Acute promyelocytic leukemia with additional chromosome abnormalities in a patient positive for HIV: A case report and literature review

Acute promyelocytic leukemia (APL), especially cases of high-risk with complex chromosomes (CK), is rare in individuals infected with human immunodeficiency virus (HIV), making the establishment of therapeutic approaches challenging; often the treatment is individualized. This report describes a 49-year-old female patient with HIV who was diagnosed with high-risk APL with a new CK translocation and presents a literature review. At diagnosis, the patient presented with typical t(15;17)(q24;q21) with additional abnormalities, including add(5)(q15), add(5)(q31), add(7)(q11.2) and add(12) (p13). The results of acute myeloid leukemia mutation analysis suggested positivity for calreticulin and lysine methyltransferase 2C genes. The patient received all-trans retinoic acid combined with arsenic trioxide and chemotherapy, with morphologically complete remission after the first cycle of chemotherapy. The present report provided preliminary data for future clinical research.

First platelet transfusion refractoriness in a patient with acute myelocytic leukemia: A case report

BACKGROUND

Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia. In recent years, with platelet transfusion increasing, ineffective platelet transfusion has become increasingly prominent. Generally speaking, platelet antibodies can be produced after repeated transfusion, thus rendering subsequent platelet transfusion ineffective. We report a case of first platelet transfusion refractoriness (PTR) in a patient with acute myelocytic leukemia (AML). Due to the rarity of such cases in clinical practice, there have been no relevant case reports so far.

CASE SUMMARY

A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d. Her diagnosis was acute myelocytic leukemia [M2 type Fms related receptor tyrosine kinase 3, Isocitrate Dehydrogenase 1, Nucleophosmin 1, Neuroblastoma RAS viral oncogene homolog (+) high-risk group]. She was treated with "IA" (IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5) chemotherapy. When her condition improved, the patient was discharged from the hospital, instructed to take medicine as prescribed by the doctor after discharge, and returned to the hospital for further chemotherapy on time.

CONCLUSION

We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy, which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load. This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML. When platelet antibodies are produced, immunoglobulins can be used to block antibodies, thereby reducing platelet destruction. For patients with PTR, both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.

Multiple myeloma in a patient with chronic myeloid leukemia: A case report

Chronic myeloid leukemia (CML), a clonal myeloproliferative disorder of pluripotent hematopoietic stem cells, results from the Philadelphia chromosome (Ph) chromosome. The Ph is from a translocation, t(9;22)(q34q11), that creates a BCR-ABL fusion gene, which is transcribed into proteins with abnormal tyrosine kinase activity, driving the abnormal proliferation of white blood cells. Multiple myeloma (MM) is a proliferation disorder of plasma cells derived from a single clone, which may lead to uncontrolled growth, kidney injury, destructive bone lesions, hypercalcemia and anemia. It is extremely rare that MM and CML should occur in the same patient either synchronously or metachronously. To date, MM accompanied with CML has only been reported in limited studies, and the the cause behind the occurrence of both malignancies together is not understood. With the advent of novel therapies, the survival time in patients with CML and MM has improved. Therefore, the further investigation of the pathophysiology and clinical characteristics of these cases is valuable. The present study reports the case of a 79-year-old male who had been diagnosed with CML and treated with tyrosine kinase inhibitor, and then developed immunoglobulin G-κ MM after 6 years. This report should provide valid raw data for clinical research.

Effect of Haemophilus influenzae, Streptococcus pneumoniae and influenza vaccinations on infections, immune response, and asthma control in preschool children with asthma

BACKGROUND

Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (pneumococcus), and influenza vaccines are administered in children to prevent infections caused by these pathogens. The benefits of vaccination for asthma control in children and the elicited immune response are not fully understood. This study aims to investigate the impact of these vaccinations on respiratory infections, asthma symptoms, asthma severity and control status, pathogen colonization, and in vitro immune responses to different stimulants mimicking infections in asthmatic children.

