Polylactic acid electrospun membrane loaded with cerium nitrogen co-doped titanium dioxide for visible light-triggered antibacterial photocatalytic therapy

Wound infection caused by multidrug-resistant bacteria poses a serious threat to antibiotic therapy. Therefore, it is of vital importance to find new methods and modes for antibacterial therapy. The cerium nitrogen co-doped titanium dioxide nanoparticles (N-TiO2, 0.05Ce-N-TiO2, 0.1Ce-N-TiO2, and 0.2Ce-N-TiO2) were synthesized using the hydrothermal method in this study. Subsequently, electrospinning was employed to fabricate polylactic acid (PLA) electrospun membranes loaded with the above-mentioned nanoparticles (PLA-N, PLA-0.05, PLA-0.1, and PLA-0.2). The results indicated that cerium and nitrogen co-doping tetrabutyl titanate enhanced the visible light photocatalytic efficiency of TiO2 nanoparticles and enabled the conversion of ultraviolet light into harmless visible light. The photocatalytic reaction under visible light irradiation induced the generation of ROS, which could effectively inhibit the bacterial growth. The antibacterial assay showed that it was effective in eliminating S. aureus and E. coli and the survival rates of two types of bacteria under 30 min of irradiation were significantly below 20% in the PLA-0.2 experimental group. Moreover, the bactericidal membranes also have excellent biocompatibility performance. This bio-friendly and biodegradable membrane may be applied to skin trauma and infection in future to curb drug-resistant bacteria and provide more alternative options for antimicrobial therapy.

Research on duck egg recognition algorithm based on improved YOLOv4

1. The following study addressed the problem of small duck eggs as challenging to detect and identify for pick up in complex free-range duck farm environments. It introduces improvements to the YOLOv4 convolutional neural network target detection algorithm, based on the working conditions of egg-picking robots.2. Specifically, one scale of anchor boxes was removed from the prediction network, and a duck egg labelling dataset was established to make the improved algorithm YOLOv4-ours better match the working state of egg-picking robots and enhance detection performance.3. Through multiple comparative experiments, the YOLOv4-ours object detection algorithm exhibited superior overall performance, achieving a precision of 98.85%, recall of 96.67%, and an average precision of 98.60% and F1 score increased to 97%. Compared to the original YOLOv4 model, these improvements represented increases of 1.89%, 3.41%, 1.32%, and 1.04%, respectively. Furthermore, detection time was reduced from 0.26 seconds per image to 0.20 seconds.4. The enhanced model accurately detected duck eggs in free-range duck housing, effectively meeting the real-time egg identification and picking requirements.

High-sensitivity immunoassay on interdigitated electrode to detect osteoporosis biological marker

Osteoporosis is with porous bones, which refers to a decrease in the bone mineral density and weakens the bones to become brittle. Osteoporosis often progresses without any pain or symptoms until the bone fractures. Monitoring the condition of bone regularly helps to identify the bone that weakens at its earlier stages. In general, radiological techniques have been used to measure bone mineral density, are expensive, and the procedures are complicated. Therefore, researchers are focusing on the alternative method of biomarker quantification to identify bone mineral density. This research work was focused on quantifying the osteoporosis biomarker of C-terminal telopeptide of type I collagen (CTX-I) on an interdigitated electrode (IDE) sensor. Gold nanomaterial-modified anti-CTX-I antibody was attached to silica nanomaterial-decorated IDE and then identified by CTX-I interaction. Higher immobilization of antibodies was recorded on diamond-modified IDE through gold nanoparticles, and detected CTX-I as low as 0.5 pg/mL [y = 1.5507x - 0.9043 R2 = 0.9715], determined on a linear curve at the range 0.5-3.5 ng/mL. Further, specific identification of CTX-I was confirmed by control performances with osteopontin, IL-6, and anti-IgG antibody.

An early screening model for preeclampsia: utilizing zero-cost maternal predictors exclusively

To provide a reliable, low-cost screening model for preeclampsia, this study developed an early screening model in a retrospective cohort (25,709 pregnancies) and validated in a validation cohort (1760 pregnancies). A data augmentation method (α-inverse weighted-GMM + RUS) was applied to a retrospective cohort before 10 machine learning models were simultaneously trained on augmented data, and the optimal model was chosen via sensitivity (at a false positive rate of 10%). The AdaBoost model, utilizing 16 predictors, was chosen as the final model, achieving a performance beyond acceptable with Area Under the Receiver Operating Characteristic Curve of 0.8008 and sensitivity of 0.5190. All predictors were derived from clinical characteristics, some of which were previously unreported (such as nausea and vomiting in pregnancy and menstrual cycle irregularity). Compared to previous studies, our model demonstrated superior performance, exhibiting at least a 50% improvement in sensitivity over checklist-based approaches, and a minimum of 28% increase over multivariable models that solely utilized maternal predictors. We validated an effective approach for preeclampsia early screening incorporating zero-cost predictors, which demonstrates superior performance in comparison to similar studies. We believe the application of the approach in combination with high performance approaches could substantially increase screening participation rate among pregnancies. Machine learning model for early preeclampsia screening, using 16 zero-cost predictors derived from clinical characteristics, was built on a 10-year Chinese cohort. The model outperforms similar research by at least 28%; validated on an independent cohort.

An Entity Extraction Pipeline for Medical Text Records Using Large Language Models: Analytical Study

BACKGROUND

The study of disease progression relies on clinical data, including text data, and extracting valuable features from text data has been a research hot spot. With the rise of large language models (LLMs), semantic-based extraction pipelines are gaining acceptance in clinical research. However, the security and feature hallucination issues of LLMs require further attention.

OBJECTIVE

This study aimed to introduce a novel modular LLM pipeline, which could semantically extract features from textual patient admission records.

METHODS

The pipeline was designed to process a systematic succession of concept extraction, aggregation, question generation, corpus extraction, and question-and-answer scale extraction, which was tested via 2 low-parameter LLMs: Qwen-14B-Chat (QWEN) and Baichuan2-13B-Chat (BAICHUAN). A data set of 25,709 pregnancy cases from the People's Hospital of Guangxi Zhuang Autonomous Region, China, was used for evaluation with the help of a local expert's annotation. The pipeline was evaluated with the metrics of accuracy and precision, null ratio, and time consumption. Additionally, we evaluated its performance via a quantified version of Qwen-14B-Chat on a consumer-grade GPU.

RESULTS

The pipeline demonstrates a high level of precision in feature extraction, as evidenced by the accuracy and precision results of Qwen-14B-Chat (95.52% and 92.93%, respectively) and Baichuan2-13B-Chat (95.86% and 90.08%, respectively). Furthermore, the pipeline exhibited low null ratios and variable time consumption. The INT4-quantified version of QWEN delivered an enhanced performance with 97.28% accuracy and a 0% null ratio.

