Safety analysis of pedestrians distracted by mobile phones at street crossings: Field study in Nanjing

The growing public concern over traffic safety hazards caused by pedestrians' distracted behavior, particularly related to mobile phone usage at pedestrian crossings. Through video recording of pedestrians' street-crossing behaviors on 12 sidewalks across 9 urban road intersections in Nanjing city, 1778 valid pedestrian samples were collected. The study categorizes mobile phone use during the crossing into five distinct types: no use, voice call, screen gaze, screen gaze with operation, and listening to music with headphones. Then, the effects of gender, age and companion conditions on the mobile phone during the crossing were examined by chi-square tests. Utilizing binomial logistic and Relogit regression models, the study analyzed the impact and safety risks of distraction on crossing behavior. Additionally, a random parameters (RP) logit model with heterogeneity in means was used to investigate the determinants affecting mobile phone usage. Notably, individuals aged 18 to 30 years were identified as the random parameter, while factors such as being under 18 years old, having a companion without interaction, having a companion with interaction, weekdays, sidewalk length, and the total number of other pedestrians were identified as fixed parameters. The study also presented significant variables affecting the probability of mobile phone usage through marginal effects, highlighting the potential safety risks associated with mobile phone usage during street crossing. These findings emphasize the need for heightened pedestrian safety awareness and a reduction in distracted behaviors to enhance overall traffic safety.

External validation of a four-tiered grading system for chromophobe renal cell carcinoma

This study aimed to validate the prognostic value of a four-tiered grading system recently proposed by Avulova et al. and to explore the prognostic ability of another four-tiered classification grading system in which there is a separate Grade 3 for tumor necrosis. Grading of chromophobe renal cell carcinoma (ChRCC) by the Fuhrman system is not feasible because of the inherent nuclear atypia in ChRCC. We collected relevant data of 263 patients with ChRCC who had undergone surgery in our hospital from 2008 to 2020. The Kaplan-Meier method was used to calculate the survival rate and Cox proportional hazard regression models to assess associations with cancer-specific survival and distant metastasis-free survival by hazard ratios (HRs) and 95% confidence intervals (CIs). Ten patients died from ChRCC, and 12 developed metastases. The 5 year CSS rates were 95.9%. Grades 2 (HR = 10.9; CI 1.11-106.4; P = 0.04), 3 (HR = 33.6, CI 3.32-339.1; P = 0.003), and 4 (HR = 417.4, CI 35.0-4976.2; P < 0.001) in a four-tiered grading system were significantly associated with CSS in a multivariate setting. However, the difference in CSS between Grades 2 and 3 was not significant (HR = 2.14, 95% CI 0.43-10.63; P = 0.35). The HRs of the associations between an exploratory grading system that includes a separate Grade 3 for tumor necrosis and CSS were as follows: Grade 2, 10.2 (CI 1.06-97.9, P = 0.045); Grade 3, 11.4 (CI 1.18-109.6, P = 0.04); and Grade 4, 267.9 (CI 27.6-2603.3, P < 0.001). Similarly, Grades 2 and 3 did not differ significantly. The four-tiered grading system studied is useful for predicting death from ChRCC and metastasis. However, Grade 3 did not more accurately predict risk of death and metastasis than did Grade 2. This was also true for the novel exploratory grading system that classifies tumors with necrosis into a separate Grade 3.

Deep Learning Radiomics Nomogram Based on Enhanced CT to Predict the Response of Metastatic Lymph Nodes to Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer

BACKGROUND

We aimed to construct and validate a deep learning (DL) radiomics nomogram using baseline and restage enhanced computed tomography (CT) images and clinical characteristics to predict the response of metastatic lymph nodes to neoadjuvant chemotherapy (NACT) in locally advanced gastric cancer (LAGC).

METHODS

We prospectively enrolled 112 patients with LAGC who received NACT from January 2021 to August 2022. After applying the inclusion and exclusion criteria, 98 patients were randomized 7:3 to the training cohort (n = 68) and validation cohort (n = 30). We established and compared three radiomics signatures based on three phases of CT images before and after NACT, namely radiomics-baseline, radiomics-delta, and radiomics-restage. Then, we developed a clinical model, DL model, and a nomogram to predict the response of LAGC after NACT. We evaluated the predictive accuracy and clinical validity of each model using the receiver operating characteristic curve and decision curve analysis, respectively.

RESULTS

The radiomics-delta signature was the best predictor among the three radiomics signatures. So, we developed and validated a DL delta radiomics nomogram (DLDRN). In the validation cohort, the DLDRN produced an area under the receiver operating curve of 0.94 (95% confidence interval, 0.82-0.96) and demonstrated adequate differentiation of good response to NACT. Furthermore, the DLDRN significantly outperformed the clinical model and DL model (p < 0.001). The clinical utility of the DLDRN was confirmed through decision curve analysis.

CONCLUSIONS

In patients with LAGC, the DLDRN effectively predicted a therapeutic response in metastatic lymph nodes, which could provide valuable information for individualized treatment.

Identification and validation of a ferroptosis-related signature for prediction of the prognosis and tumor microenvironment in patients with chromophobe renal cell carcinoma

BACKGROUND

Ferroptosis is a novel form of regulated cell death that is different from other forms, which has an important role in tumor growth inhibition. The purpose of this study was to construct and validate a prognostic signature related to ferroptosis in chromophobe renal cell carcinoma (ChRCC) and to explore its role in immune cell infiltration and systemic therapy.

METHODS

The gene expression profiles of ChRCC patients obtained from The Cancer Genome Atlas (TCGA) database were used to identify differentially expressed prognostic ferroptosis-related genes (FRGs) by univariate Cox proportional hazards analyses. Ferroptosis molecular subtypes were obtained by consensus clustering analysis. The FRG-based signature in the training set was established by least absolute shrinkage and selection operator analysis and verified in the testing set. The association between molecular subtypes and the prognostic signature and immune microenvironment was explored to predict responses to immunotherapy. Immunohistochemistry was used to verify expression of the FRG-based signature externally.

RESULTS

ChRCC patients were divided into two FRG subtypes. Two FRGs (TFRC and SLC7A11) were identified to construct the prognostic signature. The high-risk group and cluster 2 had worse overall survival than the low-risk group and cluster 1, respectively. The low-risk group and cluster 1 had higher levels of immune cell infiltration and expression of MHC and immune checkpoint molecules than the high-risk group and cluster 2. The risk score was a predictor of overall survival and had a good predictive ability, which was verified in the testing set and evaluated by ROC and calibration curves. The high-risk group had a higher tumor mutation burden. The different sensitivities of targeted drugs in patients with different risks were evaluated. External immunohistochemical analysis showed that TFRC and SLC7A11 were highly expressed in tumor tissues compared with para-cancer normal tissues, and the expression level was significantly associated with a more advanced stage and worse cancer-specific survival.

