Effective Management of Polycythemia Vera With Ropeginterferon Alfa-2b Treatment.

Background: Polycythemia vera (PV) is a myeloproliferative neoplasm. Ropeginterferon alfa-2b is a new-generation polyethylene glycol-conjugated proline-interferon. It is approved for the treatment of PV at a starting dose of 100 µg (50 µg for patients receiving hydroxyurea (HU)) and dose titrations up to 500 µg by 50 µg increments. The study was aimed at assessing its efficacy and safety at a higher starting dose and simpler intra-patient dose escalation. Methods: Forty-nine patients with PV having HU intolerance from major hospitals in China were treated biweekly with an initial dose of 250 µg, followed by 350 µg and 500 µg thereafter if tolerated. Complete hematological response (CHR) was assessed every 12 weeks based on the European LeukemiaNet criteria. The primary endpoint was the CHR rate at week 24. The secondary endpoints included CHR rates at weeks 12, 36 and 52, changes of JAK2V617F allelic burden, time to first CHR, and safety assessments. Results: The CHR rates were 61.2%, 69.4% and 71.4% at weeks 24, 36, and 52, respectively. Mean allele burden of the driver mutation JAK2V617F declined from 58.5% at baseline to 30.1% at 52 weeks. Both CHR and JAK2V617F allele burden reduction showed consistent increases over the 52 weeks of the treatment. Twenty-nine patients (63.0%) achieved partial molecular response (PMR) and two achieved complete molecular response (CMR). The time to CHR was rapid and median time was 5.6 months according to central lab results. The CHRs were durable and median CHR duration time was not reached at week 52. Mean spleen index reduced from 55.6 cm2 at baseline to 50.2 cm2 at week 52. Adverse events (AEs) were mostly mild or moderate. Most common AEs were reversible alanine aminotransferase and aspartate aminotransferase increases, which were not associated with significant elevations in bilirubin levels or jaundice. There were no grade 4 or 5 AEs. Grade 3 AEs were reversible and manageable. Only one AE led to discontinuation. No incidence of thromboembolic events was observed. Conclusion: The 250-350-500 µg dosing regimen was well tolerated and effectively induced CHR and MR and managed spleen size increase. Our findings demonstrate that ropeginterferon alfa-2b at this dosing regimen can provide an effective management of PV and support using this dosing regimen as a treatment option.

Adherence to the Standards for Reporting of Diagnostic Accuracy Studies (STARD): a survey of four journals in laboratory medicine.

BACKGROUND: The Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement has been updated in 2015. Many diagnostic test accuracy (DTA) studies have been published in medical laboratory journals, but their adherence to the updated STARD statement remains unknown. METHODS: We searched the PubMed database to verify studies published in 4 laboratory journals, including Clinical Chemistry, Clinical Chemistry and Laboratory Medicine, Clinica Chimica Acta, and Clinical Biochemistry, in 2019. DTA studies were identified and their adherence to the STARD statement was assessed. RESULTS: A total of 45 studies were included in this analysis. Overall, 18 out of 34 STARD items were reported. The items (adherence rate) of sample size estimation (4%), adverse events (9%), protocol (9%), registration (16%), missing value (22%), indeterminate results (18%), and cross-tabulation (22%) were the most frequently unreported items. CONCLUSIONS: Adherence to the STARD statement in DTA articles published in laboratory medicine seems as yet unsatisfactory. Our study emphasizes the necessity to improve the reporting quality of DTA studies published in medical laboratory journals.

Changes in circulating follicular helper T cells in peripheral blood of patients with acute hepatitis C virus infection.

BACKGROUND: To investigate the changes in circulating follicular helper T cells (cTfh) in peripheral blood of patients with acute hepatitis C virus (HCV) infection and its correlation with symptom severity of the disease. METHODS: A total of 105 subjects were enrolled in this study, including 35 healthy people, 35 patients with acute HCV infection and 35 acute HCV patients with antiviral therapy. Flow cytometry was used to detect the expression of molecular markers related to the surface of cTfh cells, such as CD69, HLA-DR and CD57, and ELISA was used to detect the secretion of cytokines (IL-21, IL-4) in each group. The relationship between these markers and disease was analyzed statistically. RESULTS: Flow cytometry analysis demonstrated that the percentage of CD69 in peripheral blood of patients with acute hepatitis C infection was (18.90%±9.29%) significantly higher than that of normal control group (5.10%±4.21%) and antiviral treatment group (11.50%±5.38%). The difference was statistically significant (P<0.05). The results of HLA-DR and CD57 were consistent with CD69. The serum levels of IL-4 and IL-21 in the acute HCV infection group were significantly higher than those in the treatment and the control groups. After antiviral treatment, IL-4 and IL-21 levels significantly decreased but remained higher than those in the control group. This showed that antiviral treatment was effective, and the difference was statistically significant (P<0.05). The ratio of cTfh in infected group was negatively correlated with HCV RNA content (r=-0.6858, P=0.0028). CONCLUSIONS: Antiviral immune response in patients with acute hepatitis C infection may be related to the proportion of T helper cells in peripheral blood circulation follicles. Dynamic detection of the number of T helper cells in clinical practice is conducive to identifying more effective methods to treat acute hepatitis C infection, which has important theoretical and clinical significance.

[Effect of the contralateral needling therapy on post-stroke shoulder-hand syndrome].

