Study on the correlation between dietary inflammatory index and reflux esophagitis / 中华消化杂志

Objective:To evaluate the correlation between inflammatory diet and reflux esophagitis (RE) with the dietary inflammatory index (DII), and to provide scientific evidence for the prevention and treatment of RE at the level of dietary guidance.Methods:From December 2021 to September 2022, 145 RE patients (RE group) who visited the First Affiliated Hospital of Xinjiang Medical University were recruited. During the same period, 145 subjects who underwent check-ups at the First Affiliated Hospital of Xinjiang Medical University were selected as the healthy control group, and age and gender were matched according to the ratio of 1 to 1. The baseline data of the 2 groups, including body mass index, the history of smoking and drinking, poor dietary habits, and physical activity intensity were collected. Dietary intake of the patients was assessed by a semi-quantitative food frequency questionnaire, and the overall DII was calculated to evaluate the potential anti-inflammatory or pro-inflammatory effects of diet. According to the tertiles of the DII of the healthy control group (33.3% and 66.7% as the cut-off), dietary inflammatory potential was divided into low (<-0.06), moderate (-0.06 to 1.11) and high pro-inflammatory potential diet (>1.11). Logistic regression model was performed to analyze the correlation between DII and RE risk. Linear trend test was used to compare the overall change trend of RE risk OR value along with the increase of DII. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:The body mass index of RE group was higher than that of healthy control group( (24.11±2.57) kg/m 2 vs. (23.38 ±2.60) kg/m 2), and the difference was statistically significant ( t=-2.41, P=0.017). The proportions of smoking, drinking, over-eating, and eating within 3 h before bedtime of RE group was higher than those of the healthy control group (42.8%, 62/145 vs. 31.0%, 45/145; 31.0%, 45/145 vs. 16.6%, 24/145; 33.1%, 48/145 vs. 17.9%, 26/145; 52.4%, 76/145 vs. 13.1%, 19/145), and the differences were statistically significant ( χ2=4.28, 8.39, 8.78 and 50.86, P=0.039, 0.004, 0.003 and<0.001). While the proportions of night snacking and moderate to severe physical activity of RE group were lower than those of the healthy control group (14.5%, 21/145 vs. 24.1%, 35/145; 22.8%, 33/145 vs.37.2%, 54/145), and the differences were statistically significant ( χ2=4.34 and 7.24, P=0.037 and 0.007). The DII of RE group was higher than that of the healthy control group (1.05 (0.03, 1.62) vs. 0.34(-0.61, 1.35)), and the difference was statistically significant ( Z=8 661.50, P=0.010). Compared with the low pro-inflammatory potential diet, high pro-inflammatory potential diet had a 1.30-fold increased the risk of RE ( OR=2.30, 95% confidence interval (95% CI) 1.29 to 4.09, P=0.005). After adjusting for total energy intake, age, gender, ethnicity, body mass index, education level, and physical activity intensity, the high pro-inflammatory potential diet was still positively correlated with the risk of RE ( OR=2.58, 95% CI 1.16 to 5.76, P=0.020). In the continuous DII, the risk of RE increased by 36% for each 1 increase in DII ( OR=1.36, 95% CI 1.11 to 1.68, P=0.003). After adjusting for major confounding factors, the continuous DII was still positively correlated with the risk of RE ( OR=1.41, 95% CI 1.08 to 1.85, P=0.012; OR=1.42, 95% CI 1.05 to 1.93, P=0.023). The results of trend test showed that the higher the DII, the greater the risk of RE ( P=0.039). Conclusions:Pro-inflammatory diet is correlated with the increased risk of RE, and there is a certain dose-response relationship. Reasonable reduction of the intake of pro-inflammatory food may be beneficial to reduce the risk of RE.

Clinical characteristics and drug efficacy evaluation of voltage-gated potassium channel-related genetic epilepsy / 中国药理学通报

Aim To analyze the genotype-phenotype characteristics of voltage-gated potassium channels (Kv) associated genetic epilepsy and evaluate the efficacy of anti-seizure medications(ASMs). Methods PubMed database was searched and patients meeting the inclusion criteria were included for analysis. We divided the patients into “benign”, “encephalopathic” and other phenotypes according to the clinical characteristics. We performed descriptive statistical analysis of patients' mutated genes, clinical phenotype and drug efficacy, and used logistic regression to explore the influencing factors of treatment outcome. Results Data of 474 children were included for analysis. There were significant differences among different phenotypes in mutated genes, source of mutations and so on. In terms of clinical characteristics, there were also significant differences between patients with different phenotypes in age of onset, combined developmental delay and so on. In terms of monotherapy, phenobarbital was the most common treatment choice for children with “benign” phenotype, and sodium channel blockers (SCBs) were the most common treatment choice for children with “encephalopathy” phenotype, and the efficacy of SCBs monotherapy was superior to that of other ASMs. Multivariate Logistic analysis of the children receiving monotherapy showed that whether the children were combined with developmental delay and whether SCBs were used were significant factors influencing the efficacy of drug therapy. Conclusions Patients with the “benign” and “encephalopathic” phenotypes differ in several aspects of genetic variation, clinical characteristics, and drug selection. These results suggest that SCBs may be one of the recommended options for monotherapy.