CONCLUSIONS

An FRG signature was identified and validated to predict the clinicopathological features and prognosis of ChRCC. A significant association between the signature and immune cell infiltration, immune checkpoint expression, and drug response is helpful to guide comprehensive treatment of ChRCC.

Visualizable intracardiac flow pattern in fetuses with congenital heart defect: pilot study of blood speckle-tracking echocardiography

OBJECTIVES

Blood-flow pattern is an essential factor in cardiovascular development. Recently, blood speckle-tracking echocardiography (BST) based on high-frame-rate ultrasound has emerged as a promising technique for the assessment of blood-flow patterns and properties. The objectives of this study were to determine the feasibility of BST in the fetus and to assess intracardiac blood-flow patterns of fetuses with a congenital heart defect (CHD) using this technique.

METHODS

This was a prospective study consisting of 35 normal fetuses, 35 fetuses with left-sided obstructive lesion (LSOL) and 35 fetuses with right-sided obstructive lesion (RSOL). BST images of fetal intracardiac regions of interest (ROIs), including the left ventricle (LV), right ventricle (RV), ascending aorta (AAo), aortic arch (AA), descending aorta (DAo) and pulmonary artery (PA), were obtained and analyzed. The feasibility of BST was assessed, and blood-flow pattern and number of vortices in the ROIs were recorded.

RESULTS

The median gestational age of the fetuses was 24.7 weeks (range, 19.6-34.3 weeks). BST was feasible in 81.6% of cases, and the cut-off value of depth for an adequate BST image was ≤ 7.9 cm. There were no differences in the presence of vortex/turbulent blood flow in the LV or RV among the three groups. Vortex/turbulent blood flow in the AAo was detected in 0% (0/35), 14.3% (5/35) and 57.1% (20/35) of cases in the control, LSOL and RSOL groups, respectively. The respective values were 5.7% (2/35), 14.3% (5/35) and 51.4% (18/35) for the AA; 0% (0/35), 48.6% (17/35) and 0% (0/35) for the DAo; and 0% (0/35), 40.0% (14/35) and 51.4% (18/35) for the PA. With the exception of the DAo in the RSOL group, vortex/turbulent flow in the great artery ROIs was significantly more common in the LSOL and RSOL groups than in controls (P < 0.01). In the LSOL group, the number of vortices in the AAo, AA, DAo and PA was significantly greater compared with that in controls (P < 0.01). In the RSOL group, the number of vortices in the LV, AAo, AA and PA was significantly greater compared with that in controls (P < 0.01).

CONCLUSIONS

Fetuses with CHD were more likely to exhibit vortex/turbulent blood flow and increased number of vortices in the great arteries compared with healthy controls. Further research is needed to determine the biomechanical effect of blood-flow patterns, especially vortex flow, on fetal cardiovascular structure and function. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Differences in single-vehicle motorcycle crashes caused by distraction and overspeed behaviors: considering temporal shifts and unobserved heterogeneity in prediction

Distraction and overspeed behaviors are acknowledged as two significant contributors to single-vehicle motorcycle crashes, injuries and fatalities resulting from which are severe and critical issues in Pakistan. To explore the temporal instability and differences in the factors determining the injury severities between single-vehicle motorcycle crashes caused by distraction and overspeed behaviors, this study estimated two groups of random parameter logit models with heterogeneity in means and variances. Single-vehicle motorcycle crash data in Rawalpindi city between 2017 and 2019 was used for model estimation, and a wide variety of explanatory variables relating to the rider, roadways, environments, and temporal attributes was simulated in the models. The current study considered three possible crash injury severity outcomes: minor injury, severe injury and fatal injury. Likelihood ratio tests were conducted to explore the temporal instability and non-transferability. Marginal effects were also calculated to further reveal temporal instability of the variables. Except for several variables, the most significant factors reported temporal instability and non-transferability, manifested as the effects varied from year to year and across different crashes. Moreover, out-of-sample prediction was also implemented to capture temporal instability and non-transferability between distraction and overspeed crash observations. The non-transferability between motorcycle crashes caused by distraction and overspeed behaviors provides insights into developing differentiated countermeasures and policies targeted at preventing and mitigating single-vehicle motorcycle crashes caused by the two risk-taking behaviors.

[Efficacy of decitabine in patients with glucocorticoid-resistant primary immune thrombocytopenia: factors influencing treatment responses]

Objective: This study aimed to evaluate the efficacy of decitabine (DAC) and identify factors influencing treatment responses in patients with primary immune thrombocytopenia (ITP) who had failed glucocorticoid therapy. Methods: Clinical data of 61 patients with glucocorticoid-resistant ITP who received DAC therapy (5 mg·m(-2)·d(-1)×3 d via intravenous infusion) for at least three cycles with 3-4-week intervals at the Department of Hematology, Qilu Hospital of Shandong University, from November 2015 to June 2021 were analyzed retrospectively. Results: The 61 patients comprised 20 males and 41 females, with a median age of 45 years (range: 15-81 years). Among them, 43 patients were glucocorticoid-dependent (glucocorticoid-dependent group), while 18 patients were glucocorticoid-resistant (glucocorticoid-resistant group). Following DAC treatment, 12 patients (19.67% ) achieved complete response (CR), and 16 patients (26.23% ) exhibited response (R), resulting in an overall response (OR) rate of 45.90% (28/61). Comparison between the OR group (n=28) and the non-response (NR) group (n=33) revealed significant differences in responses to glucocorticoids (dependent or resistant) and platelet counts before treatment (χ(2)=8.789, P=0.003; z=-2.416, P=0.016). The glucocorticoid-dependent group showed higher platelet counts than the glucocorticoid-resistant group after the second and third cycles of DAC treatment (P=0.032, 0.024). Moreover, the OR rates after the first, second, and third cycles of DAC treatment in the glucocorticoid-dependent group were all higher than those in the glucocorticoid-resistant group (P=0.042, P=0.012, P=0.029). A significant correlation was observed between glucocorticoid dependence and responses to DAC treatment (OR=9.213, 95% CI 1.937-43.820, P=0.005) . Conclusion: DAC demonstrates definitive efficacy with mild adverse effects in a subset of patients with glucocorticoid-resistant primary ITP. Glucocorticoid dependence and higher platelet counts before treatment are associated with a favorable response to DAC therapy.