METHODS

Children aged 4-6 years were recruited into the multi-center prospective PreDicta study conducted across five European countries. Information about vaccination history, infections, antibiotic use, inhaled corticosteroid (ICS) use, and asthma symptoms in the last 12 months were obtained from questionnaires of the study. Nasopharyngeal samples were collected at the first visit to assess bacterial and viral colonization, and venous blood for isolation of peripheral blood mononuclear cells (PBMCs). PBMCs were stimulated with phytohemagglutinin, R848, Poly I:C and zymosan. The levels of 22 cytokines and chemokines were measured in cell culture supernatants using a luminometric multiplex assay.

RESULTS

140 asthmatic preschool children (5.3 ± 0.7 years) and 53 healthy children (5.0 ± 0.8 years) from the PreDicta cohort were included in the current study. Asthmatic children were associated with more frequent upper and lower respiratory infections, and more frequent and longer duration of antibiotic use compared to healthy children. In asthmatic children, sufficient H. influenzae vaccination was associated with a shorter duration of upper respiratory infection (URI) and overall use and average dose of ICS. The airway colonization was characterized by less pneumococcus and more rhinovirus. Pneumococcal vaccination was associated with a reduction in the use rate and average dose of ICS, improved asthma control, and less human enterovirus and more H. influenzae and rhinovirus (RV) airway colonization. Influenza vaccination in the last 12 months was associated with a longer duration of URI, but with a decrease in the occurrence of lower respiratory infection (LRI) and the duration of gastrointestinal (GI) infection and antibiotic use. Asthmatic preschoolers vaccinated with H. influenzae, pneumococcus or influenza presented higher levels of Th1-, Th2-, Th17- and regulatory T cells (Treg)-related cytokines in unstimulated PBMCs. Under stimulation, PBMCs from asthmatic preschoolers with pneumococcal vaccination displayed a predominant anti-inflammatory immune response, whereas PBMCs from asthmatic children with sufficient H. influenzae or influenza vaccination were associated with both pro- and anti-inflammatory immune responses.

CONCLUSION

In asthmatic preschoolers, the standard childhood vaccinations to common respiratory pathogens have beneficial effects on asthma control and may modulate immune responses relevant to asthma pathogenesis.

[Promoting the application of federated learning in medical imaging artificial intelligence]

Medical image-based artificial intelligence (AI) systems have shown great potential in assisting disease diagnosis and treatment. However, the challenges, such as data silos, privacy security and standardization, seriously impedes the application of AI in disease diagnosis and treatment. By integrating federated learning technology and FAIR data principle, it is possible to resolve the aforementioned obstacles. Then, it is able to maximize the value of multicenter data to develop a more efficient and accurate disease diagnosis and treatment AI systems, and promote the clinical application of medical image-based AI systems in the field of disease diagnosis and treatment.

[Paying attention to the clinical application of radiomics]

Since the concept of radiomics was proposed, both domestic and foreign scholars have successively carried out many scientific researches on radiomics. Domestic and foreign research teams and their corresponding research have achieved certain results in radiomics, but we still face many challenges on the clinical application of radiomics-based models. Currently radiomics is still facing challenges. We should certainly pay attention to the research hotspots, existing problems, and future perspectives of radiomics.

[Breeding of new Artemisia annua variety "Kehao No.1"]

As a natural plant source of artemisinin,a first-line drug against malaria,Artemisia annua directly affects the extraction process of artemisinin and the source of artemisinin. At present,traditional breeding methods combined with tissue culture are often used to breed high-yield artemisinin-containing new varieties of A. annua. However,the breeding method has the disadvantages of low efficiency and continuous selection. In this study,heavy ion beam irradiation technology was used to observe the specific germplasm resources of A. annua,and the morphological characteristics,agronomic traits and artemisinin content were used as indicators to observe the selection materials and materials. The cultivated new varieties were compared with trials and regional trials. In addition,the new variety of A. annua was identified by SRAP molecular marker technology. The results showed that the new variety of A. annua, " Kehao No.1",had an average yield of 235. 0 kg of dry leaf per mu,which was more than 20% higher than that of the control. Especially,the average artemisinin content was 2. 0%,which was 45% higher than that of the control,and the " Kehao No.1" has high anti-white powder disease,high-yield and high-quality new varieties. Therefore,mutagenic breeding of heavy ion beam irradiation can significantly improve the yield and artemisinin content of the " Kehao No. 1" and it has a good promotion value.