CONCLUSIONS

The pipeline exhibited consistent performance across different LLMs and efficiently extracted clinical features from textual data. It also showed reliable performance on consumer-grade hardware. This approach offers a viable and effective solution for mining clinical research data from textual records.

Investigating the Impact of Prompt Engineering on the Performance of Large Language Models for Standardizing Obstetric Diagnosis Text: Comparative Study

BACKGROUND

The accumulation of vast electronic medical records (EMRs) through medical informatization creates significant research value, particularly in obstetrics. Diagnostic standardization across different health care institutions and regions is vital for medical data analysis. Large language models (LLMs) have been extensively used for various medical tasks. Prompt engineering is key to use LLMs effectively.

OBJECTIVE

This study aims to evaluate and compare the performance of LLMs with various prompt engineering techniques on the task of standardizing obstetric diagnostic terminology using real-world obstetric data.

METHODS

The paper describes a 4-step approach used for mapping diagnoses in electronic medical records to the International Classification of Diseases, 10th revision, observation domain. First, similarity measures were used for mapping the diagnoses. Second, candidate mapping terms were collected based on similarity scores above a threshold, to be used as the training data set. For generating optimal mapping terms, we used two LLMs (ChatGLM2 and Qwen-14B-Chat [QWEN]) for zero-shot learning in step 3. Finally, a performance comparison was conducted by using 3 pretrained bidirectional encoder representations from transformers (BERTs), including BERT, whole word masking BERT, and momentum contrastive learning with BERT (MC-BERT), for unsupervised optimal mapping term generation in the fourth step.

RESULTS

LLMs and BERT demonstrated comparable performance at their respective optimal levels. LLMs showed clear advantages in terms of performance and efficiency in unsupervised settings. Interestingly, the performance of the LLMs varied significantly across different prompt engineering setups. For instance, when applying the self-consistency approach in QWEN, the F1-score improved by 5%, with precision increasing by 7.9%, outperforming the zero-shot method. Likewise, ChatGLM2 delivered similar rates of accurately generated responses. During the analysis, the BERT series served as a comparative model with comparable results. Among the 3 models, MC-BERT demonstrated the highest level of performance. However, the differences among the versions of BERT in this study were relatively insignificant.

CONCLUSIONS

After applying LLMs to standardize diagnoses and designing 4 different prompts, we compared the results to those generated by the BERT model. Our findings indicate that QWEN prompts largely outperformed the other prompts, with precision comparable to that of the BERT model. These results demonstrate the potential of unsupervised approaches in improving the efficiency of aligning diagnostic terms in daily research and uncovering hidden information values in patient data.

Multi-stimuli responsive photonic hydrogel based on a novel photonic crystal template containing gold nanorods

Multi-stimuli responsive photonic hydrogels (MRPHs) fabricated by doping nanoparticles into hydrogels show promising potential value in the fields of visual detection and drug delivery. However, complicated surface chemical modification is selected to improve the compatibility between nanoparticles and a pre-gel solution of hydrogel. Herein, we developed a simple and convenient vertical deposition method to prepare a novel photonic crystal (PC) template containing gold nanorods (Au NRs) (Au NRs/PC template), which could respond to near-infrared (NIR) light due to the conversion capability of Au NRs from NIR light to heat. Additionally, carboxyl groups on the surface of polystyrene (PS) colloids endowed the Au NRs/PC template with pH-stimulus responsiveness. Based on the Au NRs/PC template, MRPH film was fabricated by infiltrating the pre-gel solution of poly(N-isopropylacrylamide) (PNIPAM) hydrogel into the gap of a 'sandwich' structure through capillary forces and then polymerizing at 25 °C for 24 h. The obtained MRPH film could respond to NIR light, pH and temperature. Under the irradiation of NIR light, only the irradiated position lost structural color while the film volume had no distinct change. With the increase of ambient temperature, the whole MRPH film completely lost structural color and shrank significantly, which was greatly different from the phenomenon irradiated by NIR light. Besides, the structural color of the MRPH film exhibited a red shift from green to orange-red as the pH increased. Overall, both the Au NRs/PC template and the MRPH film may have potential applications in visual detection, due to their multi-stimuli responsiveness.

Tracing the evolving dynamics and research hotspots of microbiota and immune microenvironment from the past to the new era

Gut microbiota can regulate many physiological processes within gastrointestinal tract and other distal sites. Dysbiosis may not only influence chronic diseases like the inflammatory bowel disease (IBD), metabolic disease, tumor and its therapeutic efficacy, but also deteriorate acute injuries. This article aims to review the documents in this field and summarize the research hotspots as well as developing processes. Gut microbiota and immune microenvironment-related documents from 1976 to 2022 were obtained from the Web of Science Core Collection database. Bibliometrics was used to assess the core authors and journals, most contributive countries and affiliations together with hotspots in this field and keyword co-occurrence analysis. Data were visualized to help comprehension. Nine hundred and twelve documents about gut microbiota and immune microenvironment were retrieved, and the annual publications increased gradually. The most productive author, country, and affiliation were "Zitvogel L," USA and "UNIV TEXAS MD ANDERSON CANC CTR," respectively. FRONTIERS IN IMMUNOLOGY, CANCERS, and INTERNATIONAL JOURNAL OF MOLECULAR SCIENCE were the periodicals with most publications. Keyword co-occurrence analysis identified three clusters, including gut microbiota, inflammation, and IBD. Combined with the visualized analysis of documents and keyword co-occurrence as well as literature reading, we recognized three key topics of gut microbiota: cancer and therapy; immunity, inflammation and IBD; acute injuries and metabolic diseases. This article revealed researches on gut microbiota and immune microenvironment were growing. More attention should be given to the latest hotspots like gut microbiota, inflammation, IBD, cancer and immunotherapy, acute traumas, and metabolic diseases.IMPORTANCEGut microbiota can regulate many physiological processes within gastrointestinal tract and other distal sites. Dysbiosis may not only influence chronic diseases like inflammatory bowel disease (IBD), metabolic disease, tumor and its therapeutic efficacy, but also deteriorate acute injuries. While the application of bibliometrics in the field of gut microbiota and immune microenvironment still remains blank, which focused more on the regulation of the gut microbiota on the immune microenvironment of different kinds of diseases. Here, we intended to review and summarize the presented documents in gut microbiota and immune microenvironment field by bibliometrics. And we revealed researches on gut microbiota and immune microenvironment were growing. More attention should be given to the latest hotspots like gut microbiota, inflammation, IBD, cancer and immunotherapy, acute traumas, and metabolic diseases.