[Clinical management and prognosis for descending necrotizing mediastinitis]

Objective: To investigate the clinical characteristics, treatment experiences and prognostic factors for descending necrotizing mediastinitis (DNM). Methods: A retrospective analysis was performed on the data of 22 patients with DNM diagnosed and treated in Henan Provincial People's Hospital from January 2016 to August 2022, including 16 males and 6 females, aged 29-79 years. After admission, all patients underwent CT scanning of the maxillofacial, cervical, and thoracic regions to confirm their diagnoses. Emergency incision and drainage were performed. The neck incision was treated with continuous vacuum sealing drainage. According to the prognoses, the patients were divided into cure group and death group, and the prognostic factors were analyzed. SPSS 25.0 software was used to analyze the clinical data. Rusults: The main complaints were dysphagia (45.5%, 10/22) and dyspnea (50.0%, 11/22). Odontogenic infection accounted for 45.5% (10/22) and oropharyngeal infection accounted for 54.5% (12/22). There were 16 cases in the cured group and 6 cases in the death group, with a total mortality rate of 27.3%. The mortality rates of DNM typeⅠand typeⅡwere respectively 16.7% and 40%. Compared with the cured group, the death group had higher incidences for diabetes, coronary heart disease and septic shock (all P<0.05). There were statistically significant differences between the cure group and the death group in procalcitonin level (50.43 (137.64) ng/ml vs 2.92 (6.33) ng/ml, M(IQR), Z=3.023, P<0.05) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score (16.10±2.40 vs 6.75±3.19, t=6.524, P<0.05). Conclution: DNM is rare, with high mortality, high incidence of septic shock, and the increased procalcitonin level and APACHE Ⅱ score combined diabetes and coronary heart disease are the poor prognostic factors for DNM. Early incision and drainage combined with continuous vacuum sealing drainage technique is a better way to treat DNM.

[Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020]

Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.

Willingness to vaccinate children against COVID-19 declined during the pandemic

OBJECTIVES

To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3).

RESULTS

Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively).

CONCLUSIONS

COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

Stereoselective Synthesis of 2-Deoxy Glycosides via Iron Catalysis

An Fe-catalyzed 2-deoxy glycosylation method was developed from 3,4-O-carbonate glycals directly at room temperature. This novel approach enabled facile access to alkyl and aryl 2-deoxy glycosides in high yields with exclusive α-stereoselectivity, tolerating various alcohols, phenols, and glycals. The synthetic utility and advantage of this strategy have been demonstrated by the modification of six natural products and the construction of a tetrasaccharide.

Development of a removable three-dimensional magnetic probe system for measuring field null on the NanChang Spherical Tokamak

The field null configuration of a poloidal magnetic field is one of the critical conditions for achieving Ohmic breakdown during the initial discharge of a new tokamak. The issue of the Ohmic breakdown on the NanChang Spherical Tokamak (NCST) is still not solved satisfactorily although plasma currents of about 2 kA were found. Hence, a removable three-dimensional magnetic probe (RTMP) system consisting of 25 magnetic probes was designed, calibrated, and constructed on the NCST to evaluate the field null inside a vacuum vessel. After repeated tests, the RTMP system exhibited outstanding performance in terms of accuracy and stability with errors of about 1%. Meanwhile, the RTMP system successfully measured the toroidal field (TF) coil ripples at the magnetic axis. During experiments, the stray field arising from the TF coil implied a strong link between the flexible connection of the TF coil and the Ohmic breakdown on the NCST. After the field null was effectively modified by using a new flexible connection of the TF coil and controlling the induced current in the poloidal field coil, the NCST tokamak reproducibly obtained 20 kA plasma current with the limiter configuration during the plasma current flat-top phase.

Response of root and root hair phenotypes of cotton seedlings under high temperature revealed with RhizoPot

Driven by the increase in its frequency and duration, high temperature weather is increasingly seriously affecting crop development. High temperature inhibits the leaf development, flowering, and pollination of cotton, but its effects on the roots and root hair phenotypes and lifespans remain unclear. Thus, this study selected the two cotton varieties Nongda 601 (ND) and Guoxin 9 (GX) as materials and adopted the RhizoPot, an in situ root observation system, to investigate the effects of high temperature (38°C day and 32°C night) on the growth dynamics of the aboveground parts and root phenotypes of cotton at the seedling stage. The results showed that high temperature reduced the net photosynthetic rate and chlorophyll content, decreased the dry matter accumulation and transfer to the root, and lowered the root-shoot ratio (R/S ratio). The root phenotypes changed significantly under high temperature. After 7 d of high temperature stress, the root lengths of ND and GX decreased by 78.14 mm and 59.64 mm, respectively. Their specific root lengths increased by 79.60% and 66.11%, respectively. Their specific root surface areas increased by 418.70 cm²·g^-1 and 433.42 cm²·g^-1, respectively. Their proportions of very fine roots increased to 99.26% and 97.16%, respectively. After the removal of high temperature (RHT), their root lengths tended to increase, and their proportions of very fine roots continued to increase. The root hairs of ND and GX were also significantly affected by high temperature. In particular, the root hair densities of ND and GX decreased by 52.53% and 56.25%, respectively. Their average root hair lengths decreased by 96.62% and 74.29%, respectively. Their root hair lifespans decreased by 7 d and 10 d, respectively. After the RHT, their average root hair lengths failed to recover. A principal component analysis indicated that the root architectures were significantly affected by root hair density, average root hair length, specific root length, and specific root surface area under high temperatures. In summary, cotton adapts to high temperature environments by increasing the specific root length, specific root surface area, and the proportions of very fine roots, and reducing the lifespan of root hairs.

Optimal reduction and conversion of range-difference measurements for positioning

For positioning an object with m references, there are m−1 linearly independent range differences and measuring them is essential. However, none of m(m−1) possible range differences should be considered redundant unless their measurements are free of noise and locations of the references are exactly known. From all available range-difference measurements, m range measurements are obtained for positioning based on the least squares principle. The problem formulation treats missing and weighted range-difference measurements simultaneously. The exact relationships among several formulations of least squares positioning are established. A numerical example illustrates the results.

The effect of risk perception and other psychological factors on mobile phone use while crossing the street among pedestrians

Pedestrians may be the most vulnerable group among road users, and mobile phone use while crossing the street is ubiquitous worldwide in this information era. However, previous studies have found that such distracting behaviors may increase the risk of injury and death. The present study primarily aimed to explore the effect of reinforcement sensitivity theory components (i.e., Behavioral Inhibition System (BIS), Behavioral Approach System (BAS)), risk perception, attitudes towards red light running, and fear of missing out (FoMO) on mobile phone use while crossing the street among pedestrians. Risk perception was measured in three ways (i.e., assessing the probability of a negative outcome (RP-Pro), judging the severity of the consequence (RP-Se), and evaluating the general riskiness of the behavior (RP-Ri)). An online questionnaire survey was conducted, and only valid responses (N = 425) were used for subsequent data analyses. The results indicated significant differences in the responses across the risk perception questions with different focuses. Participants who reported engaging in more distracted street-crossing (i.e., high-risk takers) perceived a significantly lower risk, and this difference did not depend on the focus of risk perception. Three path analysis models with differential risk perception constructs (RP-Pro, RP-Se, and RP-Ri) were developed to examine the relationship between risk perception and distracted street-crossing. The results suggest that the relationship between these two variables does not depend on the focus of the risk perception questions. Moreover, FoMO was a predictor of mobile phone use while crossing the street, while attitudes had both direct and indirect effects on behavior. BIS and BAS had the lowest total effect on mobile phone use among pedestrians. In particular, a direct association between BAS and distracted street-crossing was found only in the model in which risk perception was measured by judging the severity of crashes caused by mobile phone use distraction. This study may be meaningful for understanding the associations between psychological factors and mobile phone use among pedestrians. The implications of the findings for the development of safety interventions are discussed in this study.