Clinical features and prognosis of core binding factor acute myeloid leukemia children in South China: a multicenter study / 中华儿科杂志

Objective: To analyze the clinical features, efficacy and prognosis factors of core binding factor (CBF) acute myeloid leukemia (AML) children in South China. Methods: This was a retrospective cohort study. Clinical data of 584 AML patients from 9 hospitals between January 2015 to December 2020 was collected. According to fusion gene results, all patients were divided into two groups: CBF-AML group (189 cases) and non-CBF-AML group (395 cases). CBF-AML group were divided into AML1-ETO subgroup (154 cases) and CBFβ-MYH11 subgroup (35 cases). Patients in CBF-AML group chosen different induction scheme were divided into group A (fludarabine, cytarabine, granulocyte colony stimulating factor and idarubicin (FLAG-IDA) scheme, 134 cases) and group B (daunorubicin, cytarabine and etoposide (DAE) scheme, 55 cases). Age, gender, response rate, recurrence rate, mortality, molecular genetic characteristics and other clinical data were compared between groups. Kaplan-Meier method was used for survival analysis and survival curve was drawn. Cox regression model was used to analyze prognostic factors. Results: A total of 584 AML children were diagnosed, including 346 males and 238 females. And a total of 189 children with CBF-AML were included, including 117 males and 72 females. The age of diagnosis was 7.3 (4.5,10.0)years, and the white blood cell count at initial diagnosis was 21.4 (9.7, 47.7)×109/L.The complete remission rate of the first course (CR1) of induction therapy, relapse rate, and mortality of children with CBF-AML were significantly different from those in the non-CBF-AML group (91.0% (172/189) vs. 78.0% (308/395); 10.1% (19/189) vs. 18.7% (74/395); 13.2% (25/189) vs. 25.6% (101/395), all P<0.05). In children with CBF-AML, the CBFβ-MYH11 subgroup had higher initial white blood cells and lower proportion of extramedullary invasion than the AML1-ETO subgroup, with statistical significance (65.7% (23/35) vs. 14.9% (23/154), 2.9% (1/35) vs. 16.9% (26/154), both P<0.05). AML1-ETO subgroup had more additional chromosome abnormalities (75/154), especially sex chromosome loss (53/154). Compared with group B, group A had more additional chromosome abnormalities and a higher proportion of tumor reduction regimen, with statistical significance (50.0% (67/134) vs. 29.1% (16/55), 34.3% (46/134) vs. 18.2% (10/55), both P<0.05). Significant differences were found in 5-years event free survival (EFS) rate and 5-year overall survival (OS) rate between CBF-AML group and non-CBF-AML group ((77.0±6.4)%vs. (61.9±6.7)%,(83.7±9.0)%vs. (67.3±7.2)%, both P<0.05).EFS and OS rates of AML1-ETO subgroup and CBFβ-MYH11 subgroup in children with CBF-AML were not significantly different (both P>0.05). Multivariate analysis showed in the AML1-ETO subgroup, CR1 rate and high white blood cell count (≥50×109/L) were independent risk factors for EFS (HR=0.24, 95%CI 0.07-0.85,HR=1.01, 95%CI 1.00-1.02, both P<0.05) and OS (HR=0.24, 95%CI 0.06-0.87; HR=1.01, 95%CI 1.00-1.02; both P<0.05). Conclusions: In CBF-AML, AML1-ETO is more common which has a higher extramedullary involvement and additional chromosome abnormalities, especially sex chromosome loss. The prognosis of AML1-ETO was similar to that of CBFβ-MYH11. The selection of induction regimen group FLAG-IDA for high white blood cell count and additional chromosome abnormality can improve the prognosis.

Quality evaluation of Qilong Zhuang'er oral liquid based on UHPLC-Q-exactive orbitrap MS and chemometrics analysis / 药学学报

An UHPLC-Q-exactive orbitrap MS method for the simultaneous determination of 19 chemical components in Qilong Zhuang'er oral liquid was established and the quality differences between different batches of samples was compared by chemometric analysis to provide a basis for the quality evaluation of the preparation. The contents of allantoin, L-proline, pyroglutamic acid, hordenine, adenosine, L-phenylalanine, guanosine, L-tryptophan, caffeic acid, calycosin-7-glucoside, verbascoside, isoacteoside, ononin, calycosin, 3-hydroxy-9,10-dimethoxyptercarpan, formononetin, atractylenolide III, atractylenolide II and astragaloside A were analyzed by cluster heat map, principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) using Hiplot platform and MarkerlynxXS software to comprehensively evaluate the quality difference of different batches of Qilong Zhuang'er oral liquid. The 19 chemical compounds showed good linearity in their respective concentration ranges (r ≥ 0.999). The RSD of precision, repeatability and stability (24 h) tests were all less than 1.94%. The average recovery was 97.24%-102.75% (RSD < 2.74%, n = 6). The 10 batches of samples were divided into two categories by cluster heat map and PCA analysis. 3-Hydroxy-9,10-dimethoxyptercarpan, atractylenolide III, calycosin, atractylenolide II, formononetin, allantoin and caffeic acid were identified as differential markers by PLS-DA. The established multi component quantitative method of Qilong Zhuang'er oral liquid combined with chemometric analysis can provide reference for the quality evaluation of the preparation.

Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children's Leukemia Group.

Objectives: The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children's Leukemia Group (SCCLG). Methods: A total of 1,872 childhood patients were recruited for the study between October 2016 and July 2021. The diagnosis of CNSL depends on primary cytological examination of cerebrospinal fluid, clinical manifestations, and imaging manifestations. Patients with CNSL at diagnosis received two additional courses of intrathecal triple injections during induction. Results: The frequency of CNLS at the diagnosis of B-cell ALL was 3.6%. Patients with CNSL at diagnosis had a significantly higher mean presenting leukocyte count (P = 0.002) and poorer treatment response (P <0.05) compared with non-CNSL patients. Moreover, CNSL status was associated with worse 3-year event-free survival (P = 0.030) and a higher risk of 3-year cumulative incidence of relapse (P = 0.008), while no impact was observed on 3-year overall survival (P = 0.837). Multivariate analysis revealed that CNSL status at diagnosis was an independent predictor with a higher cumulative incidence of relapse (hazard ratio = 2.809, P = 0.016). Conclusion: CNSL status remains an adverse prognostic factor in childhood B-cell ALL, indicating that additional augmentation of CNS-directed therapy is warranted for patients with CNSL at diagnosis.

Inhibition of Human Sulfotransferases by Phthalate Monoesters.

Objective: This study aimed to investigate the inhibition of human important phase II metabolic enzyme sulfotransferases (SULTs) by phthalate monoesters, which are important metabolites of phthalate esters (PAEs). Method: Recombinant SULT-catalyzed metabolism of p-nitrophenol (PNP) was employed as the probe reactions of SULTs to investigate the inhibition of 8 kinds of phthalate monoesters towards SULT isoforms. An in vitro incubation system was utilized for preliminary screening, and 100 µM of phthalate monoesters was used. Inhibition kinetics were carried out to determine the inhibition of SULTs by phthalate monoesters. Result: Multiple phthalate monoesters have been demonstrated to exert strong inhibition potential towards SULT1A1, SULT1B1, and SULT1E1, and no significant inhibition of phthalate monoesters towards SULT1A3 was found. The activity of SULT1A1 was strongly inhibited by mono-hexyl phthalate (MHP), mono-octyl phthalate (MOP), mono-benzyl phthalate (MBZP), and mono-ethylhexyl phthalate (MEHP). Monobutyl phthalate (MBP), MHP, MOP, mono-cyclohexyl phthalate (MCHP), and MEHP significantly inhibited the activity of SULT1B1. MHP, MOP, and MEHP significantly inhibited the activity of SULT1E1. MOP was chosen as the representative phthalate monoester to determine the inhibition kinetic parameters (Ki) towards SULT1B1 and SULT1E1. The inhibition kinetic parameters (Ki) were calculated to be 2.23 µM for MOP-SULT1B1 and 5.54 µM for MOP-SULT1E1. In silico docking method was utilized to understand the inhibition mechanism of SULT1B1 by phthalate monoesters. Conclusions: All these information will be beneficial for understanding the risk of phthalate monoester exposure from a new perspective.

A Nomogram for Predicting Event-Free Survival in Childhood Acute Lymphoblastic Leukemia: A Multicenter Retrospective Study.

Objective: Even though childhood acute lymphoblastic leukemia (ALL) has an encouraging survival rate in recent years, some patients are still at risk of relapse or even death. Therefore, we aimed to construct a nomogram to predict event-free survival (EFS) in patients with ALL. Method: Children with newly diagnosed ALL between October 2016 and July 2021 from 18 hospitals participating in the South China children's leukemia Group (SCCLG) were recruited and randomly classified into two subsets in a 7:3 ratio (training set, n=1187; validation set, n=506). Least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis were adopted to screen independent prognostic factors. Then, a nomogram can be build based on these prognostic factors to predict 1-, 2-, and 3-year EFS. Concordance index (C-index), area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance and clinical utility of nomogram. Result: The parameters that predicted EFS were age at diagnosis, white blood cell at diagnosis, immunophenotype, ETV6-RUNX1/TEL-AML1 gene fusion, bone marrow remission at day 15, and minimal residual disease at day 15. The nomogram incorporated the six factors and provided C-index values of 0.811 [95% confidence interval (CI) = 0.792-0.830] and 0.797 (95% CI = 0.769-0.825) in the training and validation set, respectively. The calibration curve and AUC revealed that the nomogram had good ability to predict 1-, 2-, and 3-year EFS. DCA also indicated that our nomogram had good clinical utility. Kaplan-Meier analysis showed that EFS in the different risk groups stratified by the nomogram scores was significant differentiated. Conclusion: The nomogram for predicting EFS of children with ALL has good performance and clinical utility. The model could help clinical decision-making.