How Effective are Metal Nanotherapeutic Platforms Against Bacterial Infections? A Comprehensive Review of Literature

The emergence of multidrug-resistant bacteria has been deemed a global crisis that affects humans worldwide. Novel anti-infection strategies are desperately needed because of the limitations of conventional antibiotics. However, the increasing gap between clinical demand and antimicrobial treatment innovation, as well as the membrane permeability obstacle especially in gram-negative bacteria fearfully restrict the reformation of antibacterial strategy. Metal-organic frameworks (MOFs) have the advantages of adjustable apertures, high drug-loading rates, tailorable structures, and superior biocompatibilities, enabling their utilization as drug delivery carriers in biotherapy applications. Additionally, the metal elements in MOFs are usually bactericidal. This article provides a review of the state-of-The-art design, the underlying antibacterial mechanisms and antibacterial applications of MOF- and MOF-based drug-loading materials. In addition, the existing problems and future perspectives of MOF- and MOF-based drug-loading materials are also discussed.

Research for correlation between heart rate variability parameters and bone mineral density in patients of type 2 diabetes mellitus

PURPOSE

The relationship of CAN and BMD, fracture risk is still unclear in T2DM. The aim of the present study is to investigate the correlation between heart rate variability (HRV) and BMD in T2DM.

METHODS

The study included 276 patients with T2DM aged ≥ 50 years, and Cardiovascular Autonomic Reflex Tests (CARTs) were applied to divide patients into two groups: CAN ( ±). 24 h Ambulatory ECG was assessed for HRV, BMD was measured by dual-energy X-ray bone densitometry, and FRAX scores were calculated for 10-year hip fracture risk (HF¹) and major osteoporotic fracture risk (MOF). Adjusted regression analysis was performed to investigate influence factors for BMD and fracture risk. ROC curve was used to analyze the optimal cut-off point of LF/HF for screening osteoporosis.

RESULTS

Baseline data showed significant differences in the duration of T2DM, insulin resistance index (HOMA-IR), 25-hydroxyvitamin D[25(OH)D], femoral neck BMD, hip BMD, lumbar BMD, HF¹, and MOF between the CAN ( +) and CAN (-) groups. The proportion of patients with osteoporosis increased as the degree of CAN lesion increased. Correlation analysis showed that LF/HF was significantly correlated with BMD, especially with hip (r = - 0.534, p < 0.001). Regression analysis showed that LF/HF was a risk factor for reduced BMD and increased fracture risk. The optimal cut-point value for LF/HF to predict osteoporosis by ROC curve analysis was 3.17.

CONCLUSIONS

CAN is associated with reduced BMD and increased fracture risk in patients with T2DM, and LF/HF may have the potential to be a predictor of diabetic osteoporosis and have some clinical value in early diagnosis of diabetic osteoporosis and non-traumatic fractures in T2DM.

Recent progress and perspectives on the relationship between hyperuricemia and periodontitis

Periodontitis is one of the most prevalent diseases in oral cavity, which could not merely lead to the destruction of supporting or surrounding tooth structures but also affect the whole-body health such as the digestive and nervous systems. Epidemiological investigations suggested that in some developed countries, more than 45% or even 50% population were suffering from periodontitis. However, the prevalence increases with age remarkably and it is investigated that a high prevalence (>50%) is affecting the elderly who is over 65 years old. There is an increasing interest in the direct and indirect relationships between periodontitis and hyperuricemia. Currently, hyperuricemia has become the second major metabolic disease in modern society and the prevalence of hyperuricemia among adult males and females was 21.7% and 14.4% respectively. As an inflammatory disease associated with various systemic diseases, periodontitis may have certain connections with hyperuricemia. Partial existing research announced that hyperuricemia could act as an inhibitory factor for periodontitis, while other scholars presented that a high uric acid (UA) level was more likely to aggravate inflammatory immune response and lead to more serious tissue destruction. This article provides a detailed and comprehensive overview of the relationship underlying hyperuricemia and periodontitis in the molecular mechanisms. Given the impact of hyperuricemia, this review could provide insight into its comorbidities.

Antibacterial and anti-inflammatory ZIF-8@Rutin nanocomposite as an efficient agent for accelerating infected wound healing

Essentially, wound healing is a complicated physiological process in which there exists an interaction between the organism’s immune regulation and antimicrobial therapy. However, multiple drug-resistant bacteria implicated in chronic non-healing wound are not merely impeding the cure process, but more than a burden on economic and social development. Due to the inefficiency of conventional antibiotics, nanomedicine in the biomedical field is emerging as a prospective anti-infective therapy method. Herein, a novel nano-drug with antibacterial and anti-inflammatory characteristics was synthesized by loading Rutin into zeolitic imidazolate framework-8 (ZIF-8), abided by the principle of electrostatic adsorption. The synthetic ZIF-8 loaded Rutin (ZIF-8@Rutin) was affirmed by testing the changes in the diameter and chemical functional group. Interestingly, the ladened Rutin afforded nanocomposite with anti-inflammatory activity by its antioxidant capacity for the polarization of macrophages. Further, the prepared ZIF-8@Rutin exhibited highly effective antibacterial activity against Escherichia coli and Staphylococcus aureus in vitro. More importantly, it could shorten the infected wound healing process and alleviate the inflammation around the wound in vivo. Also, ZIF-8@Rutin had acceptable cytocompatibility. Thus, ZIF-8@Rutin may become a multifunctional nanomedicine with anti-inflammatory and bactericidal properties to promote infected wound healing.

Upconversion nanoparticles and its based photodynamic therapy for antibacterial applications: A state-of-the-art review

Major medical advances in antibiotics for infectious diseases have dramatically improved the quality of life and greatly increased life expectancy. Nevertheless, the widespread and inappropriate exploitation of antibacterial agents has resulted in the emergence of multi-drug-resistant bacteria (MDR). Consequently, the study of new drugs for the treatment of diseases associated with multi-drug-resistant bacteria and the development of new treatments are urgently needed. Inspiringly, due to the advantages of a wide antimicrobial spectrum, fast sterilization, low resistance, and little damage to host tissues and normal flora, antibacterial photodynamic therapy (APDT), which is based on the interaction between light and a nontoxic photosensitizer (PS) concentrated at the lesion site to generate reactive oxygen species (ROS), has become one of the most promising antibacterial strategies. Recently, a burgeoning APDT based on a variety of upconversion nanoparticles (UCNPs) such as PS and near-infrared (NIR) light has been fully integrated in antibacterial applications and achieved excellent performances. Meanwhile, conjugated nanoparticles have been frequently reported in UCNP design, including surface-modified PS conjugates, antibiotic-PS conjugates, and dual or multiple antibacterial modal PS conjugates. This article provides an overview of the state-of-the-art design and bactericidal effects of UCNPs and their based APDTs. The first part discusses the design and mechanisms for UCNPs currently implemented in biomedicine. The second part focuses on the applications and antimicrobial effects of diverse APDT based on UCNPs in antibacterial-related infectious diseases.