CircRIP2 aggravates the deterioration of colorectal carcinoma by negatively regulating CBFB

OBJECTIVE

This study aims to detect expression pattern and clinical significance of circRIP2 in colorectal carcinoma (CRC). In the meantime, the regulatory effect of circRIP2 on CRC cell functions is clarified.

PATIENTS AND METHODS

Relative levels of circRIP2 in 45 cases of CRC tissues and paracancerous tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Its clinical significance in predicting pathological manifestations of CRC was analyzed. In vitro regulation of circRIP2 on proliferative and migratory abilities of Sw620 and HCT-116 cells was assessed by cell counting kit-8 (CCK-8), 5-Ethynyl-2'-deoxyuridine (EdU) and transwell assay, respectively. Dual-Luciferase reporter assay and rescue experiments were conducted to reveal the interaction between circRIP2 and its target gene CBFB, as well as their co-regulation on CRC cell functions. At last, in vivo regulation of circRIP2 on CRC growth in nude mice implanted with HCT-116 cells was explored.

RESULTS

CircRIP2 was upregulated in these samples of CRC tissues and cell lines. High level of circRIP2 predicted advanced staging, and high risk of distant metastasis of CRC. In vitro knockdown of circRIP2 weakened proliferative and migratory abilities in Sw620 and HCT-116 cells. CBFB was downregulated in CRC tissues, which was negatively regulated by circRIP2 as its target gene. The attenuated proliferative and migratory abilities in Sw620 and HCT-116 cells with circRIP2 knockdown were abolished by co-silence of circRIP2 and CBFB. Moreover, in vivo knockdown of circRIP2 slowed down CRC growth in nude mice, and upregulated positive expression of CBFB in xenografted CRC tissues.

CONCLUSIONS

CircRIP2 is a potential indicator for predicting tumor staging and distant metastasis of CRC. It aggravates the deterioration of CRC through negatively regulating CBFB.

Locally fitting hyperplanes to high-dimensional data

Problems such as data compression, pattern recognition and artificial intelligence often deal with a large data sample as observations of an unknown object. An effective method is proposed to fit hyperplanes to data points in each hypercubic subregion of the original data sample. Corresponding to a set of affine linear manifolds, the locally fitted hyperplanes optimally approximate the object in the sense of least squares of their perpendicular distances to the sample points. Its effectiveness and versatility are illustrated through approximation of nonlinear manifolds Möbius strip and Swiss roll, handwritten digit recognition, dimensionality reduction in a cosmological application, inter/extrapolation for a social and economic data set, and prediction of recidivism of criminal defendants. Based on two essential concepts of hyperplane fitting and spatial data segmentation, this general method for unsupervised learning is rigorously derived. The proposed method requires no assumptions on the underlying object and its data sample. Also, it has only two parameters, namely the size of segmenting hypercubes and the number of fitted hyperplanes for user to choose. These make the proposed method considerably accessible when applied to solving various problems in real applications.

The function of floral traits and phenotypic selection in Aconitum gymnandrum (Ranunculaceae)

Floral evolution in angiosperms is thought to be driven by pollinator-mediated selection. Understanding flower integration and adaptation requires resolving the additive and nonadditive contributions of floral pollinator attraction and pollination efficiency traits to fitness components. In this study, a flower manipulation experiment with a factorial design was used to study the adaptive significance of galea height (a putative attraction trait) and entrance width (a putative efficiency trait) in Aconitum gymnandrum Maxim. flowers. Simultaneously, phenotypic selection analysis was conducted to examine selection by pollinators on galea height, entrance width, nectar production and plant height. Increased galea height increased the pollinator visitation rate, which confirmed its attractiveness function. Increasing floral entrance width by spreading the lower sepals increased the seed number per fruit without affecting pollinator visitation. This suggests a pollination efficiency role for the entrance width. The phenotypic selection analysis, however, did not provide evidence of pollinator-mediated selection for either of these traist, but it did for plant height. According to the manipulation treatment and correlational selection results, the combined variation in galea height and entrance width of A. gymnandrum flowers did not have nonadditive effects on female reproductive success. This study demonstrated the adaptive value of A. gymnandrum flowers through manipulation of an attractiveness trait and an efficiency trait. However, neither trait was associated with pollinator-mediated selection. A combination of manipulating traits and determining current phenotypic selection could help to elucidate the mechanism of selection on floral traits involved in different functions and flower integration.

Mesenchymal-Epithelial Transition Exon 14 Skipping Mutation and Amplification in 5,008 Patients With Lung Cancer

Background

Lung cancer is a major health concern worldwide because of its increasing incidence and mortality. This study aimed to clarify the association between mesenchymal-epithelial transition (MET) genomic alterations and clinical characteristics of lung cancer.

Method

We collected data from 5,008 patients with lung cancer diagnosed and treated between January 2017 and July 2021 at the Affiliated Hospital of Qingdao University. Genomic alterations in the MET gene, including the exon 14 skipping mutation and amplification, were detected using amplification refractory mutation system-polymerase chain reaction (2,057 cases) and next-generation sequencing (2,951 cases). Clinical characteristics such as age, sex, tumor location, tumor stage, smoking, pleural invasion, and histology were statistically analyzed for MET exon 14 skipping mutation and amplification. The DNA splicing sites causing the MET exon 14 skipping mutation at the mRNA level were also investigated.

Results

The incidence of the MET exon 14 skipping mutation was 0.90% (41/4,564) in adenocarcinoma, 1.02% (3/294) in squamous cell carcinoma, and 8.33% (1/12) in sarcomatoid carcinoma specimens. It was more frequently observed in patients over 60 years of age than the MET exon 14 skipping mutation wildtype. The MET exon 14 skipping mutation co-occurred with epidermal growth factor receptor (EGFR) L858R, EGFR 19-Del, and BRAF V600E mutations. At the DNA level, single nucleotide mutation and small fragment deletion (1-38 base pairs) upstream and downstream of MET exon 14 led to MET exon 14 skipping mutation at the mRNA level. MET amplification occurred in 0.78% (21/2,676) adenocarcinoma and 1.07% (2/187) squamous cell carcinoma specimens and was significantly associated with advanced tumor stages (III + IV) compared to the MET amplification wildtype. MET amplification primarily co-occurred with the EGFR mutation.

