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Objective: This study is aimed at exploring the association between autophagy and tumor immune infiltration (TII) in colorectal cancer (CRC). Methods and Materials: We downloaded the transcriptome profiling and clinical data for CRC from The Cancer Genome Atlas (TCGA) database and obtained the normal colon transcriptome profiling data from Genotype-Tissue Expression Project (GTEx) database. The list of autophagy-related signatures was obtained from the Human Autophagy Database. We isolated the autophagy-related genes from the CRC gene expression matrix and constructed an autophagy-related prognostic (ARP) risk model. Then, we constructed a multiROC curve to validate the prognostic ability of the ARP risk model. CIBERSORT was used to determine the fractions of 22 immune cells in each CRC sample, and the association between these TII cells and CRC clinical variables was further investigated. Finally, we estimated the association of 3 hub-ARP signatures and 20 different types of TII cell distribution. Results: We classified 447 CRC patients into 224 low-risk and 223 high-risk patients using the median ARP risk score. According to the univariate survival test results, except for gender (P = 0.672), age (P = 0.008), cancer stage, and pathological stage T, M, and N were closely correlated with the prognosis of CRC patients (P < 0.001). Multivariate survival analysis results indicate that age and rescore were the only independent prognostic indicators with significant differences (P < 0.05). After merging the immune cell distribution (by CIBERSORT) with the CRC clinical data, the results indicate that activated macrophage M0 cells exhibited the highest clinical response, which included cancer stage and stage T, N, and M. Additionally, six immune cells were closely associated with cancer stage, including regulatory T cells (Tregs), gamma delta T cells, follicular helper T cells, activated memory CD4 T cells, activated NK cells, and resting dendritic cells. Finally, we evaluated the correlation of ARP signatures with TII cell distribution. Compared with the other correlation, NRG1 and plasma cells (↑), risk score and macrophage M1 (↑), NRG1 and dendritic cell activated (↑), CDKN2A and T cell CD4 memory resting (↓), risk score and T cell CD8 (↑), risk score and T cell CD4 memory resting (↓), and DAPK1 and T cell CD4 memory activated (↓) exhibited a stronger association (P < 0.0001). Conclusions: In summary, we explored the correlation between the risk of autophagy and the TII microenvironment in CRC patients. Furthermore, we integrated different CAR signatures with tumor-infiltrating immune cells and found robust associations between different levels of CAR signature expression and immune cell infiltrating density.
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Neoplasias Colorrectales , Autofagia/genética , Neoplasias Colorrectales/metabolismo , Perfilación de la Expresión Génica , Humanos , Estadificación de Neoplasias , Microambiente Tumoral/genéticaRESUMEN
Lactate has always been regarded as a metabolic waste in the brain‚ and the understanding of its functions have been seriously lagging behind. In recent years‚ more and more experimental evidence has shown that lactate plays an important role in a variety of physiological and pathological processes. Among nerve cells‚ astrocytes are the main source of cells for the production and release of lactate. The cells produce lactate through aerobic glycolysis‚ which is then released to the outside of the cells via transmembrane channels and enters neurons to supply energy. In the central nervous system‚ lactate plays a significant role in homeostasis regulation. Lactate regulates the functions and activities of neurons mainly through two pathways: metabolic pathways (as energy substrates) and signal pathways (as signal molecules) ‚which is extensively manifested in the regulation of physiological processes such as neuronal energy metabolism‚ excitatory‚ plasticity‚ learning and memory‚ and nervous system development‚ as well as the pathological processes including depression‚ Alzheimer’ s disease (AD) and brain injury. There is a lactate-specific receptor (GPR81) in brain tissue‚ and lactate binds to it to regulate the intracellular second messenger. In addition‚ it was also found that lactate can modulate the excitability of neurons through unknown receptors and other functions as signal molecules. Therefore‚ this article focus on the research progress of lactate as an energy substrate and signaling molecule and its involvement in related neurological diseases‚ which may provide new ideas for the prevention and treatment of related central nervous system diseases.
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BackgroundCurrent reporting of Covid-19 mortality data by race and ethnicity across the United States could bias our understanding of population-mortality disparities. Moreover, stark differences in age distribution by race and ethnicity groups are seldom accounted for in analyses. MethodsTo address these gaps, we conducted a cross-sectional study using publicly-reported Covid-19 mortality data to assess the quality of race and ethnicity data (Black, Latinx, white), and estimated age-adjusted disparities using a random effects meta-analytic approach. ResultsWe found only 28 states, and NYC, reported race and ethnicity-stratified Covid-19 mortality along with large variation in the percent of missing race and ethnicity data by state. Aggregated relative risk of death estimates for Black compared to the white population was 3.57 (95% CI: 2.84-4.48). Similarly, Latinx population displayed 1.88 (95% CI: 1.61-2.19) times higher risk of death than white patients. DiscussionIn states providing race and ethnicity data, we identified significant population-level Covid-19 mortality disparities. We demonstrated the importance of adjusting for age differences across population groups to prevent underestimating disparities in younger population groups. The availability of high-quality and comprehensive race and ethnicity data is necessary to address factors contributing to inequity in Covid-19 mortality.