Optimization of a pretreatment and hydrolysis process for the efficient recovery of recycled sugars and unknown compounds from agricultural sweet sorghum bagasse stem pith solid waste

Background

Sweet sorghum bagasse (SSB), comprising both a dermal layer and pith, is a solid waste generated by agricultural activities. Open burning was previously used to treat agricultural solid waste but is harmful to the environment and human health. Recent reports showed that certain techniques can convert this agricultural waste into valuable products. While SSB has been considered an attractive raw material for sugar extraction and the production of value-added products, the pith root in the SSB can be difficult to process. Therefore, it is necessary to pretreat bagasse before conventional hydrolysis.

Methods

A thorough analysis and comparison of various pretreatment methods were conducted based on physicochemical and microscopic approaches. The responses of agricultural SSB stem pith with different particle sizes to pretreatment temperature, acid and alkali concentration and enzyme dosage were investigated to determine the optimal pretreatment. The integrated methods are beneficial to the utilization of carbohydrate-based and unknown compounds in agricultural solid waste.

Results

Acid (1.5−4.5%, v/v) and alkali (5−8%, w/v) reagents were used to collect cellulose from different meshes of pith at 25–100 °C. The results showed that the use of 100 mesh pith soaked in 8% (w/v) NaOH solution at 100 °C resulted in 32.47% ± 0.01% solid recovery. Follow-up fermentation with 3% (v/v) acid and 6.5% (w/v) alkali at 50 °C for enzymolysis was performed with the optimal enzyme ratio. An analysis of the surface topography and porosity before and after pretreatment showed that both the pore size of the pith and the amount of exposed cellulose increased as the mesh size increased. Interestingly, various compounds, including 42 compounds previously known to be present and 13 compounds not previously known to be present, were detected in the pretreatment liquid, while 10 types of monosaccharides, including D-glucose, D-xylose and D-arabinose, were found in the enzymatic solution. The total monosaccharide content of the pith was 149.48 ± 0.3 mg/g dry matter.

Discussion

An integrated technique for obtaining value-added products from sweet sorghum pith is presented in this work. Based on this technique, lignin and hemicellulose were effectively broken down, amorphous cellulose was obtained and all sugars in the sweet sorghum pith were hydrolysed into monosaccharides. A total of 42 compounds previously found in these materials, including alcohol, ester, acid, alkene, aldehyde ketone, alkene, phenolic and benzene ring compounds, were detected in the pretreatment pith. In addition, several compounds that had not been previously observed in these materials were found in the pretreatment solution. These findings will improve the transformation of lignocellulosic biomass into sugar to create a high-value-added coproduct during the integrated process and to maximize the potential utilization of agricultural waste in current biorefinery processing.

[Exploring the clinical characters of Shugan Jieyu capsule through text mining]

In this paper,the potential climate factors affecting the Pairs polyphylla var. yunnanensis distribution in China at rational scales were selected from related literatures, using the sampling point geographic information from of P. polyphylla var. yunnanensis, combine the maximum entropy model (MaxEnt) with spatial analyst function of ArcGIS software, to study the climate suitability of P. polyphylla var. yunnanensis cultivating region in China and the leading climate factors. The results showed that, average rainfall in August, average rainfall in October, coefficient of variation of seasonal precipitation, the average temperature of the dry season, isothermal characteristic, average temperature in July were the leading climate factors affecting the potential distribution of P. polyphylla var. yunnanensis cultivating region in China, with their cumulative contribution rate reached 97.2% of all candidate climate factors. Existence probability of the region to be predicted of P. polyphylla var. yunnanensis through the constructed model, the climate unsuitable region, low, medium and high region of P. polyphylla var. yunnanensis in China were clarified and the threshold of climatic factors were gave and clarified the climate characteristics of the cultivating region in each climatic suitability division. The results of research can provide reference for production layout and introduction of P. polyphylla var. yunnanensis.