Conclusions

Our study found that MET genomic alterations were statistically related to age and tumor stage and co-existed with mutations of other oncogenic driver genes, such as EGFR and BRAF. Moreover, various splicing site changes at the DNA level led to the exon 14 skipping mutation at the mRNA level. Further studies are required to clarify the association between MET genomic alterations and prognosis.

Assessments of bilateral asymmetry with application in human skull analysis

As a common feature, bilateral symmetry of biological forms is ubiquitous, but in fact rarely exact. In a setting of analytic geometry, bilateral symmetry is defined with respect to a point, line or plane, and the well-known notions of fluctuating asymmetry, directional asymmetry and antisymmetry are recast. A meticulous scheme for asymmetry assessments is proposed and explicit solutions to them are derived. An investigation into observational errors of points representing the geometric structure of an object offers a baseline reference for asymmetry assessment of the object. The proposed assessments are applicable to individual, part or all point pairs at both individual and collective levels. The exact relationship between the developed treatments and the widely used Procrustes method in asymmetry assessment is examined. An application of the proposed assessments to a large collection of human skull data in the form of 3D landmark coordinates finds: (a) asymmetry of most skulls is not fluctuating, but directional if measured about a plane fitted to shared landmarks or side landmarks for balancing; (b) asymmetry becomes completely fluctuating if one side of a skull could be slightly rotated and translated with respect to the other side; (c) female skulls are more asymmetric than male skulls. The methodology developed in this study is rigorous and transparent, and lays an analytical base for investigation of structural symmetries and asymmetries in a wide range of biological and medical applications.

[A physician-patient survey for primary immune thrombocytopenia: Chinese subgroup analysis of I-WISh International Survey]

Objective: To explore the impact of primary immune thrombocytopenia (ITP) on patient's quality of life and emotional well-being, and both the physician and the patient's perception of the treatment. Methods: This study was a Chinese Subgroup analysis of I-WISh survey, including 102 physicians and 286 ITP patients invited to complete the survey. A descriptive analysis of the results of the physician-patient survey was conducted in three parts: symptoms, impact of ITP on quality of life and emotion, and treatment perception. Results: Fatigue and anxiety about unstable platelet counts were the main symptoms after treatment. Physicians reported inadequate frequency of anxiety and fatigue. In terms of quality of life, over 90.0% of patients thought that ITP had a negative impact on their working life/studies, daily tasks, energy, capacity to exercise, and sexual life. With regard to emotion, 60.8% (174/286) patients thought that ITP had a greater impact on overall emotion, concerns about the fluctuation in platelet level (74.8%, 214/286) , disease itself (71.7%, 205/286) and disease progression (68.9%, 197/286) were the common issues, which were similar to the physicians' evaluations. Both physicians and patients agreed that reducing spontaneous bleeding, maintaining a healthy blood count and improving quality of life were the top three important treatment goals. Physicians considered reducing bleeding risk as the most important factor for decision making. Physicians believed that patients receiving glucocorticoid (54.9%, 56/102) were most likely to succeed in achieving sustained response while patients had the best response to thrombopoietin receptor agonist (TPO-RA) treatment, with about 83.9% (240/286) being satisfied with the overall effectiveness of TPO-RA. Conclusions: Physicians in the I-WISh Chinese subgroup had low awareness on patients' fatigue and anxiety. The quality of life and emotion of patients were significantly negatively affected by ITP. There are differences in the selection of treatments between physicians and patients, suggesting that physicians should raise concerns about the quality of life of ITP patients and make individualized treatment options through physician-patient shared decisions.

Transcriptome and Co-expression Network Analyses Reveal Differential Gene Expression and Pathways in Response to Severe Drought Stress in Peanut (Arachis hypogaea L.)

Drought is one of the major abiotic stress factors limiting peanut production. It causes the loss of pod yield during the pod formation stage. Here, one previously identified drought-tolerant cultivar, "L422" of peanut, was stressed by drought (35 ± 5%) at pod formation stage for 5, 7, and 9 days. To analyze the drought effects on peanut, we conducted physiological and transcriptome analysis in leaves under well-watered (CK1, CK2, and CK3) and drought-stress conditions (T1, T2, and T3). By transcriptome analysis, 3,586, 6,730, and 8,054 differentially expressed genes (DEGs) were identified in "L422" at 5 days (CK1 vs T1), 7 days (CK2 vs T2), and 9 days (CK3 vs T3) of drought stress, respectively, and 2,846 genes were common DEGs among the three-time points. Furthermore, the result of weighted gene co-expression network analysis (WGCNA) revealed one significant module that was closely correlated between drought stress and physiological data. A total of 1,313 significantly up-/down-regulated genes, including 61 transcription factors, were identified in the module at three-time points throughout the drought stress stage. Additionally, six vital metabolic pathways, namely, "MAPK signaling pathway-plant," "flavonoid biosynthesis," "starch and sucrose metabolism," "phenylpropanoid biosynthesis," "glutathione metabolism," and "plant hormone signal transduction" were enriched in "L422" under severe drought stress. Nine genes responding to drought tolerance were selected for quantitative real-time PCR (qRT-PCR) verification and the results agreed with transcriptional profile data, which reveals the reliability and accuracy of transcriptome data. Taken together, these findings could lead to a better understanding of drought tolerance and facilitate the breeding of drought-resistant peanut cultivars.

Circular RNA hsa_circ_0000034 promotes the progression of retinoblastoma via sponging microRNA-361-3p

Retinoblastoma is the commonest eye cancer occurring in the pediatric population. Circular RNAs (circRNAs) are essential regulators of tumorigenesis and development. The current experiment delves into the function and molecular basis of hsa_circ_0000034 in retinoblastoma progression. In the study, these series of experiments noted an upregulation of hsa_circ_0000034 in retinoblastoma cell lines and tissues. Retinoblastoma patients with raised hsa_circ_0000034 expressions were more likely to possess a more progressive International Integrated Reporting Council (IIRC) stage and optic nerve invasion. hsa_circ_0000034 knockdown caused a marked suppression in the proliferation and invasion of retinoblastoma cells in vitro. Mechanistically, hsa_circ_0000034 appeared to serve as a competitive endogenous RNA (ceRNA) in retinoblastoma through miR-361-3p sponging. In conclusion, our data proved that hsa_circ_0000034 promoted the oncogenicity of retinoblastoma via regulation of miR-361-3p expression, a finding that may contribute toward retinoblastoma therapeutics.