Analysis of reporting quality of clinical practice guidelines/consensuses on metastatic colorectal cancer based on the RIGHT checklist

OBJECTIVE

The current study aimed to assess the reporting quality of the clinical practice guidelines/consensuses on metastatic colorectal cancer based on the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist.

METHODS

We searched China National Knowledge Infrastructure, VIP database, Wanfang Data, Chinese Biological Literature Service System, PubMed, Web of Science, ScienceDirect, Elsevier clinicalkey, BMJ Database, EMBASE, Cochrane Library, World Health Organization Network and other websites. We collected clinical practice guidelines/consensuses on metastatic colorectal cancer with published between 1 January 2017 and 1 April 2021 after release of the RIGHT checklist. Two reviewers extracted the basic information independently and conducted a RIGHT evaluation.

RESULTS

Eighteen guidelines/consensuses were included, 10 from China and 8 from other countries. The average reporting rate was 74.1%±11.2%. Thirteen items had 100% reporting rate, and the reporting rate for items No. 16 (11.1%), 17 (16.7%) and 18b (22.2%) was low. Basic information had the highest reporting rate (100%), whereas review and quality assurance had the lowest (13.9%). The average reporting rate of guidelines/consensuses published in other countries was higher than in China [p=0.005; odds ration (OR) 1.17, 95% confidence interval (CI) 1.07-1.28]. The average reporting rate of the guidelines was higher than that of the consensus statements (p<0.001; OR 1.20, 95% CI 1.10-1.31). The reporting rates of guidelines/consensuses focused on whole body (79.0%±12.7%) were higher than local organ (69.2%±7.3%) metastases (p=0.005; OR 1.14, 95% CI 1.04-1.25).

CONCLUSIONS

The quality of reporting using the RIGHT checklist varied among the guidelines/consensuses on metastatic colorectal cancer. Low-quality items were external review and quality assurance. Developers of guidelines/consensuses should aim to improve the reporting quality in the future.

Extracellular vesicles derived from bone marrow mesenchymal stem cells alleviate neuroinflammation after diabetic intracerebral hemorrhage via the miR-183-5p/PDCD4/NLRP3 pathway

OBJECTIVES

Intracerebral hemorrhage (ICH) induced by diabetes results in further brain injury and nerve cell death. Bone marrow mesenchymal stem cell (BMSC) transplantation contributes to attenuating neurological deficits after ICH. This study investigated the mechanism of extracellular vesicles (EVs) derived from BMSCs in reducing neuroinflammation after diabetic ICH.

METHODS

BMSC-EVs were isolated and identified. The rat model of db/db-ICH was established and the model rats were administered with EVs. miR-183-5p expression in brain tissues of db/db-ICH rats was detected. The brain injury of db/db-ICH rats was evaluated by measuring neurobehavioral score, brain water content and inflammatory factors. BV2 cells were cultured in vitro to establish high-glucose (HG)-Hemin-BV2 cell model. The levels of reactive oxygen species (ROS) and inflammatory factors in BV2 cells were measured, and BV2 cell viability and apoptosis were assessed. The targeting relationship between miR-183-5p and PDCD4 was predicted and verified. The activation of PDCD4/NLRP3 pathway in rat brain tissues and BV2 cells was detected.

RESULTS

miR-183-5p expression was reduced in db/db-ICH rats brain tissues. BMSC-EVs ameliorated cranial nerve function, decreased brain water content and repressed inflammatory response by carrying miR-183-5p. BMSC-EVs mitigated HG-Hemin-BV2 cell injury, reduced ROS level and suppressed inflammatory response. miR-183-5p targeted PDCD4. PDCD4 promoted BV2 cell inflammation by activating the NLRP3 pathway. BMSC-EVs inhibited HG-Hemin-BV2 cell inflammation through the miR-183-5p/PDCD4/NLRP3 pathway, and inhibition of miR-183-5p reversed the protective effect of EVs.

CONCLUSION

BMSC-EVs carried miR-183-5p into db/db-ICH rat brain tissues and repressed the NLRP3 pathway by targeting PDCD4, thus alleviating neuroinflammation after diabetic ICH.

Traumatic fractures in China from 2012 to 2014: a National Survey of 512,187 individuals

The China National Fracture Study has been conducted to provide a national dataset of traumatic fractures across China. A national representative sample of 512,187 individuals was selected. The population-weighted incidence rates, distribution, injury mechanisms, and risk factors for traumatic fractures were identified for various groups of individuals.

INTRODUCTION

The China National Fracture Study (CNFS) has been conducted to provide a comprehensive and up-to-date national dataset of traumatic fractures across China. This study aims to report the national incidences and distributions of traumatic fractures that occurred in 2012, 2013, and 2014 and to analyze the risk factors.

METHODS

A national representative sample of individuals was selected from 24 rural counties and 24 urban cities of 8 provinces using stratified random sampling and the probability proportional to size (PPS) methodology. Participants were interviewed to identify whether they sustained traumatic fractures of the trunk and/or four extremities that had occurred in 2012, 2013, and 2014. The main risk factors associated with traumatic fractures were analyzed by multiple logistic regression models.

RESULTS

A total of 512,187 individuals, including 259,649 males and 252,538 females, participated in the CNFS. The population-weighted incidence rates of traumatic fractures in China were calculated to be 2.5 (95% CI, 2.2-2.8) per 1000 population in 2012, 2.8 (95% CI, 2.5-3.3) in 2013, and 3.2% (95% CI, 2.8-3.6) in 2014. The population-weighted incidence rates of fragility fractures among participants aged 65 years and older were calculated to be 27.4 (95% CI, 21.4-33.4) per 1000 population in 2012, 36.0 (95% CI, 28.6-43.5) in 2013, and 42.4 (95% CI, 34.9-49.9) in 2014. The most common cause of fracture was low-energy injuries, followed by traffic accidents. For all age groups, sleeping less than 7 h was a risk factor for traumatic fractures. Alcohol consumption and previous fracture history were identified as risk factors for adults aged 15 years and over. Cigarette smoking was found to be a risk factor for males aged 15-64 years old. For individuals aged 15-64 years old, underweight incurred a risk effect for males and overweight for females. Alcohol consumption, sleeping less than 7 h per day, living in the central and eastern regions, a body mass index less of than 18.5, and having a previous fracture history were identified as strong risk factors for fragility fractures.