[Comparative and path analysis between underground tuber yield and agronomic traits in cultivation provenances of Gastrodia elata f. glauca from Zhaotong]

To provide guidance for quality control and variety breeding of Gastrodia elata f. glauca cultivated form in Zhaotong, nine agronomic traits of G. elata f. glauca cultivation form were measured and the traits were analyzed using multiple comparison,correlation analysis, multiple stepwise regression analysis and path analysis. The results of multiple comparison and analysis showed that the number of dot ring and the length-width ratio of tuber were no different in G. elata f. glauca cultivation form. The coefficient of variation about the single tuber fresh weigh, ring spacing and belly button diameter was about 20%. The coefficient of variation about the length of the tuber, the width of the tuber, the thickness of the tuber, the length-width ratio of tuber and the number of dot ring was near 10%. The correlation analysis results showed that the single tuber fresh weigh and the length,the width and the thickness of the tuber were extremely significant positive correlated. The results of multiple stepwise regression analysis and path analysis showed that the length, the width and the thickness of the tuber were the main factors affecting the fresh weight of single tuber,which were the best agronomic traits on high yield of G. elata f. glauca. The length of the tuber,the width of the tuber and the thickness of the tuber, which would be used as indicators of the characteristics of high yield varieties in Zhaotong. The number of dot ring and the length-width ratio of tuber, which would be selected as quality control indicators of the genuine Chinese medicinal materials in Zhaotong.

(-)-Epigallocatechin-3-gallate alleviates doxorubicin-induced cardiotoxicity in sarcoma 180 tumor-bearing mice

AIMS

(-)-Epigallocatechin-3-gallate (EGCG), a major green tea polyphenol compound, plays an important role in the prevention of cardiovascular disease and cancer. The present study aimed to investigate the effects of EGCG on doxorubicin (DOX)-induced cardiotoxicity in Sarcoma 180 (S180) tumor-bearing mice.

MAIN METHODS

S180 tumor-bearing mice were established by subcutaneous inoculation of S180 cells attached to the axillary region. The extent of myocardial injury was accessed by the amount of lactate dehydrogenase (LDH) released in serum. Heart tissue was morphologically studied with transmission electron microscopy. Apoptosis, reactive oxygen species (ROS) generation, mitochondrial membrane potential (ΔѰm) as well as calcium concentration were measured by flow cytometric analysis. Expression levels of manganese superoxide dismutase (MnSOD) were analyzed by Western blot.

KEY FINDINGS

Results showed that the combination with EGCG and DOX significantly inhibited tumor growth and enhanced induction of apoptosis compared with DOX alone. Moreover, administration of EGCG could suppress DOX-induced cardiotoxicity as evidenced by alleviating LDH release and apoptosis in cardiomyocyte. EGCG-evoked cardioprotection was in association with the increase of ΔѰm and MnSOD expression. EGCG was also found to attenuate ROS generation and myocardial calcium overload in Sarcoma 180 tumor-bearing mice subjected to DOX.

SIGNIFICANCE

EGCG alleviated DOX-induced cardiotoxicity possibly in part mediated by increasing of MnSOD and Ѱm, reducing myocardial calcium overload and subsequently attenuating the apoptosis and LDH release. Our findings suggest that co-administration of EGCG and DOX have potential as a feasible strategy to mitigate cardiotoxicity of DOX without compromising its chemotherapeutic value.

Relationship between left ventricular end-diastolic compliance and abnormal Doppler mitral filling in patients with coronary artery disease

Left ventricular end-diastolic compliance (LVEDC) and transmitral flow velocities were measured in 19 patients with coronary artery disease associated with hypertension and 10 normal subjects by LV catheterization and pulsed-Doppler echocardiography. LVEDC was much lower in the patient than in the normal subjects (P less than 0.01). The data showed that abnormal Doppler diastolic function such as elevated late diastolic peak flow velocity (PVA) and decreased LVEDC occurred in the patients at the same time. In addition, the negative correlation of PVA with LVEDC observed in normal controls but not in patients suggested that in patients with impaired diastolic filling, factors other than the decreased LVEDC itself must also participate in the development of diastolic dysfunction.