Molecular cloning and expression characterization of flavonol synthase genes in peanut (Arachis hypogaea)

Flavonol is an important functional bioactive substance in peanut seeds, and plays important roles responding to abiotic stress. The flavonol content is closely related to the activity and regulation of gene expression patterns of flavonol synthase (FLS). In this study, eight FLS genes, AhFLSs were cloned and their expression characterization in different peanut organ and seedling under different abiotic stress were conducted. The results showed that the expressions levels of AhFLSs were differed in all assayed peanut organs and seedlings under abiotic stress treatments. Expression levels of AhFLS2, AhFLS3, AhFLS4, and AhFLS6 were higher than those of other AhFLSs. The flavonol contents of peanut organs and seedlings under different abiotic stress were also determined using high performance liquid chromatography (HPLC). Dried mature peanut seeds were the organ tissue with the highest flavonol content, and flavonol content increased with seed development. Under abiotic stress treatments, the types of flavonols induced differed among stress treatments. Correlation analysis results suggested that eight AhFLS genes may have different functions in peanut. Moreover, changes in the expression of the eight genes appear to has substrate preference. These results can lay the foundation for the study of improving nutritional value of peanut seed and resistance of peanut plant.

[Efficacy and safety of generic azacitidine in Chinese patients with higher-risk myelodysplastic syndromes: a multicenter, prospective, single-arm study]

Objective: To evaluate the efficacy, safety, and pharmacokinetics of the generic azacitidine in Chinese patients with higher-risk myelodysplastic syndromes(MDS). Methods: Between October 2013 and 2016, 72 patients were eligible for enrollment at 9 sites from China received generic subcutaneous azacitidine 75 mg·m(-2)·d(-1) for 7 days per 28-day cycle, for ≥6 cycles. Pharmacokinetic blood samples were collected on day 1 of a single-dose. Results: For each patient at cycle 6 or at the time of study discontinuation, whichever came first, the overall response rate, which included complete remission (CR)and partial remission(PR), was 6.9%(5/72), the rate of patients who had the best effect with CR or PR during the treatment was 12.5%(9/72). Patients who were dependent on red-blood-cell transfusions and platelet transfusions at baseline became transfusion independent were 46.3%(19/41)and 41.2% (7/17), respectively. The median time of treatment was 6 cycles, and the median OS was 16.1 months (95%CI 10.9-20.6 months). For 36 patients(50%)received treatment at ≥6 cycles, and the median OS was 22.3 months(95%CI 16.1- not evaluative). Most common grade Ⅲ-Ⅳ hematologic treatment-emergent adverse events were neutropenia(55%), leukopenia(47%), and thrombocytopenia(61%). Pharmacokinetic profiles were similar for generic and original azacitidine in Chinese patients. Conclusion: Generic azacitidine treatment was favorable and safe and can be used as a standard treatment for patients with higher-risk MDS.

Immunorelated gene polymorphisms associated with acute myeloid leukemia

Although the pathogenesis of acute myeloid leukemia (AML) is still unknown, accumulating evidence has revealed that immune response plays a vital part in the pathogenesis. Here, we investigated the involvement of 21 single nucleotide polymorphisms (SNPs) of immunorelated genes, including cytokines [interleukin (IL)-2, IL-4, IL-9, IL-12A, IL-22, interferon (IFN-α) and transforming growth factor (TGF)-β1], transcriptional regulatory genes (TBX21, STAT1, STAT3, STAT5B, STAT6, GATA3, FOXP3 and IRF4) and others (IL2RA, IL6R, NFKBIA) in 269 AML in-patients and 200 healthy controls. Furthermore, we analyzed the relationship between the SNPs and clinical characteristics. Immunorelated SNP genotyping was performed on the Sequenom MassARRAY iPLEX platform. All the SNPs in healthy controls were consistent with Hardy-Weinberg equilibrium. All final P-values were adjusted by Bonferroni multiple testing. Our results showed that IL-22 (rs2227491) was significantly associated with the white blood cell (WBC) counts. Signal transducer and activator of transcription 5B (STAT-5B) (rs6503691) showed a close relationship with the recurrent genetic abnormalities in patients with AML. We verified the negatively independent effect of age and risk of cytogenetics on overall survival (OS). More importantly, the GG genotype of IL-12A (rs6887695) showed a negative impact on AML prognosis independently. Furthermore, the relative expression of IL-12 was decreased in GG genotype, no matter under a co-dominant or recessive model. However, no correlation was observed between the SNPs mentioned above and disease susceptibility, risk stratification and survival. Our findings suggest that immunorelated gene polymorphisms are associated with prognosis in AML, which may perform as novel inspection targets for AML patients.

[Effect and mechanism of low-dose chidamide on the treatment of primary immune thrombocytopenia]

目的

探讨低剂量（0.1 mg/kg）西达本胺治疗原发免疫性血小板减少症（ITP）的作用及机制。

方法

①应用C57BL/6J小鼠建立ITP被动模型，灌胃给予0、0.01、0.1、0.5、5.0 mg/kg西达本胺，观察治疗前后ITP小鼠模型外周血血小板计数。②应用C57BL/6J小鼠建立ITP主动模型，灌胃给予0.1 mg/kg西达本胺，观察治疗前后ITP小鼠模型外周血血小板计数；4周后处死小鼠，流式细胞术检测脾细胞中CD4⁺CD25⁺Foxp3⁺自然调节性T细胞（nTreg）比例并应用ELISA方法检测小鼠外周血IL-6水平。③分离ITP患者外周血单个核细胞，与低剂量西达本胺共培养72 h后检测nTreg细胞比例；免疫磁珠法分离CD4⁺CD25⁺调节性T细胞（Treg细胞）以及CD4⁺CD25⁻效应T细胞，将二者以1∶4比例混合共培养，加入低剂量西达本胺干预，检测Treg细胞对效应T细胞增殖的抑制作用。

结果

①低剂量西达本胺可明显提高ITP被动模型鼠外周血血小板水平。②低剂量西达本胺可显著提高ITP动物模型外周血血小板水平，降低出血相关死亡率。③低剂量西达本胺可显著提高ITP动物模型脾细胞中nTreg比例、降低血清IL-6水平。④低剂量西达本胺可显著提高ITP患者外周血单个核细胞培养体系中nTreg细胞比例、增强Treg细胞对效应T细胞增殖的抑制作用。

结论

低剂量西达本胺可促进nTreg生成、增强Treg细胞的免疫抑制功能、降低IL-6水平，促进免疫耐受，对ITP有较好的治疗作用。

[Clinicopathological and molecular features of pulmonary enteric adenocarcinoma]