Oral sulfate solution versus polyethylene glycol for colonoscopy bowel preparation: a randomized controlled study in phase Ⅲ / 中华消化内镜杂志

Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.

Impact of nutrition intervention and physical exercise on muscle mass and body fat among community elderly with sarcopenia: a randomized controlled study / 中华临床营养杂志

Objective:To investigate the impact of nutrition supplementation (whey protein, fish oil and vitamin D) and physical exercise (resistance and aerobic exercise) on muscle mass and body fat metrics among community elderly with sarcopenia.Method:102 eligible sarcopenic participants per inclusion and exclusion criteria were randomized into the control group (routine consultation, n=34) or the groups receiving nutrition supplementation (Nutr, n=34) or nutrition supplementation combined with exercise (Nutr+Ex, n=34) for 12 weeks. Muscle and body fat related indicators were compared across groups pre- and post-intervention. Results:Analysis of covariance showed that all indicators were significantly different between groups (all P<0.05). Further pairwise comparisons showed that compared with controls, patients in Nutr group showed increased appendicular muscle mass (ASM) by 0.837 kg ( P=0.003, 95% CI: 0.301 to 1.372) and decreased fat mass by 2.876 kg ( P<0.01, 95% CI: -3.941 to -1.812), while patients in Nutr+Ex group showed increased ASM by 0.745 kg ( P=0.010, 95% CI: 0.180 to 1.311) and decreased fat mass by 2.928kg ( P<0.01, 95% CI: -4.408 to -1.808). Other muscle-related indicators also increased while fat-related indicators decreased in both Nutr and Nutr+Ex groups. However, there is no significant difference between Nutr and Nutr+Ex groups. Conclusions:Nutrition supplementation and physical exercise contribute to muscle mass and body fat improvement among sarcopenic elderly. Lifestyle intervention based on nutrition intervention is important for the community elderly with sarcopenia.

Enzyme-instructed and mitochondria-targeting peptide self-assembly to efficiently induce immunogenic cell death

Immunogenic cell death (ICD) plays a major role in cancer immunotherapy by stimulating specific T cell responses and restoring the antitumor immune system. However, effective type II ICD inducers without biotoxicity are still very limited. Herein, a tentative drug- or photosensitizer-free strategy was developed by employing enzymatic self-assembly of the peptide F-pY-T to induce mitochondrial oxidative stress in cancer cells. Upon dephosphorylation catalyzed by alkaline phosphatase overexpressed on cancer cells, the peptide F-pY-T self-assembled to form nanoparticles, which were subsequently internalized. These affected the morphology of mitochondria and induced serious reactive oxygen species production, causing the ICD characterized by the release of danger-associated molecular patterns (DAMPs). DAMPs enhanced specific immune responses by promoting the maturation of DCs and the intratumoral infiltration of tumor-specific T cells to eradicate tumor cells. The dramatic immunotherapeutic capacity could be enhanced further by combination therapy of F-pY-T and anti-PD-L1 agents without visible biotoxicity in the main organs. Thus, our results revealed an alternative strategy to induce efficient ICD by physically promoting mitochondrial oxidative stress.

Effects of oxytocin on neonatal lactation behavior expression and breastfeeding / 中国实用护理杂志

Objective:To investigate the effect of oxytocin on neonatal instinctive behavior expression and breast-feeding.Methods:A total of 71 pairs of parturient women and their newborns who delivered in the delivery room of the Affiliated Hospital of Weifang Medical College from February to May 2021 were selected. According to whether oxytocin induced labor, they were divided into the oxytocin group and the control group. Widstr?m nine stages was used to observe and record neonatal behavior. Breastfeeding was followed up 3 days and 3 months after delivery.Results:Totally 35 pairs in each group were included. In the oxytocin group, the occurrence time of neonatal head or head turning, hand in mouth, body moving to nipple, lips touching areola, licking nipple, nipple and effective sucking were (18.2 ± 5.4), (27.8 ± 8.3), (31.0 ± 10.1), (44.3 ± 14.5), (47.2 ± 15.6), (49.4 ± 16.3), (48.3 ± 13.6) min, which were significantly later than those in the control group (15.3 ± 5.3), (21.0 ± 8.1), (24.3 ± 9.0), (34.0 ± 11.4), (37.2 ± 11.9), (38.6 ± 11.8), (39.6 ± 8.7) min. The difference was statistically significant ( t values ranged from -3.10 to -2.17, P<0.05). The duration of neonatal awakening, activity, crawling and familiarity in the oxytocin group were (6.9 ± 3.2), (18.9 ± 9.3), (13.6 ± 7.9), (9.2 ± 5.1) min, which were significantly longer than those in the control group (5.1 ± 2.8), (12.3 ± 7.1), (10.3 ± 5.3), (6.7 ± 4.3) min; sucking stage duration in the oxytocin group was (35.1 ± 7.2) min, which was significantly shorter than that in the control group (39.6 ± 7.1) min; all the differences were statistically significant ( t values ranged from -3.25 to 2.28, P<0.05). The times of exclusive breast-feeding in the oxytocin group were (2.8 ± 3.1), (4.5 ± 3.3), (6.9 ± 3.0) at 24, 48 and 72 h postnatal, and the exclusive breastfeeding rate at 3 months after birth was 77.1%(27/35), which were significantly lower than those (7.6 ± 3.6), (8.9 ± 2.7), (10.3 ± 2.0) and 82.9%(29/35) in the control group, the differences were statistically significant ( t=6.05, 6.11, 5.48, χ2=0.36, P<0.05). Conclusions:The use of oxytocin during labor may affect the expression of neonatal lactation behavior and negatively affect the breastfeeding.