CONCLUSION

The national incidence, distribution, and injury mechanisms for traumatic fractures were revealed in the CNFS. Risk factors were identified for various groups of individuals.

Education intervention for older adults with osteoporosis: a systematic review

BACKGROUND

Various education interventions were developed for preventing or managing OP, but the effects of those interventions on older adults were inconclusive.

PURPOSE

This study evaluated the effectiveness of educational interventions in preventing osteoporosis in older adults. A literature search was performed in MEDLINE (PubMed), Cochrane Library, and CBM (China BioMed Database) from the initial date of each database to Oct 2016.

DATA EXTRACTION

Two investigators independently extracted essential data from qualified studies concerning the settings, population, interventions, follow-ups, and outcomes of interest, namely effects of bone mineral density tests, changes in behavior, knowledge increase, self-efficacy, medication adherence (calcium and vitamin D), and quality of life, respectively.

DATA SYNTHESIS

A total of 17 studies met the inclusion criteria and therefore were included in the current study. The overall quality of the included studies was moderate. We were unable to carry out a meta-analysis due to the heterogeneity of these studies. We fond that compared with control groups, patients' knowledge of osteoporosis increased significantly (p < .05) through all five interventions, which included PowerPoint presentations and discussion, class-based educational programs, osteoporosis self-management courses, revised health belief model and classes, computerized support programs and brush-up courses.

LIMITATION

Studies included in the present study were all conducted in Western countries and only descriptive methods were applied in synthesis due to heterogeneity in interventions and outcomes.

CONCLUSION

Education interventions were effective in preventing osteoporosis in older adults. Future research should focus on approaching this issue quantitatively (i.e., through meta-analysis).

Immunogenicity and safety of an accelerated hepatitis E vaccination schedule in healthy adults: a randomized, controlled, open-label, phase IV trial

OBJECTIVES

This study aimed to evaluate the immunogenicity and safety of a hepatitis E (HE) vaccine using an accelerated vaccination schedule (vaccine doses at 0, 7 and 21 days).

METHODS

A total of 126 participants aged ≥18 years were randomly assigned to receive the hepatitis E virus vaccine in either the accelerated group (0, 7 and 21 days) or the routine group (0, 1 and 6 months). Serology samples were obtained at 0, 21, 28 and 51 days, and 7 months in the accelerated group, or 0, 1, 2 and 7 months in the routine group after the first vaccine injection. Adverse events (AEs) reported during the whole study were analysed.

RESULTS

A total of 126 participants were randomized, 63 for each group. Sixty-two participants in the accelerated group and 63 in the routine group received at least one dose of vaccine; 57 and 63 participants received all three doses and were included in per-protocol set, respectively. In the per-protocol population, at 1 month after the last dose (accelerated group at 51 days versus routine group at 7 months), the seropositive rates were both 100% (57/57 and 63/63, respectively), and the geometric mean concentrations (GMCs) were 8.51 WHO units/mL (95% CI 6.73-10.76) in the accelerated group and 9.67 WHO units/mL (95% CI 7.67-12.20) in the routine group. The ratio of the accelerated group GMC to the routine group GMC was 0.88 (95% CI 0.61-2.17, lower limit of 95% CI > 0.5), indicating that the accelerated vaccination schedule was non-inferior to the routine one. The overall incidence rates of solicited AEs in the accelerated and routine groups were 32.26% (20/62) and 30.16% (19/63), respectively (p 0.800). Most AEs were moderate.

CONCLUSIONS

An accelerated schedule is safe and provides protective antibodies in a shorter time compared with the routine schedule. The accelerated schedule should be recommended to adults who are travelling on short notice to an HE-endemic area or during an HE outbreak (Clinical Trial Registration. NCT03168412).

Combination therapy with parathyroid hormone analogs and antiresorptive agents for osteoporosis: a systematic review and meta-analysis of randomized controlled trials

Combination therapy with parathyroid hormone (PTH) analogs and antiresorptive agents may be more effective than monotherapy for the treatment of osteoporosis. This study aimed to estimate the effectiveness and safety of this combination therapy for osteoporosis. MEDLINE, EMBASE, and Cochrane Library were searched from inception to May 1, 2018, including randomized controlled trials (RCTs) with a duration of at least 6 months on adults with osteoporosis treated with combination therapy versus monotherapy. Outcomes included fractures, bone mineral density (BMD) changes, and adverse events. A meta-analysis was performed using a random-effect model, to estimate risk ratios (RRs) for fractures, and mean differences (MDs) for BMD changes. A total of 19 RCTs and 2177 patients were included. Compared with monotherapy, combination therapy had an advantage of 36% (RR, 0.64; 95% confidence interval (CI), 0.42-0.98) regarding fracture risk reduction. It also appears to improve lumbar spine BMD by 4.06% (95%CI = 2.60-5.53) and total hip BMD by 1.89% (95%CI = 1.25-2.53). No RCT reported an increased risk of serious adverse events. Among patients with osteoporosis, combination therapy was superior to monotherapy regarding improvement of the lumbar spine and total hip BMD, without risk of serious adverse events. Combination therapy also had an advantage over monotherapy on fracture risk reduction. However, owing to the limited sample size, additional larger studies are required to confirm this benefit.

Multichannel continuous-wave fiber cavity ringdown gas sensing utilizing frequency-shifted interferometry

We present a multichannel continuous-wave (CW) fiber cavity ringdown (FCRD) gas sensing method based on frequency-shifted interferometry (FSI). This scheme detects gas concentration by measuring the intensity decay rates of continuous light from different ringdown cavities in the spatial domain, unlike conventional FCRD techniques, which measure the decay rates of pulse light in the time domain. This method shares one CW light source, one slow detector, and one slow data collector. In order to illustrate the theory, acetylene gas concentration measurement in a two-channel FSI-FCRD system was experimentally conducted in the range of 0%-1%. A linear relation was established between concentration and absorption loss, which is proportional to the intensity decay rate, and the measurement resolutions of 3.871%/dB and 3.658%/dB were achieved, respectively. The results reveal that the proposed system has the advantages of low cost, high sensitivity, high precision, and good stability in multichannel gas detection.

