ACSL5, a prognostic factor in acute myeloid leukemia, modulates the activity of Wnt/β-catenin signaling by palmitoylation modification / 医学前沿

Acyl-CoA synthetase long chain family member 5 (ACSL5), is a member of the acyl-CoA synthetases (ACSs) family that activates long chain fatty acids by catalyzing the synthesis of fatty acyl-CoAs. The dysregulation of ACSL5 has been reported in some cancers, such as glioma and colon cancers. However, little is known about the role of ACSL5 in acute myeloid leukemia (AML). We found that the expression of ACSL5 was higher in bone marrow cells from AML patients compared with that from healthy donors. ACSL5 level could serve as an independent prognostic predictor of the overall survival of AML patients. In AML cells, the ACSL5 knockdown inhibited cell growth both in vitro and in vivo. Mechanistically, the knockdown of ACSL5 suppressed the activation of the Wnt/β-catenin pathway by suppressing the palmitoylation modification of Wnt3a. Additionally, triacsin c, a pan-ACS family inhibitor, inhibited cell growth and robustly induced cell apoptosis when combined with ABT-199, the FDA approved BCL-2 inhibitor for AML therapy. Our results indicate that ACSL5 is a potential prognosis marker for AML and a promising pharmacological target for the treatment of molecularly stratified AML.

Clinical progress of surgical methods for chronic subdural hematoma / 中国医师杂志

Chronic subdural hematoma (CSDH) is a common neurosurgical disease, especially in elderly patients, and its treatment currently includes medication conservation, surgical intervention and combination therapy. Although many cases have achieved good results through drug treatment, as far as the present situation is concerned, surgical intervention is still an irreplaceable treatment, especially for patients with large amounts of hematoma, even those with cerebral hernia or recurrence. However, there are many surgical methods about CSDH, the clinical selection is controversial, what is more, there has been some progress in minimally invasive surgery in recent years. In this paper, the surgical methods of CSDH are summarized as follows. The purpose is to provide for clinical evaluation and selection.

Predictive factors and follow-up treatment of residual cervical lesions after primary cervical conization / 中国医师进修杂志

Objective:To explore the necessity of supplementary operation after primary cervical conization for cervical lesions and the choosing method of reoperation, so as to provide clinical data for further stratification treatment after primary conization.Methods:A prospective study was performed in 116 patients with complete data due to cervical biopsy diagnosis of cervical lesions who first received cervical conization, and received supplementary surgeries within 6 months at Wenzhou People Hospital from March 2016 to March 2018, and 17 cases who received radical resection diagnosed grade Ⅰa1 with vascular infiltration or above were excluded. The patients were divided into residual and non-residual according to residual disease of supplementary surgical specimens. The residual rates of clinical and pathological factors (including incision margin, gland involvement, curettage of cervical canal) were analyzed by univariate analysis. The factors of P ≤ 0.10 were further analyzed by progressive Logistic regression. The clinical and pathological data of 41 patients undergoing repeated conization were analyzed. The follow-up data were analyzed and summarized. Results:Univariate analysis showed that the residual rate of disease in the patients with positive margin, endocervical cone margin involvement and other positive margin was 55.36% (31/56), 63.64% (14/22) and 50.00% (17/34), respectively, higher than that of the patients with negative margin 30.00% (18/60) with statistical significance ( P<0.05). There was no significant difference in pregnancy (≥ 3), parity (≥ 2), symptomatic cases between the two groups, but all P < 0.10. Multivariate analysis showed that both endocervical cone margin involvement and vaginal incision margin were independent risk factors for residual disease, and OR was 4.083 (95% CI 1.459 to 11.430, P = 0.007) and 2.333 (95% CI 0.978 to 5.569, P = 0.056); 19 cases (46.34%) of cervical lesions and 11 cases (26.83%) of high-grade cervical lesions were found in 41 cases after repeated conization. 2 cases (4.88%) of positive margin of incision were supplemented with total hysterectomy; the incidence of intraoperative massive bleeding was 4.88% (2/41). The incidence of massive hemorrhage after operation was 2.43% (1/41). Conclusions:Margin involvement and vaginal incision margin might predict the occurrence of residual disease. Additional surgery should be considered in these cases. Repeat conization can remove residual cervical lesions with minimal trauma and can be used as the preferred treatment.