Risk factor analysis of 46 cases of ulcerative colitis complicated with thromboembolism / 中华消化杂志

Objective:To analyze the independent risk factors of ulcerative colitis (UC) with thromboembolism (TE), in order to diagnose UC with TE as early as possible and take corresponding preventive measures, so as to improve the prognosis and reduce the mortality of UC with TE.Methods:From January 1, 2011 to December 31, 2020, at the First Affiliated Hospital of Xinjiang Medical University, from January 1, 2015 to December 31, 2020, at the Second Affiliated Hospital of Xinjiang Medical University, from January 1, 2015 to December 31, 2020, at the Fifth Affiliated Hospital of Xinjiang Medical University, during hospitalization 46 patients diagnosed with UC with TE were enrolled. According to the ratio of 1∶2, at same period 92 simple UC patients were selected as control. The condition of embolization of UC patients with TE was analyzed. The clinical data(hypertension history, length of hospital stay, etc.), the degree of disease activity, laboratory test indicators (prothrombin time (PT), D-dimer, fibrin degradation product(FDP), hemoglobin(Hb), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), etc.)of the patients of UC with TE and UC without comorbidities were compared. Multivariate logistic regression was used to analyze the independent risk factors of UC with TE. Independent sample t test, Mann-Whitney U test, Chi-square test or Fisher′s exact probability method were used for statistical analysis. Results:Among the 46 cases of UC with TE, 14 cases (30.4%) had single site venous TE, mainly venous thrombosis of lower limbs; 20 cases (43.5%) had single site arterial TE, mainly myocardial infarction and cerebral infarction; 12 cases (26.1%) had multi-site TE. The proportion of patients with hypertension history and with severe active period of UC, and the levels of D-dimer, FDP, ESR and CRP in patients with UC with TE were all higher than those in patients without comorbidities(52.2%, 24/46 vs.33.7%, 31/92, 45.7%, 21/46 vs.19.6%, 18/92, (822.03±654.33) μg/L vs.(230.28±225.62) μg/L, 5.77 mg/L(6.87 mg/L) vs. 2.10 mg/L(1.55 mg/L), (46.32±28.27) mm/1 h vs.(33.08±24.30) mm/1 h, 22.05 mg/L(46.42 mg/L) vs. 5.58 mg/L(11.58 mg/L)); the hospital stay and PT were longer than those in patients without comorbidities ((12.76±10.18) d vs.(8.66±4.89) d, (14.13±6.06) s vs.(11.86±1.42) s); the Hb and MPV were lower than those in patients without comorbidities ((110.91±31.38) g/L vs.(123.83±27.67) g/L, (9.60±0.94) fL vs.(10.04±1.16) fL; and the differences were statistically significant( χ2=4.37 and 10.29, t=-5.96, Z=-5.78, t=-2.85, Z=-3.87, t=-2.58, -2.50, 2.47 and 2.47; all P<0.05). The results of multivariate logistic regression analysis showed that severe activity period of UC ( OR=3.079, 95% confidence interval (95% CI) 1.100 to 8.615), hypertension history ( OR=4.454, 95% CI 1.467 to 13.519), and D-dimer level( OR=1.003, 95% CI 1.001 to 1.005) were all independent risk factors of UC with TE(all P<0.05). Conclusions:Lower extremity venous, myocardial infarction and cerebral infarction are common in UC with TE. Severe activity period of UC, history of hypertension and D-dimer level are independent risk factors of UC with TE. These above factors should be paid attention to and corresponding prevention should be taken.

Prognostic Value and Outcome for ETV6/RUNX1-Positive Pediatric Acute Lymphoblastic Leukemia: A Report From the South China Children's Leukemia Group.

