Objective To compare the clinical value of three visual rating scales (VRS) for white matter lesions (WML) in Alzheimer's disease (AD) and mild cognitive impairment (MCI).Methods Totally 184 subjects (including 107 AD patients,47 MCI patients and 30 normal controls)were recruited.All subjects underwent comprehensive neuropsychological tests and were examined with a standard protocol of MR imaging.WML burden was rated with the Age-Related White Matter Changes (ARWMC) rating scale,Cholinergic Pathways Hyperintensities Scale (CHIPS) and Fazekas scale.Consistence of the three rating scales were analyzed,and detection results of WML in AD/ MCI/NC group with the three rating scales were compared.The relationship between WML and cognitive function in AD and MCI groups were explored.Results ARWMC rating scale,CHIPS and Fazekas scales were moderately to highly correlated with WML (r=0.61-0.78,all P＜0.01).ARWMC showed that WML were in the left and right frontal lobes in AD and MCI groups and in the right frontal lobe and left temporal lobe in NC group,which had significant differences (F=4.20,4.69,4.69,3.36,respectively,all P＜0.05).WML in the left temporal lobe had a significant difference between MCI group and NC group (F=3.36,P＜0.05).CHIPS showed that WML in the front left side of centrum semiovale in AD and MCI groups had significant difference as compared with that in NC group (F=4.88,P＜0.05),and WML in the rear right side of low external capsule had a significant difference between AD and NC groups (F=3.04,P＜0.05).Fazekas scale showed that there was no difference in WML among AD,MCI and NC groups.ARWMC showed that scores of WML in right temporal lobe were positively correlated with concentration and visual construction,and bilateral basal ganglia were negatively correlated with the concentration.Fazekas scale showed that scores of WML in periventricular were negatively correlated with concentration,MMSE and orientation,scores of WML in deep white matter were negatively correlated with concentration,abstraction and judgment,and the whole scores were negatively correlated with concentration.CHIPS showed that the scores of WML in the rear left side of low external capsule were negatively correlated with short-term memory in MCI group.Conclusions The three rating scales well consistent with each other.ARWMC rating scale and CHIPS can detect the differences in WML between AD,MCI and NC groups.The scores of CHIPS in WML are related with cognition in MCI group,while scores of ARWMC and Fazekas scale in WML are correlated with many aspects in cognitive function in AD group.In general speaking,CHIPS in MCI patients and ARWMC rating scale in AD patients show more advantages in the detection of WML and have better correlation with cognitive function.

A 41-year-old man presented with recurrent pustules and scales on both hands and feet for 1year and with neoplasm on the left toe for 4 months.On physical examination,there were multiple irregular rufous patches with lamellar white scales on bilateral thumbs,forefingers,thenar eminence,toes,and the onethird anterior part of bilateral soles.Deep-seated pustules and vesicles arising on some erythematous patches were disrupted with the formation of punctiform or patches of erosions covered by yellow brown crusts.Some toenails and fingernails were thickened and deformed.An obviously tender neoplasm measuring 4 cm × 3.5 cm× 3.5 cm was observed in the anterior part of the left fourth toe,which was a little indurated and obviously tender with superficial erosion,large amount of purulent exudates and fresh granulation tissue mixing to form black and thick blood crusts on the surface.Biopsy of the nail bed of the right index finger and neoplasm on the left toe revealed a diffuse,dense,and mixed infiltrate of small- to medium-sized atypical lymphocytes and a few inflammatory cells.Meanwhile,epidermotropism and Pautrier's microabscess were visible.Immunohistochemistry showed that the abnormal lymphocytes were positive for leukocyte common antigen (LCA),Vimentin,CD3,CD45RO,CD4,Bcl-2,partly positive for CD8,CD5,CD10,Ki-67 (＞ 80％ ),but negative for CD79a,CD20,CD30,cytokeratin,S-100,Bc1-6,anaplastic lymphoma kinase (ALK),HMBMS,CD1a or P63.Based on the above findings,a diagnosis of mycosis fungoides palmaris et plantaris was made.

Objective:To investigate the prevalence of uremic pruritus and related factors in patients undergoing hemodialysis.Methods:A total of 212 patients with uremia who undergo hemodialysis in the First Affiliated Hospital of Xiamen University in March 2021 were included in this cross-sectional study. Data including gender, age and blood biochemical indicators were collected. The 5D itch scale was used to evaluate skin itch in patients. The included patients were divided into pruritus and no pruritus groups according to evaluation results. Related indicators were compared between the two groups. Binary logistic regression analysis of skin itch related factors was performed.Results:According to 5D itch scale evaluation results, 129 patients (60.85%) of the 212 patients had no skin pruritus, and 83 patients (39.15%) had skin pruritus. In the pruritus group, age, hypersensitive C-reactive protein, alkaline phosphatase, brain natriuretic peptide, ferritin were 63.0 (51.0, 72.0) years, 1.66 (0.30, 7.85) mg/L, 93.0 (70.0, 118.0) U/L, 192.0 (84.9, 446.4) ng/L and 421.0 (291.6, 577.6) μg/L, respectively, which were significantly higher than 53.0 (42.0, 63.0) years, 0.40 (0.30, 1.88) mg/L, 79.0 (62.0, 99.0) U/L, 143.3 (65.8, 256.5) ng/L, 356.8 (203.3, 528.4) μg/L in the pruritus group ( Z = -3.14, -3.96, -3.05, -2.88, -2.11, all P < 0.05). Increased hypersensitive C-reactive protein, brain natriuretic peptide, ferritin levels ( Wald = 14.58, 4.17, 4.23, all P < 0.05) were independent risk factors for uremic pruritus. Conclusion:Uremic pruritus remains a serious problem in patients undergoing hemodialysis. Increased hypersensitive C-reactive protein, ferritin, brain natriuretic peptide levels are independent risk factors for uremic pruritus. In clinical work, physicians should focus on strengthening the early identification of patients, optimizing treatment measures, and improving the quality of life of patients.