Resting-State Functional MRI: Everything That Nonexperts Have Always Wanted to Know

Resting-state fMRI was first described by Biswal et al in 1995 and has since then been widely used in both healthy subjects and patients with various neurologic, neurosurgical, and psychiatric disorders. As opposed to paradigm- or task-based functional MR imaging, resting-state fMRI does not require subjects to perform any specific task. The low-frequency oscillations of the resting-state fMRI signal have been shown to relate to the spontaneous neural activity. There are many ways to analyze resting-state fMRI data. In this review article, we will briefly describe a few of these and highlight the advantages and limitations of each. This description is to facilitate the adoption and use of resting-state fMRI in the clinical setting, helping neuroradiologists become familiar with these techniques and applying them for the care of patients with neurologic and psychiatric diseases.

HIV-1-Induced miR-146a Attenuates Monocyte Migration by Targeting CCL5 in Human Primary Macrophages

MicroRNAs (miRNAs) are widely involved in immune regulation during virus infection. Several studies showed that the expression of miR-146a was increased in human immunodeficiency virus type I (HIV-1)-infected cells, but the definitive function of miR-146a in HIV-1 infection remains obscure. The production of chemokine (C-C motif) ligand 5 (CCL5) in macrophages has been reported to play an important role in HIV/AIDS-associated pathogenesis. In this study, we examined the effects of miR-146a on CCL5 regulation in HIV-1-infected macrophages. Gain and loss of function studies showed that CCL5 might be one of the miR-146a targets, as miR-146a mimic reduced, while miR-146a inhibitor increased CCL5 production in HIV-1-infected macrophages. In addition, we demonstrated that miR-146a reduced CCL5-induced monocyte migration. Our study provided evidence that miR-146a targets CCL5 3' untranslated regions, downregulates its release from macrophages, and affects monocyte migration consequently. These findings drew a novel layer of posttranscriptional control of the chemokine CCL5 by miR-146a during HIV infection, which might contribute to HIV pathogenesis.

Hip fracture patients who experience a greater fluctuation in RDW during hospital course are at heightened risk for all-cause mortality: a prospective study with 2-year follow-up

This study aims to detect whether there remains valuable prognostic information in fluctuation of red cell distribution width (RDW) in hip fracture patients. Results show that this readily available parameter may provide a more effective strategy for assessment of mortality risk, therefore providing a reference for clinical planning and decision-making.

INTRODUCTION

Prognostic values have been found in the fluctuation of some hematologic parameters. The red cell distribution width (RDW) routinely reported with all complete blood cell counts (CBC) has proven to be associated with poor outcomes in various diseases. However, whether the fluctuation in RDW is predictive of long-term mortality in hip fracture patients treated with surgery remains unknown.

METHODS

One thousand three hundred thirty hip fracture patients who underwent surgery from January 1, 2000 to November 18, 2012 were recruited in this prospective cohort study. Fluctuation in the RDW between admission and discharge was measured, and a Kaplan-Meier (KM) analysis and multivariable Cox regression model were applied to evaluate the relationship between this fluctuation and mortality. Risk factors for a larger fluctuation were detected by using Logistic regression analyses.

RESULTS

In addition to the admission RDW, a high RDW level at the time of discharge was also associated with an increased risk of death, while no significant difference was found in the postoperative RDW. Fluctuation in the RDW between admission and discharge was an independent risk predictor for 2-year mortality (HR 1.45 95%CI 1.06-2.00, p = 0.022). Factors affecting the change in the RDW between admission and discharge included both the demographic characteristics of the patients and clinical interventions.

CONCLUSION

Hip fracture patients who experience a greater fluctuation in RDW during the hospital course are at a heightened risk for 2-year all-cause mortality.

FBXW7 deletion contributes to lung tumor development and confers resistance to gefitinib therapy

Gefitinib, an epidermal growth factor receptor–tyrosine kinase inhibitor (EGFR‐TKI), is an effective treatment for non‐small‐cell lung cancer (NSCLC) with EGFR activating mutations, but inevitably, the clinical efficacy is impeded by the emergence of acquired resistance. The tumor suppressor gene FBXW7 modulates chemosensitivity in various human cancers. However, its role in EGFR‐TKI therapy in NSCLC has not been well studied. Here, we demonstrate that the mice with deficient Fbxw7 have greater susceptibility to urethane‐induced lung tumor development. Through analysis of The Cancer Genome Atlas data, we show that deletion of FBXW7 occurs in 30.9% of lung adenocarcinomas and 63.5% of lung squamous cell carcinomas, which significantly leads to decrease in FBXW7 mRNA expression. The reduction in FBXW7 mRNA level is associated with poor overall survival in lung cancer patients. FBXW7 knockdown dramatically promotes epithelial–mesenchymal transition, migration, and invasion in NSCLC cells. Moreover, with silenced FBXW7, EGFR‐TKI‐sensitive cells become resistant to gefitinib, which is reversed by the mammalian target of rapamycin inhibitor, rapamycin. Furthermore, xenograft mouse model studies show that FBXW7 knockdown enhances tumorigenesis and resistance to gefitinib. Combination of gefitinib with rapamycin treatment suppresses tumor formation of gefitinib‐resistant (GR) FBXW7‐knockdown cells. In conclusion, our findings suggest that loss of FBXW7 promotes NSCLC progression as well as gefitinib resistance and combination of gefitinib and rapamycin may provide an effective therapy for GR NSCLC.

The association between serum uric acid level and the risk of fractures: a systematic review and meta-analysis

Controversy has arisen in regarding the association between serum uric acid (UA) and fracture risk. Therefore, we conducted a systemic review and meta-analysis by pooling estimate of five prospective studies (29,110 participants). Results showed that an increased serum UA level is associated with a lower risk of fracture. Numerous studies have demonstrated that high serum UA is a relevant risk factor for a wide variety of diseases, whereas new understanding in serum uric acid follows recent reports demonstrating a protective role of UA in health status. However, the association between serum UA and fracture remains controversial. Therefore, we conduct a systemic review and meta-analysis to determine whether elevated UA level is a protective factor for fracture among prospective studies. We searched for studies published before May 6, 2016, using PubMed, Embase, and Cochrane databases, without any language restriction. The inclusion criteria were published studies investigating the association between UA and fractures. Two authors independently screened the retrieved articles in accordance to the predefined inclusion criteria. We pooled the study-specific relative risk estimates using a random-effect model for comparison of persons whose UA levels were in the top tertile with those in the bottom tertile. Factors that may predict these associations were evaluated in subgroup analysis and meta-regression. The five included prospective studies included 29,110 participants. In random-effect models that included all five included studies, the summary hazard ratios (HRs) (top vs bottom tertiles) were 079 (95% CI, 0.69 to 0.89), without evidence of heterogeneity (P for heterogeneity = 0.458; I ² = 0%). Similar results were shown when pooling estimate of three higher-quality studies (HR 0.80 95% CI, 0.69 to 0.93). The association between UA and fracture remained in sensitivity and subgroup analyses. An increased serum UA level is shown to be associated with a lower risk of fracture, albeit additional large, high-quality prospective studies or a meta-analysis of individual data are still needed to verify the association.