OBJECTIVE: To observe the effect contralateral needling of in improving pain, edema and limb dysfunction in stroke patients with shoulder-hand syndrome. METHODS: A total of 62 patients with post-stroke shoulder-hand syndrome were divided into a control group and an observation group, 31 cases in each one. The routine treatment with internal medicine and rehabilitation manipulation was adopted in the two groups. Additionally, the routine acupuncture treatment was used in the control group and the contralateral needling techniques was applied in the observation group. The needles were retained for 30 min. The treatment was given once a day for 5 days a week and consecutively for 4 weeks. Before and after treatment, the score of the modified Fugl-Meyer assessment scale (FMA scale), the score of the visual analogue scale (VAS), the score of the hand edema rating and the score of the modified Barthel index (ADL score) were evaluated. RESULTS: The total effective rate was 90.32% (28/31) in the observation group and was 67.74% (21/31) in the control group. The effective rate in the observation group was higher than that in the control group (P<0.05). VAS score, the score of the hand edema rating, FMA score and ADL score were obviously improved as compared with those before treatment in each group and the scores in the observation group were better than those of the control group (P<0.05). CONCLUSION: The contralateral needling therapy of acupuncture is effective for relieving pain and edema as well as improving the motor function of the affected limb in the patients with post-stroke shoulder-hand syndrome.

Drosophila decapping protein 2 modulates the formation of cortical F-actin for germ plasm assembly.

In Drosophila, the deposition of the germ plasm at the posterior pole of the oocyte is essential for the abdomen and germ cell formation during embryogenesis. To assemble the germ plasm, oskar (osk) mRNA, produced by nurse cells, should be localized and anchored on the posterior cortex of the oocyte. Processing bodies (P-bodies) are cytoplasmic RNA granules responsible for the 5'-3' mRNA degradation. Evidence suggests that the components of P-bodies, such as Drosophila decapping protein 1 and Ge-1, are involved in the posterior localization of osk. However, whether the decapping core enzyme, Drosophila decapping protein 2 (dDcp2), is also involved remains unclear. Herein, we generated a dDcp2 null allele and showed that dDcp2 was required for the posterior localization of germ plasm components including osk. dDcp2 was distributed on the oocyte cortex and was localized posterior to the osk. In the posterior pole of dDcp2 mutant oocytes, osk was mislocalized and colocalized with F-actin detached from the cortex; moreover, considerably fewer F-actin projections were observed. Using the F-actin cosedimentation assay, we proved that dDcp2 interacted with F-actin through its middle region. In conclusion, our findings explored a novel function of dDcp2 in assisting osk localization by modulating the formation of F-actin projections on the posterior cortex.

[Identification of Chinese character ""in Huangdi Neijing and "" in Taisu].

In order to identify the differences between "" in Huangdi Neijing (The Yellow Emperor's Internal Classic) and "" in Taisu (Grand Simplicity of the Yellow Emperor's Inner Classic), the edition of Ninna-ji, Japan, the author analyzed all "" and ""of the extant Huangdi Neijing, its annotation books, its handed-down books and its collated books during the past dynasties. "" and "" are similar in Chinese character pattern. The authors had also analyzed the evolution factors of Chinese character patterns in detail, which induced the misunderstanding of "" as "". Hence, the phonology and Chinese exegetics were adopted in analysis. "" and "()" were completely same in ancient pronunciation. In compliance with the theory as seeking for the connotation from the pronunciation, "" was explained as "()", meaning cleft needling or point needling. Additionally, the academic significance of "" was explored. It was believed that it was the specific recognition stage from the vessel to the point regarding the sites of acupuncture and moxibustion in terms of the differences in needling techniques, i.e. vessel needling, muscle needling or tendon needling. It is concluded that "" resulted from the misunderstanding of "" in the books of different dynasties, hence, the mistakes in the explanation and annotation of "" since the Northern Song Dynasty have been clarified.

The emerging role of interleukin-21 in allergic diseases (Review).

Interleukin (IL)-21 is a newly discovered member of the type I cytokine family. Since its discovery in 2000, IL-21 has been the focus of extensive investigation, due to its homology to IL-2, IL-4 and IL-15 and its pleiotropic effects on innate and adaptive immune responses. An increasing amount of experimental evidence supports a role for IL-21 in the pathogenesis of several allergic diseases, such as allergic rhinitis, atopic dermatitis (AD) and atopic asthma. In this review, we aimed to discuss the biological characteristics of IL-21 and summarize the current progress on the role of IL-21 in the regulation of allergic inflammation.

[Identification of meridian-acupoint diagrams and meridian diagrams].

In acu-moxibustion literature, there are two kinds of diagrams, meridian-acupoint diagrams and meridian diagrams. Because they are very similar in outline, and people now have seldom seen the typical ancient meridian diagrams, meridian-acupoint diagrams have been being incorrectly considered to be the meridian diagrams for a long time. It results in confusion in acu-moxibustion academia. The present paper stresses its importance in academic research and introduces some methods for identifying them correctly. The key points for identification of meridian-acupoint diagrams and meridian diagrams are: the legend of diagrams and the drawing style of the ancient charts. In addition, the author makes a detailed explanation about some acu-moxibustion charts which are easily confused. In order to distinguish meridian-acupoint diagrams and meridian diagrams correctly, he or she shoulnd understand the diagrams' intrinsic information as much as possible and make a comprehensive analysis about them.