Objective: To investigate the clinicopathological and molecular characteristics of pulmonary enteric adenocarcinoma (PEAC). Methods: The clinical and pathological data of 19 cases of PEAC in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively collected from 2015 to 2019. Immunohistochemistry (IHC) was used to detect the relevant immunophenotypes, amplification refractory mutation system (ARMS) and fluorescence in situ hybridization (FISH) were used to detect the expression of EGFR, KRAS and ALK genes. The patients were followed up, and the relevant literature was reviewed and analyzed. Results: There were 19 cases, including 10 males and 9 females, with a mean age of 58 years (range 33-71 years). Microscopically, the tumors showed moderately to highly differentiated adenoid and/or papillary growth patterns. The tumor cells were highly columnar and sometimes showed pseudostratification. Inflammatory necrosis and scattered nuclear fragmentation were seen in some glandular lumens. IHC showed variable expression of CK7 (19/19), TTF1 (8/19), Napsin A (6/19), villin (17/19), CK20 (16/19) and CDX2 (10/19). Molecular testing showed KRAS mutation in nine cases (9/19), EGFR mutation in one case (1/19), and positive ALK split signal in one case (1/19). In the literature, the reported mutation rate of KRAS in PEAC was much higher than that of EGFR and ALK. All 19 cases underwent surgical resection and 11 cases were subjected to chemotherapy or radiotherapy. Conclusions: PEAC is a rare variant of invasive pulmonary adenocarcinoma, and has similar histological and cytological features to that of colorectal adenocarcinoma. However, detailed medical history, histologic heterogeneity, an IHC combination of CK7(+)/villin(+) and high KRAS mutation rate are the key points of diagnosis. The prognosis needs long-term follow-up and big data statistics.

Identification and expression analysis of WRKY gene family under drought stress in peanut (Arachis hypogaea L.)

WRKY transcription factors play crucial roles in regulation mechanism leading to the adaption of plants to the complex environment. In this study, AhWRKY family was comprehensively analyzed using bioinformatic approaches in combination with transcriptome sequencing data of the drought-tolerant peanut variety ‘L422’. A total of 158 AhWRKY genes were identified and named according to their distribution on the chromosomes. Based on the structural features and phylogenetic analysis of AhWRKY proteins, the AhWRKY family members were classified into three (3) groups, of which group II included five (5) subgroups. Results of structure and conserved motifs analysis for the AhWRKY genes confirmed the accuracy of the clustering analysis. In addition, 12 tandem and 136 segmental duplication genes were identified. The results indicated that segmental duplication events were the main driving force in the evolution of AhWRKY family. Collinearity analysis found that 32 gene pairs existed between Arachis hypogaea and two diploid wild ancestors (Arachis duranensis and Arachis ipaensis), which provided valuable clues for phylogenetic characteristics of AhWRKY family. Furthermore, 19 stress-related cis-acting elements were found in the promoter regions. During the study of gene expression level of AhWRKY family members in response to drought stress, 73 differentially expressed AhWRKY genes were obtained to have been influenced by drought stress. These results provide fundamental insights for further study of WRKY genes in peanut drought resistance.

[Proportion and role of CD45+ erythroid progenitor cells in patients with tongue cancer metastasis]

Objective: To investigate the proportion and role of CD45+ erythroid progenitor cells (EPC) in patients with tongue cancer metastasis. Methods: The initial treatment of tongue cancer patients (n=40) from January 2017 to June 2018 in He'nan Provincial People's Hospital was included in this study. According to the presence or absence of lymph node metastasis, they were divided into tumor group (no lymph node metastasis was found in imaging and pathology) and metastasis group (both imaging and pathology confirmed lymph node metastasis). The expression of Ki-67 was detected by immunohistochemistry and the proportion of CD45+CD71+TER119+EPC was detected by flow cytometry. EPC was sorted by flow cytometry, interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) were detected by enzyme-linked immunosorbent assay (ELISA), and reactive oxygen species (ROS) was detected by flow cytometry. Transwell was used for tumor invasion test; methyl thiazolyltetrazolium (MTT) assay was used to detect proliferation level. Results: There were 20 cases in the tumor group and metastasis group. There was no significant difference between the two groups in terms of age, sex, time of onset and size of tumors. Flow cytometry showed that the ratio of CD45+EPC in peripheral blood of tumor group and metastasis group was (1.2±0.2)% and (3.1±0.2)% (t=7.823, P<0.001). Correlation analysis showed that the ratio of CD45+EPC was positively correlated with the proliferation index of Ki-67 cells (r=0.592, P=0.006). The results of flow cytometry showed that the mean fluorescence intensity (MFI) of ROS in EPC was 102.1±22.9 in tumor group and 530.0±67.2 in metastasis group (t=6.025,P<0.001). The results of ELISA showed that the mass concentrations of IL-10 and TGF-β in EPC supernatant of tumor group were (10.8±1.6) and (3.2±0.8) μg/L, respectively. The mass concentrations of IL-10 and TGF-beta in EPC supernatant of metastasis group were (26.9±3.7) and (6.4±0.9) μg/L, respectively (t=3.956, P=0.003; t=2.595, P=0.027). Transwell results showed that the proportion of invasive cells in the CD45+EPC group [(40.3±4.4)%] was higher than that in the control group [(17.5±2.2)%] (t=4.607, P=0.001). MTT proliferation experiment showed that the proliferation rate of the CD45+EPC group [(52.0±3.3)%] was higher than that of the control group [(30.5±1.9)%] (t=5.656, P<0.001). Conclusions: The proportion of CD45+EPC in patients with tongue cancer metastasis is significantly increased. CD45+EPC can promote the proliferation and metastasis of tongue cancer by secreting immunosuppressive molecules and ROS.

HMGA2 Modulates the TGFβ/Smad, TGFβ/ERK and Notch Signaling Pathways in Human Lens Epithelial-Mesenchymal Transition

BACKGROUND AND OBJECTIVE

Multiple signaling pathways coordinately promote epithelial-mesenchymal transition (EMT) in lens epithelial cells (LECs), where transforming growth factor beta (TGFβ)-mediated signaling plays a central role. But the mechanism of crosstalk among these pathways remains obscure. The objective of this study is to investigate the regulatory effect of the high mobility group protein A2 (HMGA2) on the signaling pathways in lens fibrosis.

METHODS

The human anterior capsulorhexis specimens were collected. The human SRA01/04 LEC line was cultured and treated with recombinant human TGFβ2 (5ng/ml). For inhibition of signaling pathways, a selective inhibitor SB431542, U0126 or DAPT was added to LECs respectively. The specific small interfering RNA (siRNA) were transfected to LECs for gene silence. The mRNAs expressions were measured by realtime PCR and the proteins expressions were determined by western blot and immunofluorescent staining.