Characteristics of symptoms experienced by persons with dry eye disease while driving in China

PurposeTo assess the vision-related quality of life and self-reported driving performance of patients with dry eye disease (DED).Patients and methodsThe study was performed in the eye centre of Peking University Third Hospital, China. In total, 87 dry eye patients and 42 controls were enroled, including 49 patients without any treatment (group A), 38 patients treated with artificial tears (group B) and 42 controls without DED (group C). The participants had no eye disease other than DED. Scores of a vision-related quality-of-life questionnaire (Ocular Surface Disease Index (OSDI)), a daily life-related visual function questionnaire and a questionnaire about performance during driving were collected. Data were compared among the groups and analysed.ResultsSignificant differences in all clinical characteristics and OSDI scores were found between DED patients and normal controls (P<0.05). While subjects in group A felt more uncomfortable than those in group B, the functional limitations related to dry eye were significant in all DED patients, especially for daily work and using a computer. DED was correlated with unsafe driving habits and performance, which may increase the risk of dangerous driving (P<0.01). For patients with DED, the rate of accidents and near-accidents was 10.33%, and the rate of missed targets totalled 32.17%.ConclusionsDED can lead to many inconveniences in daily life, including driving. The frequencies of unsafe driving habits and performance were increased in patients with DED.

Unipolar Nonvolatile Resistive Switching in Pt/MgO/Ta/Ru Structures Deposited by Magnetron Sputtering

The recent realization of memristors, nanodevices exhibiting non-volatile resistive switching, has sparked tremendous interest for applications in fields such as nonvolatile memories. Here we report unipolar resistive switching in Pt/MgO/Ta/Ru structures, with an oxide barrier thickness of only 15 nm. No electroforming process was required to achieve resistive switching and an ohmic conduction mechanism is associated with the ON state. We observed an inverse dependence of the ON state resistance on the SET current compliance and average values of 1.61 V and 1.38 V for the SET and RESET voltages, respectively. We show the stability of the switching for over 40 cycles and a clear separation of the ON (10¹ Ω) and OFF (10² Ω) states during at least 10⁴ s.

[Magnetic resonance imaging of dystrophinopathy that mimics adductor enthesopathy]

OBJECTIVE

To report thigh muscle magnetic resonance imaging (MRI) tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor enthesopathy.

METHODS

Four boys, who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the incidental findings of elevated serum creatine kinase levels, and were diagnosed with dystrophinopathy by gene test of Duchenne muscular dystrophy (DMD). Their creatine kinase levels were increased from 4 087 IU/L to 32 700 IU/L (Normal range: 75-175 IU/L). The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis, regeneration, hypertrophy, atrophy and connective tissue proliferation, with different proportions of dystrophin-negative muscle fibers. The gene test of DMD showed an out-frame deletion of exons in three of the four patients, involving either exons 45 or exons 49-52 deletion or exon 62 duplication, and c.2665 C>T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence. The degree of fatty infiltration changes was scored.

RESULTS

MRI of the thigh muscles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor magnus. Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion recovery (STIR) images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy. Two of the four patients presented with edema changes in the bilateral adductor longus muscles, while the other two were with only unilateral changes. Furthermore, other thigh muscles, including adductor magnus, semitendinosus, sartorius and rectus femoris muscles, could also have mild edema changes in two of the four patients.

CONCLUSION

Dystrophinopathy can manifest as edema changes in the adductor longus muscles in thigh muscle MRI tests, which is a typical lesion in adductor enthesopathy. The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.

Clinical characteristics and risk factors of postoperative pneumonia after hip fracture surgery: a prospective cohort study

In this study, we attempt to determine the clinical characteristic and risk factors of postoperative pneumonia (POP) after hip fracture surgery in a well-defined hip fracture cohort. We find that intrinsic factors as well as major clinical interventions were all important risk factors of POP.

INTRODUCTION

Postoperative pneumonia (POP) is one of the major complications following hip fractures surgery. However, the risk factors of POP are not well studied in hip fracture cohorts. We attempt to determine the clinical characteristic and risk factors of POP after hip fracture surgery in a well-defined hip fracture cohort.

METHODS

Datasets from a prospective hip fracture cohort study with a 2-year follow-up period, from 2000 to 2011, were reanalyzed for characteristics of POP. Multivariate Cox proportional regression was used to evaluate the association between the incidence of POP and all-cause mortality. Multivariate logistic regression was used to screen for potential risk factors of POP by analyzing demographic factors, comorbidities, major clinical interventions, and hematological parameters.

RESULTS

In 1429 patients who underwent hip surgery, the incidence of POP was 4.9 % (n = 70). All-cause mortality of patients with POP was significantly higher than that of patients without POP at 30 days (hazard ratio (HR) 3.05, 95 % confidence intervals (CI) 1.88-4.94), 1 year (HR 1.87, 95 % CI 1.41-2.48), and 2 years (HR 1.57, 95 % CI 1.23-1.99) postoperatively. Multivariate logistic regression showed that intrinsic factors (advanced age, anemia, diabetes, prior stroke, number of comorbidities, ASA score ≥III, and some laboratory biomarkers) as well as major clinical interventions were all significant risk factors for POP.

CONCLUSION

Intrinsic factors and major clinical interventions were all important risk factors of POP in patients after hip fracture surgery. Targeted preventive measures to mitigate the above risk factors may help in reducing the incidence of POP.

Association between the extent of sigmoid sinus dehiscence and an occurrence of pulsatile tinnitus: a retrospective imaging study

AIM

To assess the extent of sigmoid sinus dehiscence (SSD) on high-resolution computed tomography venography (HRCTV) or high-resolution computed tomography (HRCT) images in pulsatile tinnitus (PT) and non-PT groups to determine whether there is an association between the extent of SSD and occurrence of PT.

MATERIALS AND METHODS

Twenty-eight SSD patients with ipsilateral PT and 28 age- and gender-matched SSD patients without PT who underwent HRCTV or HRCT were enrolled in this study and categorised into two groups: "PT group" and "non-PT group". The extent of SSD in each group was calculated and compared.