CT and MRI features of undifferentiated embryonal sarcoma of liver in adults / 中华肝胆外科杂志

Objective@#To analyze the CT and MRI manifestations of undifferentiated hepatic embryonal sarcoma in adults with an aim to improve the preoperative diagnosis of this disease.@*Methods@#A retrospective analysis was carried out on the clinical data of 11 patients with undifferentiated hepatic embryonal sarcoma treated in Wenzhou People’s Hospital of Zhejiang and Wenzhou Central Hospital of Zhejiang between January 2008 and December 2018. There were 5 males and 6 females. The age ranged from 46 to 76 years (median 64 years). The site, size, morphology, margin, and pattern and degree of enhancement of the tumors were analyzed.@*Results@#Among the 11 patients, 10 patients had a single tumor, only 1 patient had multiple tumors. A total of seven patients' tumors were located in the right liver, 2 in the left liver, and 2 involved both the left and right livers. The maximum diameter of the tumors ranged from 5.5 cm to 21.2 cm, the maximum diameter (10.2±4.8 cm). The edge of tumors was clear in 9 patients and unclear in 2 patients. The tumors were elliptical in 4 patients or irregular in 7 patients. Plain CT scan showed 4 patients' tumors had mainly a cystic component, while 5 patients had both cystic and solid components. Plain MRI scan showed that five tumors were cystic and solid, with mixed internal signals. T1 weighted imaging (T1WI) showed slightly lower and lower signals; T2 weighted imaging (T2WI) showed slightly higher and higher signals. There was a low signal stripe separating inside; Diffusion-weighted imaging showed a high signal and apparent diffusion coefficient showed a low signal. The enhancement was characterized by "fast in and fast out" (marked enhancement in the arterial phase and fast clearance in the venous phase), and "delayed enhancement" (mild to moderate enhancement in the arterial phase and even more obvious enhancement in the venous or delayed phase).@*Conclusion@#Adult undifferentiated embryonic sarcoma has certain CT and MRI features. Its shape is elliptical or irregular, and mostly with a clear boundary. There were intratumoral cystic or cystic solid components, with mixed density/signal on CT and MRI, being characterized by "fast in and fast out" and "delayed enhancement" on intravenous contrast enhanced scans.

Plastome-wide comparison reveals new SNV resources for the authentication of and its corresponding medicinal slice (Huoshan Fengdou)

species and their corresponding medicinal slices have been extensively used as traditional Chinese medicine (TCM) in many Asian countries. However, it is extremely difficult to identify species based on their morphological and chemical features. In this study, the plastomes of were used as a model system to investigate the hypothesis that plastomic mutational hotspot regions could provide a useful single nucleotide variants (SNVs) resource for authentication studies. We surveyed the plastomes of 17 species, including the newly sequenced plastome of . A total of 19 SNVs that could be used for the authentication of were detected. On the basis of this comprehensive comparison, we identified the four most informative hotspot regions in the plastome that encompass to , to , to and to . Furthermore, to established a simple and accurate method for the authentication of and its medicinal slices, a total of 127 samples from 20 species including their corresponding medicinal slices (Fengdous) were used in this study. Our results suggest that and its medicinal slices can be rapidly and unequivocally identified using this method that combines real-time PCR with the amplification refractory mutation system (ARMS).

PD-1/PD-Ls SignaI pathway and the appIication of anti-PD-1/PD-Ls antibodies in cancer therapy / 中国药科大学学报

Programmed death-1(PD-1)is a major co-suppression receptor expressed on T cells.Binding with its ligands (PD-L1 and PD-L2),PD-1 can inhibit T cell proliferation,activation and cytokine secretion.In normal organs,PD-1 /PD-Ls signaling pathway plays an important role in maintaining immune tolerance,while during tumorigenesis,it can suppress T cell immune response and promote tumor immune escape.This article reviewed the research progress on PD-1 /PD-Ls signaling pathway,comprised of structure and expression of PD-1 /PD-Ls, mechanism of the signaling pathway,as well as the expression characteristics of soluble form of PD-1 /PD-L1 (sPD-1 /sPD-L1),and summarized the categories of anti-PD-1 /PD-Ls antibodies and their clinical trials in canc-er immunotherapy.