RESULTS

HMGA2 and EMT markers α-smooth muscle actin (SMA), fibronectin (FN) and collagen type I (Col I) were overexpressed in human ASC specimens and TGFβ2 stimulated EMT in LECs. While blockage of EMT by a selective inhibitor of TGFβ/Smad, TGFβ/extracellular signal-regulated kinase (ERK) or Notch signaling pathway could significantly inhibited HMGA2 protein expression. And silence of HMGA2 by siRNA could significantly inhibit TGFβ2 induced expression of EMT markers including FN, Col I, collagen type IV (Col IV), key transcription factors Snail and Slug, and remarkably upregulate the epithelial markers E-cadherin and tight junction protein (ZO-1). In addition, silence of HMGA2 gene could abrogate TGFβ2 induced phosphorylation of Smad2, Smad3 as well as ERK1/2. Blockage of HMGA2 could also inhibit the upregulation of Jagged1, Notch2, and Notch3 induced by TGFβ2.

CONCLUSION

This study indicated that HMGA2 functions as a shared effector in TGFβ2- induced lens fibrosis, modulating the signaling network necessary for EMT in a positive feedback loop.

[Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients]

目的

探讨含不同剂量去甲氧柔红霉素（IDA 8、10、12 mg/m²）的IA方案诱导治疗成人初发急性髓系白血病（AML）（非急性早幼粒细胞白血病）的临床疗效和安全性。

方法

采用多中心、单盲、非随机、临床对照研究，纳入2011年5月至2015年3月苏州大学附属第一医院及其他36家单位收治的1 215例成人初发AML患者，根据诱导化疗方案中IDA的剂量对患者进行分组，分析不同剂量IDA联合阿糖胞苷（100 mg/m²）组成的IA方案在成人初发AML诱导治疗中的完全缓解（CR）率、血液学及非血液学不良事件。

结果

可纳入缓解率分析的AML患者共1 207例，IDA 8 mg/m²、10 mg/m²和12 mg/m²组的CR率分别为73.6%（215/292）、84.1%（662/787）和86.7%（111/128），差异有统计学意义（P<0.001）；以IDA 8 mg/m²组为参照组，在调整了年龄、骨髓原始细胞比例、FAB分型、危险度分层后，IDA 10 mg/m²和IDA 12 mg/m²为影响患者CR的有利因素[OR=0.49（95% CI 0.34~0.70），P<0.001；OR=0.36（95%CI 0.18~0.71），P=0.003]。在中、低危组中三组CR率分别为76.5%（163/213）、86.9%（506/582）和86.1%（68/79），差异有统计学意义（P=0.007）；在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 10 mg/m²为影响患者CR的有利因素[OR=0.47（95% CI 0.31~0.71），P<0.001]。在高危组中，三组CR率分别为50.0%（18/36）、60.6%（43/71）和81.8%（18/22），差异无统计学意义（P=0.089），但在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 12 mg/m²为影响患者CR的有利因素[OR=0.22（95% CI 0.06~0.80），P=0.022]。8 mg/m²、10 mg/m²和12 mg/m²组中性粒细胞≤0.5×10⁹/L的中位持续时间分别为14（11~18）、15（11~20）和18（14~22）d，差异有统计学意义（P=0.012）；三组PLT≤20×10⁹/L的中位持续时间分别为14（7~17）、15（11~20）和17（15~21）d，差异有统计学意义（P=0.001）；三组肺部感染发生率分别为9.8%、13.5%和25.2%，差异有统计学意义（P<0.001）。

结论

在中国成人（18~60岁）初发AML中，建议中、低危组患者采用含IDA 10 mg/m²的IA方案进行诱导治疗；而高危组AML建议选择含IDA 12 mg/m²的IA方案进行诱导治疗。

Construction of High-Density Genetic Map and Mapping Quantitative Trait Loci for Growth Habit-Related Traits of Peanut (Arachis hypogaea L.)

Plant growth habit is an important and complex agronomic trait and is associated with yield, disease resistance, and mechanized harvesting in peanuts. There are at least two distinct growth habits (erect and prostrate) and several intermediate forms existing in the peanut germplasm. A recombinant inbred line population containing 188 individuals was developed from a cross of "Jihua 5" and "M130" for genetically dissecting the architecture of the growth habit. A new high-density genetic linkage map was constructed by using specific locus amplified fragment sequencing technology. The map contains 2,808 single-nucleotide polymorphism markers distributed on 20 linkage groups with a total length of 1,308.20 cM and an average inter-marker distance of 0.47 cM. The quantitative trait locus (QTL) analysis of the growth habit-related traits was conducted based on phenotyping data from seven environments. A total of 39 QTLs for growth habit-related traits was detected on 10 chromosomes explaining 4.55-27.74% of the phenotypic variance, in which 6 QTLs were for lateral branch angle, 8 QTLs were for extent radius, 7 QTLs were for the index of plant type, 11 QTLs were for main stem height, and 7 QTLs were for lateral branch length. Among these QTLs, 12 were co-localized on chromosome B05 spanning an approximately 0.17 Mb physical interval in comparison with the allotetraploid reference genome of "Tifrunner." Analysis of the co-localized genome region has shown that the putative genes are involved in light and hormones and will facilitate peanut growth habit molecular breeding and study of peanut domestication.

[Comparative study between two bleeding grading systems of primary immune thrombocytopenia]

目的

前瞻性评价中华医学会血液学分会在《成人原发免疫性血小板减少症诊断与治疗中国专家共识（2016年版）》中推荐的原发免疫性血小板减少症（ITP）出血评分量表（2016版ITP出血评分量表）的临床应用价值。

方法

采用2016版ITP出血评分量表和ITP特异性出血评价工具（ITP-BAT）对88例ITP患者进行出血评分，分析血小板计数、性别、疾病分期与2016版ITP出血评分量表评分的关系和两种出血评分系统的一致性。在47例新诊断ITP患者大剂量地塞米松治疗前及治疗后1、2周分别进行2016版ITP出血评分量表评分及血小板计数检查，评估2016版ITP出血评分量表的反应度。

结果

出血评分和患者血小板计数呈负相关（r=−0.515，P<0.001），不同性别、疾病分期患者2016版ITP出血评分量表评分差异无统计学意义（F=4.255，P=0.382；F=5.251，P=0.753）。ITP出血评分量表与ITP-BAT具有很好的一致性。47例ITP患者大剂量地塞米松治疗前后出血评分比较差异具有统计学意义（z=−5.612，P<0.001），治疗后未达到完全反应的患者治疗前后出血评分比较差异具有统计学意义（z=−3.969，P<0.001）。两名医师背靠背评分完全相同的比例为94.4%（k=0.918）。应用2016版ITP出血评分量表进行评分耗时短于ITP-BAT评分系统[3（2~6）min对7（4~13）min，z=−8.213，P<0.001]。

结论

2016版ITP出血评分量表在临床应用中具有很好的反应度及评价一致性，与ITP-BAT评分系统具有很好的一致性，且采集信息耗时短，可作为病情判断、风险评估及疗效评价的有效工具。