PURPOSE: To analyzed the outcome of ETV6/RUNX1-positive pediatric acute B lymphoblastic leukemia (B-ALL) with the aim of identifying prognostic value. METHOD: A total of 2,530 pediatric patients who were diagnosed with B-ALL were classified into two groups based on the ETV6/RUNX1 status by using a retrospective cohort study method from February 28, 2008, to June 30, 2020, at 22 participating ALL centers. RESULTS: In total, 461 (18.2%) cases were ETV6/RUNX1-positive. The proportion of patients with risk factors (age <1 year or ≥10 years, WB≥50×109/L) in ETV6/RUNX1-positive group was significantly lower than that in negative group (P<0.001), while the proportion of patients with good early response (good response to prednisone, D15 MRD < 0.1%, and D33 MRD < 0.01%) in ETV6/RUNX1-positive group was higher than that in the negative group (P<0.001, 0.788 and 0.004, respectively). Multivariate analysis of 2,530 patients found that age <1 or ≥10 years, SCCLG-ALL-2016 protocol, and MLL were independent predictor of outcome but not ETV6/RUNX1. The EFS and OS of the ETV6/RUNX1-positive group were significantly higher than those of the negative group (3-year EFS: 90.11 ± 4.21% vs 82 ± 2.36%, P<0.0001, 3-year OS: 91.99 ± 3.92% vs 88.79 ± 1.87%, P=0.017). Subgroup analysis showed that chemotherapy protocol, age, prednisone response, and D15 MRD were important factors affecting the prognosis of ETV6/RUNX1-positive children. CONCLUSIONS: ETV6/RUNX1-positive pediatric ALL showed an excellent outcome but lack of independent prognostic significance in South China. However, for older patients who have the ETV6/RUNX1 fusion and slow response to therapy, to opt for more intensive treatment.

Diagnostic value of TWEAK for predicting active lupus nephritis in patients with systemic lupus erythematosus: a systematic review and meta-analysis.

PURPOSE: Accumulative studies showed that tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) was up-regulated in the blood and urine from patients diagnosed with lupus nephritis (LN) and that it might be used as a novel biomarker for active LN. This meta-analysis aimed to determine the diagnostic value of TWEAK in active LN. METHODS: We searched the Cochrane Library, Embase, PubMed, Springer, Wanfang and CNKI databases for articles published up to 20 August 2020. The diagnostic capacity of TWEAK for active LN was assessed using pooled sensitivity and specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC). Quality assessment and publication bias were also evaluated. STATA 11.0 and Meta-Disc 1.4 were used to perform these analyses. RESULTS: Nine cross-sectional studies were included in this meta-analysis. The overall pooled sensitivity of TWEAK for the diagnosis of active LN was 0.69 (95% CI, 0.63-0.75), and specificity was 0.77 (95% CI, 0.71-0.82). The overall pooled PLR and NLR were 3.31 (95% CI, 2.05-5.35) and 0.38 (95% CI, 0.26-0.55), respectively, with a DOR of 10.89 (95% CI, 6.73-17.63) and AUC (SE) of 0.8276 (0.0289). Deeks' funnel plot revealed that the publication bias was insignificant in the study (p = .32). CONCLUSIONS: Our results suggest that TWEAK might be a potential biomarker for patients with active LN. Future cross-sectional and longitudinal studies are needed to confirm its diagnostic value, as well as to establish more definite cutoff for active LN.

Effect of Curcumin on Biological Behavior of Gastric Cancer Cells Through miR-539 / 胃肠病学

Background: Studies have shown that curcumin can regulate the expressions of a variety of miRNAs and affect tumor cell biological behavior. However, whether curcumin affects the biological behavior of gastric cancer cells by regulating expression of miR-539 has not been clarified. Aims: To investigate the effect and mechanism of curcumin on proliferation, migration, invasion, apoptosis of gastric cancer cells by regulating the expression of miR-539. Methods: A total of 49 gastric cancer tissue specimens were collected. Gastric cancer AGS, SGC7901 cells were divided into blank group, curcumin group, negative control group, miR-539 mimics group, miR-539 inhibitor group, inhibitor control group, miR-539 inhibitor +curcumin group. qRT-PCR was used to detect the mRNA expression of miR-539 in gastric cancer tissue and cells. Cell proliferation was detected by MTT. Scratch test, Transwell test were used to detected cell migration and invasion. Cell apoptosis was determined by flow cytometry. Western blotting was used to detect protein expressions of APOBEC3B, c-Myc, cyclin D1, claudin-1 and N-cadherin. Results: Expressions of miR-539 mRNA in gastric cancer tissue and gastric cancer cells were significantly decreased than those in corresponding controls (P<0.05), and was related to tumor stage in gastric cancer patients (P<0.05). Curcumin up-regulated the expression of miR-539 mRNA in a dose-dependent manner (P<0.05). Compared with corresponding control group, cell proliferation, migration and invasion were significantly decreased in miR-539 mimics group and curcumin group (P<0.05), cell apoptosis rate was significantly increased (P<0.05), and protein expressions of APOBEC3B, c-Myc, cyclin D1, claudin-1 and N-cadherin were significantly decreased (P<0.05). Conclusions: Expression of miR-539 is decreased in gastric cancer, and curcumin can inhibit proliferation, migration and invasion of gastric cancer cells and induce cell apoptosis by up-regulating the expression of miR-539.