RESULTS

The largest transverse diameter and largest vertical diameter of SSD in the PT group were 6.21±1.7 and 6.15±2.19 mm, respectively. The largest transverse diameter and largest vertical diameter of SSD in the non-PT group were 3.06±1.38 and 2.51±1.03 mm, respectively. The extent of SSD was statistically different between the two groups (p<0.001; p<0.001).

CONCLUSIONS

As a cause of PT, SSD can also occur in individuals without PT symptoms. Preliminary findings suggest that there may be a potential correlation between the extent of SSD and an occurrence of PT.

Combination of red cell distribution width and American Society of Anesthesiologists score for hip fracture mortality prediction

The prognostic value of red cell distribution width (RDW) and a combination of RDW and the American Society of Anesthesiologists (ASA) score for long-term hip fracture mortality remains unknown. Our data showed that both RDW and ASA were independent risk predictors. A combination of these two parameters may provide a more powerful strategy for the prediction of hip fracture mortality.

INTRODUCTION

Red cell distribution width (RDW) has recently been suggested as an independent predictor of prognosis in a variety of disorders. The American Society of Anesthesiologists (ASA) system has been widely used to stratify patients for outcome evaluations. However, the prognostic value of RDW and a combination of RDW and the ASA score for long-term hip fracture mortality has yet to be studied.

METHODS

This prospective cohort study included 1402 subjects from 2000 to 2011 with a follow-up study over a 2 year period. Cox proportional hazards models with a bootstrap validation were used to evaluate associations of RDW, ASA, and a combination of both with long-term mortality. The global fit and the area under the receiver operating characteristic (ROC) curve (AUC) for model discrimination were further analyzed.

RESULTS

Both RDW and ASA exhibited as independent risk predictors of 2-year mortality. The population with elevation of either RDW or ASA increased the risk of mortality (bootstrap validated hazard ratio (HR) 1.971 95 % confidence interval (CI) [1.336-3.005] p < 0.01) while those with an increase in both assessments (bootstrap validated HR 2.667 95 % CI [1.526-4.515] p < 0.01) were at the highest risk for mortality. The addition of the combination of ASA and RDW improved the discrimination power of risk prediction models (AUC increased from 0.700 to 0.723, p < 0.05).

CONCLUSION

Both RDW and ASA exhibited as independent risk predictors of 2-year hip fracture mortality. The combination of these two readily available parameters may provide a more powerful and effective strategy for the assessment of all-cause mortality in hip fracture patients.

A prospective evaluation of minimal residual disease as risk stratification for CCLG-ALL-2008 treatment protocol in pediatric B precursor acute lymphoblastic leukemia

OBJECTIVE

The aim of this prospective study was to evaluate the cut-off value of minimal residual disease (MRD) in predicting the efficacy of CCLG-ALL-2008 or CCLG-2008 treatment protocol on pediatric B-precursor ALL (BP-ALL).

PATIENTS AND METHODS

Three hundred and seventy-nine Chinese pediatric BP-ALL were enrolled in this study between Dec 2008 and Sep 2013 in two stratified cohorts. One hundred and fifty-three patients enrolled between Dec 2008 and Oct 2010 as the first cohort, and 196 patients enrolled from Nov 2010 to Sep 2013 as the second cohort. Clinical and biological characteristics and 5 years EFS, RFS, and OS were analyzed.

RESULTS

Patients with E2A-PBX1 showed a favorable treatment response with a lower minimal residual disease (MRD) level (< 10-4) at the time point 1 (TP1, p = 0.039) and the highest proportion of the 5-year EFS, RFS, and OS. A high level of MRD was associated with high WBC counts, increased age, BCR-ABL1 fusion gene, MLL rearrangements and adverse karyotypes. In comparison with the first cohort, the second cohort with the MRD assay incorporated prospectively, the standard risk (SR) and the intermediate risk (IR) patients showed a better RFS, EFS, and OS while the high-risk (HR) patients displayed worse RFS, EFS, and OS than those of the first cohort, respectively. Patients with MRD level at either 10-4 or 10-3 showed a similar OS at TP1 or TP2, and patients with MRD level above 10-2 had the worst OS.

CONCLUSIONS

This study indicated that the levels of MRD to be an adequate guide in risk-adapted treatment under the CCLG-ALL-2008 protocol and can be adapted to the future development of advanced clinical protocols.

HLA-B allele dropout in PCR sequence-specific oligonucleotide probe typing due to intronic polymorphism in the novel B*58:01:01:02 allele

Currently, Luminex technology based on the PCR sequence-specific oligonucleotide (SSO) probe method has been widely used for HLA genotyping in the immunogenetics laboratories. Here, we reported a case with HLA-B allele dropout by Luminex technology. The initial HLA-B result of the Luminex method with a commercial agent kit was inconclusive, and then, the result of PCR-SBT technology indicated the dropout as a HLA-B*58 allele. Subsequently, the full-length sequence of HLA-B allele was determined by TOPO-TA cloning, and a novel allele B*58:01:01:02 was identified in the individual. Compared with HLA-B*58:01:01:01, the novel allele showed some nucleotides difference at 509 C>T, 521 T>G and CCC insertion in position 503 of intron 2. According to the full-length sequence, the new mutations of intron 2 were contributed to HLA-B locus allele dropout in the sample. Our results indicated multiplatform should be used to improve the HLA typing accuracy when a conclusive HLA genotype cannot be determined.

HLA-A, -B and -DRB1 allele and haplotype frequencies of 8333 Chinese Han from the Zhejiang province, China

The distribution of human leucocyte antigen (HLA) allele and haplotype is varied among different ethnic populations. In this study, HLA-A, -B and -DRB1 allele and haplotype frequencies were determined in 8333 volunteer bone marrow donors of Zhejiang Han population using the polymerase chain reaction sequence-based typing. A total of 52 HLA-A, 96 HLA-B and 61 HLA-DRB1 alleles were found. Of these, the top three frequent alleles in HLA-A, HLA-B and HLA-DRB1 loci, respectively, were A*11:01 (24.53%), A*24:02 (17.35%), A*02:01 (11.58%); B*40:01 (15.67%), B*46:01 (11.87%), B*58:01 (9.05%); DRB1*09:01 (17.54%),DRB1*12:02 (9.64%) and DRB1*08:03 (8.65%). A total of 171 A-B-DRB1 haplotypes with a frequency of >0.1% were presented and the five most common haplotypes were A*33:03-B*58:01- DRB1*03:01, A*02:07-B*46:01-DRB1*09:01, A*30:01-B*13:02-DRB1*07:01, A*33:03-B*58:01-RB1*13:02 and A*11:01-B*15:02-DRB1*12:02. The information will be useful for selecting unrelated bone marrow donors and for anthropology studies and pharmacogenomics analysis.