Objective:To compare the pathological results and complications of limited and extended pelvic lymph node dissection among high-risk prostate cancer patients, and to explore the risk factors that affect the rate of lymph node metastasis in high-risk prostate cancer patients.Methods:The data of 800 high-risk prostate cancer patients who underwent radical prostatectomy and pelvic lymph node dissection from January 2016 to December 2020 in three affiliated hospital of Sun Yat-sen University were analyzed retrospectively. According to the scope of pelvic lymph node dissection, they were divided into limited pelvic lymph node dissection (LPLND) group and extended pelvic lymph node dissection (EPLND) group. There were 172 patients underwent LPLND, and 628 patients underwent EPLND.The age of the patients in the LPLND group was 67 (62, 72) years old, diagnosed PSA 20.7 (10.9, 54.8) ng/ml. The biopsy Gleason score 6 in 22 cases, 7 in 59 cases, 8 in 56 cases and 9-10 in 35 cases.The clinical T stage: T 1 in 29 cases, T 2 in 102 cases, T 3 in 37 cases, T 4 in 4 cases; N 0 in 160 cases and N 1 in 12 cases. 50 patients received neoadjuvant hormonal therapy. The age of patients in the EPLND group was 67 (63, 72) years old, diagnosed PSA was 23.9 (14.0, 46.8) ng/ml. Biopsy Gleason Score 6 in 51 cases, 7 in 194 cases, 8 in 218 cases and 9-10 in 165 cases. Clinical T stage: T 1 in 114 cases, T 2 in 341 cases, T 3 in 144 cases, T 4 in 29 cases; N 0 in 526 cases and N 1 in 102 cases.158 patients received neoadjuvant hormonal therapy. There were no significant differences in the age, PSA, puncture Gleason score, clinical T stage, and whether or not to receive neoadjuvant hormonal therapy between the two groups of patients ( P>0.05). The difference in clinical N staging was statistically significant ( P=0.002). The number of postoperative lymph nodes, positive pelvic lymph nodes and postoperative complications and other related clinical and pathological data of the two groups were analyzed. Multivariate logistic regression was used to analyze the risk factors of patients with positive lymph nodes. Results:The median number of lymph nodes harvested [13(8, 19)vs. 6(4, 13), P<0.001] and the rate of positive lymph node cases[31.2%(196/628) vs. 10.5%(18/172), P<0.001] in the EPLND group was significantly higher than those in the LPLND group. Preoperative PSA, clinical N staging, Gleason score, and way of lymph node dissection were independent risk factors for postoperative positive pelvic lymph node in high-risk prostate cancer patients. Compared with the LPLND group, the ELPND group had a higher postoperative complication rate [19.9%(125/628) vs. 11.0%(11/172), P=0.007]. Conclusions:Compared with the LPLND, EPLND in high-risk prostate cancer patients can harvest more lymph nodes and increase the detection rate of positive lymph nodes. The complications of EPLND were higher than those of LPLND. Preoperative PSA, clinical N stage, Gleason score, and the way of lymph node dissection are independent risk factors for positive pelvic lymph node dissection.

Na⁺/H⁺ antiporter (NHX) gene subfamily plays an important role in plant response to salt stress. In this study, we identified the NHX gene family members of Chinese cabbage and analyzed the expression patterns of BrNHXs gene in response to abiotic stresses such as high temperature, low temperature, drought and salt stress. The results showed that there were 9 members of the NHX gene family in Chinese cabbage, which were distributed on 6 chromosomes respectively. The number of amino acids was 513-1 154 aa, the relative molecular weight was 56 804.22-127 856.66 kDa, the isoelectric point was 5.35-7.68. Members of BrNHX gene family mainly existed in vacuoles, the gene structure is complete, and the number of exons is 11-22. The secondary structures of the proteins encoded by the NHX gene family in Chinese cabbage had alpha helix, beta turn and random coil, and the alpha helix occurred more frequently. Quantitative real-time PCR (qRT-PCR) analysis showed that the gene family members had different responses to high temperature, low temperature, drought and salt stress, and their expression levels differed significantly in different time periods. BrNHX02 and BrNHX09 had the most significant responses to these four stresses, and their expression levels were significantly up-regulated at 72 h after treatments, which could be used as candidate genes to further verify their functions.
Genome, Plant ; Multigene Family ; Stress, Physiological/genetics* ; Brassica/metabolism* ; Gene Expression Regulation, Plant ; Phylogeny ; Plant Proteins/metabolism*

One of the distinct hallmarks of cancer cells is aerobic glycolysis (Warburg effect). Lactate dehydrogenase A (LDHA) is thought to play a key role in aerobic glycolysis and has been extensively studied, while lactate dehydrogenase C (LDHC), an isoform of LDHA, has received much less attention. Here we showed that human LDHC was significantly expressed in lung cancer tissues, overexpression of Ldhc in mice could promote tumor growth, and knock-down of LDHC could inhibit the proliferation of lung cancer A549 cells. We solved the first crystal structure of human LDHC4 and found that the active-site loop of LDHC4 adopted a distinct conformation compared to LDHA4 and lactate dehydrogenase B4 (LDHB4). Moreover, we found that (ethylamino) (oxo)acetic acid shows about 10 times selective inhibition against LDHC4 over LDHA4 and LDHB4. Our studies suggest that LDHC4 is a potential target for anticancer drug discovery and (ethylamino) (oxo)acetic acid provides a good start to develop lead compounds for selective drugs targeting LDHC4.