus. However, nuclear localization signals (NLS) commonly existing in TFA-type zinc finger proteins was not found in the ZFP207 amino acid sequence. In addition, based on the alignments of the whole amino acid sequences of some known TFA-type zinc finger proteins in plants, a phylogenetic tree was con-structed by the neighbour joining method. The phylogenetic tree showed that ZFP207 and other TFA-type zinc finger proteins with single zinc finger domain were grouped into the same branch. The expression pattern of ZFP207 gene was also investigated in various rice tissues at adult stage by RT-PCR and the results showed that ZFP207 was expressed with high levels in culms and leaves, but lower in roots and spikes. Finally, the trans-activation assay in yeast cells revealed that ZFP207 lacked the trans-activation activity.

Fluorescence in situ hybridization analysis of chromosome 12 anomalies in semen cells from patients with carcinoma in situ of the testis

Carcinoma in situ (CIS) of the testis is the precursor of seminomas and non-seminomatous germ cell tumours of the adult testis. A marked cytogenetic anomaly, the isochromosome of the short arm of chromosome 12 [i(12p)], has been demonstrated in over 80 per cent of all histological varieties of testicular germ cell tumours (TGCTs). In the remaining group of i(12p)-negative TGCTs, an overrepresentation of chromosome 12p sequences has been found. The i(12p) chromosome and overrepresentation of 12p sequences in CIS cells have also been reported. In order to establish whether numerical and/or structural aberrations of chromosome 12 can be found in CIS cells exfoliated into seminal fluid, semen specimens from ten patients with CIS lesions were investigated using bicolour double fluorescence in situ hybridization (FISH). The two DNA probes used, p alpha 12H8 and YAC 5, specifically detect the centromeric region of chromosome 12 and a subregion, p11.2-p12.1, on the short arm of chromosome 12, respectively. Ejaculates of ten azoospermic or oligozoospermic infertile males, presumably CIS-free, were used as negative controls. Nuclei exhibiting three or more chromosome 12 signals were found to be present in a significantly larger number in the patient samples than in the control samples. Nuclei with five or more chromosome 12 signals were observed in eight out of the ten patients. Morphologically similar arrangements to i(12p) were observed in some of the ejaculates. These results demonstrate the potential of FISH in the early detection of CIS and TGCTs in males at high risk.

Detection and enrichment of carcinoma-in-situ cells in semen by an immunomagnetic method using monoclonal antibody M2A

Carcinoma-in-situ (CIS) is a precursor of germ cell cancers in the testis. Early detection and treatment of CIS can prevent the development of invasive cancer. We have developed an immunomagnetic approach for enrichment of CIS cells from semen. Immunomagnetic beads were coated with monoclonal antibody (mAb) M2A, which is specific for seminoma and CIS. In preliminary mixing experiments, cultured human HEY cells, which express the M2A surface antigen, were added to semen samples and recovered selectively by incubation with M2A-coated immunomagnetic beads followed by magnetic activated cell sorting (MACS). Application of this procedure to ejaculates from five subjects with CIS and 22 control subjects with no evidence of testicular neoplasia resulted in the preferential recovery of a population of large round cells from a 0.5 ml semen sample obtained from CIS subjects (median 1 x 10(4), range 2 x 10(3) to 2 x 10(4)) relative to controls (median 2 x 10(2); range 0 to 10(3)), with no overlap between the two groups (p < 0.001). These results suggest that a subpopulation of large round cells recovered from the semen of CIS patients by incubation with M2A-coated immunomagnetic beads and MACS are CIS cells. Immunomagnetic enrichment of CIS cells in semen will facilitate the definitive identification of exfoliated CIS cells in ejaculates and could be an important first step in a non-invasive screening procedure for testicular CIS.