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<p><b>OBJECTIVE</b>The Chinese Children's Leukemia Group (CCLG)-acute lymphoblastic leukemia (ALL) 08 protocol for childhood ALL was established in 2008. This study aims to evaluate the drug-related toxicities of CCLG-ALL 08 protocol in the treatment of childhood ALL.</p><p><b>METHODS</b>A total of 114 children with newly diagnosed ALL were treated with the CCLG-ALL 08 protocol. The protocol was divided into five phases: remission induction (VDLD), early reinforcement (CAM), consolidation therapy, delayed reinforcement (DIa & DIb) and maintenance treatment. Drug-related toxicities in each phase were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0.</p><p><b>RESULTS</b>Toxicities were more frequent in phase VDLD than other treatment phases, including hepatotoxicity (87.7%), dental ulcer (20.2%), hyperglycemia (20.2%), prolonged activated partial thromboplastin time (21.1%) and decreased fibrinogen (34.2%), with the incidence rates of severe adverse events at 7%, 0, 1.3%, 0.8% and 2.7% respectively. The incidence of allergic reaction to L-ASP was significantly higher in phase DIa than in phase VDLD (28.0% vs 7.9%; P<0.01), and there were no longer any allergic reactions in 15 patients who received continuing treatment with pegaspargase instead. There was no severe arrhythmia, myocardial ischemia, decreased left ventricular function, osteonecrosis, myopathy, organ failure or treatment-related mortality.</p><p><b>CONCLUSIONS</b>The drug-related toxicities of CCLG-ALL 08 protocol are common in phase VDLD, but they are mild and reversible. There is no treatment-related mortality. The CCLG-ALL 08 protocol for childhood ALL is safe.</p>
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Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica , Asparaginasa , Leucemia-Linfoma Linfoblástico de Células Precursoras , Quimioterapia , Inducción de RemisiónRESUMEN
<p><b>OBJECTIVE</b>To analyze the clinical and laboratory data from acute lymphoblastic leukemia (ALL) patients and the results of treatment using 04 Protocol (suggested by the Pediatric Hematology Group of Chinese Medical Association in 2004).</p><p><b>METHODS</b>This study included 88 children with ALL below the age of 18 years during the period from October 1, 2004 to June 30, 2007. Minimal inhibitory concentration (MIC) and clinical risk classification were done and the new chemotherapy regimen was used according to the protocol. Patients were stratified into low-risk (LR), medium-risk (MR), and high-risk (HR) groups. Life table method was used to estimate survival rate and statistical analysis was done by using software SPSS for Windows.</p><p><b>RESULTS</b>From October 2004 to June 2007, 88 childhood ALL patients were treated with the 04 Protocol. Sixty-three (91.30%) patients attained complete remission (CR) and 17 patients lost to follow up. The overall 4-year-event-free survival (EFS) rate (+/- SE) was (59.73 +/- 7.22)%. EFS was (75.60 +/- 9.71)% in the LR (n = 30), (65.50 +/- 11.69)% in the MR (n = 20) and (44.03 +/- 12.36)% in the HR. Relapse occurred in 18.18% of patients. Seven (7.95%) of 88 patients with ALL died during he induction therapy. Infection was the most common cause of death.</p><p><b>CONCLUSION</b>The outcome of patients treated with the 04 Protocol was favorable. Clinical risk classification and the leukemia cells of D19 are independent predictors of prognosis of ALL. High dose methotrexate played an important role in prevention and treatment of central nervous system leukemia. The mortality rate of this chemotherapeutic protocol during induction therapy was high.</p>
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Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica , Usos Terapéuticos , China , Leucemia-Linfoma Linfoblástico de Células Precursoras , Diagnóstico , Quimioterapia , Estudios Retrospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
@#ObjectiveTo explore effect of family rehabilitation on motor function of stroke patients.MethodsTo provide family rehabilitation with community guide for 106 stroke patients, and observe therapeutic effect.ResultsFamily rehabilitation was effective on 106 cases, and the earlier therapy started, the better effect was.ConclusionFamily rehabilitation is playing an important role in treatment of stroke patients.