Analysis on Chemical Constituents in Rhizomes of Bergenia scopulosa by UHPLC-Q Exactive Focus MS/MS / 中国实验方剂学杂志

Objective:Ultra-high performance liquid chromatography coupled with quadrupole/electrostatic field orbital trap high resolution mass spectrometry （UHPLC-Q Exactive Focus MS/MS） was developed to rapidly analyze and identify the chemical components in the rhizomes of <italic>Bergenia scopulosa</italic>. Method:The 75% methanol extract of <italic>B</italic>.<italic> scopulosa</italic> rhizomes was analyzed on a Thermo Accucore aQ RP18 column （2.1 mm×150 mm， 2.6 μm） with the mobile phase of methanol （A） and 0.1% formic acid aqueous solution （B） for gradient elution （0-40 min 5%-95%A， 40-45 min 95%A）， the flow rate was 0.3 mL·min^-1 and the column temperature was at 30 ℃. The information of the chemical constituents was acquired in positive and negative ion modes by heated electrospray ion source （HESI）， and the scanning range was <italic>m</italic>/<italic>z</italic> 80-1 200. Result:A total of 66 chemical constituents were identified， including 2 free amino acids， 7 bergenin derivatives， 15 flavonoids， 15 organic acids， 25 glycosides， and 2 others. Conclusion:The chemical constituents in the rhizomes of <italic>B</italic>.<italic> scopulosa</italic> can be identified systematically， accurately and rapidly by this method. Among them， 8 compounds were unambiguously identified by comparing with reference substances （succinic acid， arbutin， gallic acid， protocatechuic acid， bengenin， catechin， chlorogenic acid and caffeic acid）， 51 compounds were found from <italic>B</italic>.<italic> scopulosa</italic> for the first time and 28 compounds were found from the genus <italic>Bergenia</italic> for the first time. This paper can provide an important basis for the further material basis clarification and quality assessment of <italic>B</italic>.<italic> scopulosa</italic>.

Identification of Chemical Constituents in Caulis of Erycibe schmidtii by UPLC-Q-Exactive Focus-MS/MS / 中国实验方剂学杂志

Objective:To rapidly recognize and identify the chemical constituents in caulis of Erycibe schmidtii by ultra-high performance liquid chromatography coupled with Q-Exactive Focus mass spectrometry (UPLC-Q-Exactive Focus-MS/MS). Method:Taking 80% methanol extract of E. schmidtii caulis as the test solution, the chemical constituents in caulis of E. schmidtii were analyzed and identified. Thermo Accucure aQ C18 column (2.1 mm×150 mm, 2.6 μm) was used for chromatographic separation with the mobile phase of methanol (A)-0.1% formic acid solution (B) for gradient elution (0-12 min, 5%-25%A; 12-20 min, 25%-30%A; 20-28 min, 30%-38%A; 28-40 min, 38%-42%A). Positive and negative ion monitoring modes and heated electrospray ion source (HESI) were used for mass spectrographic analysis. The scanning range was m/z 80-1 200. Result:A total of 42 chemical constituents from caulis of E. schmidtii were identified, including 12 coumarins, 14 chlorogenic acids, 1 tropane alkaloid, 1 amide and 14 esterified glycosides. Conclusion:Chemical constituents in caulis of E. schmidtii can be quickly and fully identified by UPLC-Q-Exactive Focus-MS/MS. Among them, 11 compounds are unambiguously identified by comparing with reference standards, 31 compounds are reported for the first time in this herb, 2 compounds are reported for the first time in Erycibe plants. This paper can provide the important basis for study on pharmacodynamic material base and substitute development of E. schmidtii caulis.

[Clinical Significance of CRLF2 High Expression in Bone Marrow Mononuclear Cells from Children with Acute Lymphoblastic Leukemia].

OBJECTIVE: To detect the expression of CRLF2 in bone marrow mononuclear cells from children with newly diagnosed acute lymphoblastic leukemia(ALL) and to explore its clinical significance in pediatric ALL. METHODS: A total of 218 children with newly diagnosed ALL who achieveal the complete remission and had the complete follow-up information were selected, and the expression level of CRLF2 in bone marrow mononuclear cells of these children was detected by real-time fluorescent quantitative PCR, and the significance of CRLF2 expression level in clinical prognosis of ALL children was analyzed by using statistical method. RESULTS: 28 cases in 218 children with complete data showed high expression of CRLF2. The cumulative recurrence rate in the CRLF2 high expression group was significantly higher than that in the low expression group (53.6% vs 12.6%) (P＜0.01). The predicted 5-year recurrence-free survival rate (RFS) of ALL children with CRLF2 high expression was significantly higher than that of low expression group (P＜0.01). There was no significant difference in the predicted 5-year RFS between ALL children with CRLF2 low and high expression in the standard-risk(SR) group (P＞0.05). The predicted 5-year RFS of ALL children with CRLF2 low expression was higher than that of ALL children with CRLF2 high expression in the intermediate-risk (IR) and high-risk (HR) groups. (P＜0.05). Cox analysis showed that CRLF2 high expression is an independent risk factor for the relapse of children with ALL. CONCLUSION: The recurrence rate of pediatric ALL with CRLF2 high expression is high, and CRLF2 high expression is an important prognostic factor for high risk of relapse in ALL children with IR and HR. It is necessary to use CRLF2 expression as an indicator of risk stratification in pediatric ALL.