Investigation of carcinoma in situ cells of testis by quantification of argyrophilic nucleolar organizer region associated proteins (AgNORs)

The silver staining which specifically stains argyrophilic proteins (AgNORs) in interphase nuclei was applied to paraffin sections of 24 testicular specimens with carcinoma in situ (CIS). AgNOR area per nucleus was quantified by a computerized image analyser. Significant quantitative differences were found between CIS, Sertoli cells, and spermatogonia (P = 0.0001), with median values of 10.3, 2.8, and 1.4 microns2 in the three cell types, respectively. A Sertoli cell index (SCI), defined as the ratio between AgNORs in CIS or spermatogonia and Sertoli cells, was shown to be significant in the differential diagnosis of CIS cells from spermatogonia when 1.0 was used as the cut-off value (CIS > 1; spermatogonia < 1). Furthermore, CIS associated with non-seminoma was found to have a significantly higher level of AgNORs than CIS associated with pure seminoma (P < 0.01), indicating that subclonal variation in transformation potential might be present within morphologically identical CIS of the testis. It remains to be seen whether quantification of AgNORs in isolated CIS could be used to predict transformation of CIS into seminoma or non-seminoma.

Sperm morphology using strict criteria after Percoll density separation: influence on cleavage and pregnancy rates after in-vitro fertilization

The main purpose of the study was to evaluate the use of sperm morphology assessment by strict criteria on the post-Percoll separated spermatozoa used for oocyte insemination in an in-vitro fertilization programme. This study included a consecutive unselected series of 213 oocyte aspirations in 159 women. In 177 aspirations the patient had tubal infertility and in 36 unexplained infertility. Data have been analysed from 197 aspirations where the semen sample used for insemination had a normal sperm concentration (> or = 20 x 10(6)/ml). A total of 1413 oocytes were aspirated, resulting in 863 oocytes which were fertilized and cleaved (cleavage rate 61%). In all, 492 pre-embryos were transferred in 193 cycles, resulting in a pregnancy rate of 42% per transfer. Sperm morphology evaluation using strict criteria showed that Percoll separation significantly increased the percentage of sperm cells with normal morphology from 7.7 to 11.3%. Sperm morphology analysis showed that Percoll separation decreased the number of sperm samples in the 'poor prognosis pattern' group from 31 to 13% and increased the number of sperm samples classified as 'normal' from 16 to 33%. After Percoll separation the poor prognosis pattern group had a cleavage rate of 46%, which was significantly lower than in the good prognosis pattern and the normal groups. However, the poor prognosis pattern group had a significantly higher pregnancy rate than the normal group (P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Low implantation rate after in-vitro fertilization in patients with hydrosalpinges diagnosed by ultrasonography

The purpose of this study was to assess whether patients with tubal infertility and a hydrosalpinx have a reduced implantation rate after in-vitro fertilization. The study included 741 patients who had 1190 consecutive oocyte aspirations. The presence or absence of hydrosalpinges was assessed by transvaginal ultrasonography on day 2 of all cycles. In 62 patients treated in 104 cycles a hydrosalpinx was diagnosed, whereas 493 patients treated in 813 cycles had no hydrosalpinx and eight patients treated in 16 cycles had uncertain hydrosalpinx. The results show that the presence of a hydrosalpinx is associated with a reduced pregnancy rate per aspiration (19.2 versus 32.6%; P < 0.01), reduced implantation rate (2.9 versus 10.3%, P < 0.0005), reduced delivery rate per aspiration (5.8 versus 20.9%, P < 0.0005), reduced delivery rate per embryo transfer (6.6 versus 22.8%, P < 0.0005) and increased early pregnancy loss (70 versus 36%, P < 0.005). Among 178 patients with unexplained infertility or other infertility factors treated with 257 aspirations the results were similar to those in patients with tubal infertility without a hydrosalpinx. In conclusion, the presence of a hydrosalpinx does not impair the number of embryos transferred but seems to impair the implantation process. We hypothesize that this may be due to leakage of fluid into the uterine cavity which may disturb the receptivity of the endometrium and/or the developing embryos.