[Clinical and genetic analyses of juvenile myelomonocytic leukemia].

OBJECTIVE: To study the clinical and genetic features of juvenile myelomonocytic leukemia (JMML) and the association between genotype and prognosis. Methods The clinical data of 15 children who were diagnosed with JMML were collected. Next-generation sequencing was used to detect common gene mutations of JMML. RESULTS: The male/female ratio was 6.5:1, and the age of onset was 19 months (range 2-67 months). Of the 15 children, 11 (73%) experienced disease onset before the age of 4 years, with abdominal distension and pyrexia as initial symptoms. All children had hepatosplenomegaly and superficial lymphadenectasis, with a number of peripheral blood mononuclear cells of >1.0×109/L and a percentage of juvenile cells of 1%-7% in peripheral blood smear. The percentage of bone marrow blasts + juvenile cells was <20%, and the percentage of monoblasts + promonocytes was 1%-10%. Of the 15 children, 10 (67%) had a higher level of hemoglobin F than the normal level at the corresponding age, with the highest level of 62.5%. All 15 children had the absence of Philadelphia chromosome, and one child had chromosome 7 deletion. All 15 children had a negative result of BCR/ABL fusion gene detection. PTPN11 gene mutation was found in 5 children (33%), NF1 mutation in 4 children (27%), CBL mutation in 3 children (20%), and RAS mutation in 3 children (20%). No children received regular chemotherapy, and one child underwent hematopoietic stem cell transplantation. The median follow-up time of 15 children was 18 months (range 1-48 months). Among the 15 children, 8 died (among whom 4 had PTPN11 gene mutation, 3 had NF1 mutation, and 1 had RAS mutation) and 7 survived. The children with PTPN11 mutation had the worst prognosis and the highest mortality rate, and those with CBL or NRAS mutation had a relatively good prognosis. The level of hemoglobin F was negatively correlated with survival time (rs=-7.21, P=0.002). CONCLUSIONS: In children with JMML, the type of gene mutation is associated with prognosis. The children with PTPN11 mutation often have a poor prognosis, and those with CBL or NRAS mutation have a relatively good prognosis.

Effects of sarcopenia on the risks of osteoporosis and fragility fractures among community-dwelling middle and old age people: a systematic review and meta-analysis / 中华临床营养杂志

Objective To explore the relationship between sarcopenia and the risks of osteoporosis and fragility fractures among community-dwelling middle and old people (≥50 years) . Methods OVID/Medline, Pubmed, EMBASE, Cochrane Library, Web of Science ( SCI ) , China National Knowledge Infrastructure ( CNKI) , and Chinese WanFang Database were searched systematically for literatures related to the relationship between sarcopenia and osteoporosis and fragility fractures from January 1987 to July 2018. The searched litera-tures were screened based on the inclusion and exclusion criteria. The quality of the literatures were evaluated by using the risk assessment tool NOS ( Newcastle-Ottawa Scale) and AHRQ ( Agency for Healthcare Research and Quality) . Meta-regression analysis was used to explore the cause of heterogeneity between studies. The sub-group analysis was used to assess the differences in the risk of osteoporosis based on the important characteristic variables, such as gender, ethnicity, age, diagnostic criteria of sarcopenia, and outcome type. Sensitivity anal-ysis and trim and fill method were conducted to test the stability of the results of this Meta-analysis. Data col-lected and summarized by Stata 12. 2 software. Results A total of 23 studies in line with quality requirements were included eventually, including 56, 544 subjects. The results of this Meta-analysis were relatively robust. Compared with non-sarcopenia, the relative risk ( RR ) for osteoporosis among subjects with sarcopenia was 1. 61 (95％ CI: 1. 42～1. 82, P<0. 00001). Especially, compared with postmenopausal women RR=1. 37 (95％ CI: 1. 23-1. 53, P<0. 0001) and yellow race RR=1. 53 (95％ CI: 1. 34-1. 75, P<0. 0001), sar-copenia had a higher impact trend on the risk of osteoporosis in older men RR=2. 26 ( 95％ CI: 1. 71-2. 98, P<0. 0001 ) and Caucasian RR = 2. 03 ( 95％ CI: 1. 46-2. 81, P<0. 0001 ) . Conclusion Among community-dwelling middle and old aged people (≥50 year) , sarcopenia increases the risk of osteoporosis and fragility fracture by 61％ and 59％ -61％ significantly, respectively. Middle and old aged people should be pre-vented and screened early for sarcopenia, which attributes to identify high risk groups of fragile fractures and re-duce the risk of adverse outcomes.