1.Expression changes of RNA m6A regulators in mouse cerebellum affected by hypobaric hypoxia stimulation
Lingfeng XIAO ; Chunhui MA ; Shunli ZHAO ; Qing LI ; Chunying LIU ; Yamei NIU ; Weimin TONG
Chinese Journal of Pathology 2024;53(5):452-457
		                        		
		                        			
		                        			Objective:To investigate the role of RNA m6A methylation in mediating cerebellar dysplasia through analyzing the phenotypes of the mouse cerebella and the expression of several key m6A regulators upon hypobaric hypoxia treatment.Methods:Five-day old C57/BL6 mice were exposed to hypobaric hypoxia for 9 days. The status of mouse cerebellar development was analyzed by comparing the body weights, brain weights and histological features. Immunostaining of cell-type-specific markers was performed to analyze the cerebellar morphology. Real-time PCR, Western blot and immunohistochemical staining were performed to detect the expression of key m6A regulators in the mouse cerebella.Results:Compared with the control, the body weights, brain weights and cerebellar volumes of hypobaric hypoxic mice were significantly reduced ( P<0.01). The expression of specific markers in different cells, including NeuN (mature neuron), Calbindin-D28K (Purkinje cell) and GFAP (astrocyte), was decreased in hypobaric hypoxic mouse cerebella ( P<0.01), accompanied with disorganized cellular structure. The expression of methyltransferase METTL3 was significantly down-regulated in the cerebella of hypobaric hypoxic mice ( P<0.05). Conclusions:Hypobaric hypoxia stimulation causes mouse cerebellar dysplasia, with structural abnormalities in mature granular neurons, Purkinje cells and astrocytes. Expression of METTL3 is decreased in hypobaric hypoxic mice cerebellum compared with that of normobaric normoxic mice, suggesting that its mediated RNA m6A methylation may play an important role in hypobaric hypoxia-induced mouse cerebellar dysplasia.
		                        		
		                        		
		                        		
		                        	
2.Clinicopathological study of 24 cases of monkeypox virus infection-related rashes
Yanhua PANG ; Xingang ZHOU ; Man LI ; Xiangmei CHEN ; Liang ZHANG ; Kun YANG ; Ting LIU ; Jiamin CHEN ; Simeng LIU ; Weimin TONG ; Jiangyang LU ; Peng WANG
Chinese Journal of Pathology 2024;53(10):1011-1017
		                        		
		                        			
		                        			Objective:To investigate the clinicopathological characteristics of rashes in monkeypox patients through a series of skin biopsies, and examine their pathological features and the most effective tests.Methods:Patients with monkeypox virus infection admitted to Beijing Ditan Hospital from June to August 2023 were identified. Among them, 24 patients underwent skin biopsies for clinical pathological study that were included in this study. Clinical information, rash pictures, and nucleic acid test results were analyzed using histopathology, immunohistochemistry, RNAscope ? hybridization and electron microscopy. Results:All 24 patients were male, including 14 patients with concurrent human immunodeficiency virus infection. Their average age was (32.3±5.4) years. The nucleic acid test confirmed monkeypox virus infection. The clinical feature of monkeypox rashes was solitary rather than clustered distribution, with rashes occurring in similar phase, distinguishing it from herpesvirus. The rashes in these patients were mostly scattered, with an average of (13.0±11.8) rashes, and most commonly present in the perineum, face, limbs, and trunk. The three main pathological features of these rashes were ballooning degeneration of the epidermal spinous cell layer, the characteristic intra-cytoplasmic Guarnieri′s bodies and significant infiltration of inflammatory cells in whole dermal layer. Immunohistochemistry, RNAscope ? hybridization, and electron microscopy can all effectively detect the monkeypox virus. Electron microscopy showed viral replication in various types of skin cells. Conclusions:The study describes the pathological features of monkeypox virus rashes. Pathological examination of skin biopsy samples is helpful to diagnose these rashes. The study suggests that the monkeypox virus has a unique epitheliotropic affinity and can infect various types of cells in the skin.
		                        		
		                        		
		                        		
		                        	
3.Role of RNA m6A reader YTHDF2 in neurodegeneration of the aged mice
Qiao WU ; Chunhui MA ; Yao ZHANG ; Qing LI ; Weimin TONG ; Yamei NIU
Chinese Journal of Pathology 2024;53(12):1238-1243
		                        		
		                        			
		                        			Objective:To investigate the role of RNA m6A reader YTHDF2 in neurodegeneration of the aged mice.Methods:Eighteen 18-month-old control C57BL/6 mice and 22 Ythdf2 conditional knockout (cKO) mice of the same age (that exhibited significant aging characteristics) were used. Five pairs of mice were used for morphological analysis. Thirteen control mice and 17 cKO mice were used for behavioral experiments. Immunofluorescence analysis was performed to detect the expression of YTHDF2 in the brains of 18-month-old C57BL/6 mice. After establishing the neural progenitor cell-specific knockout mice of Ythdf2, their phenotypes were analyzed through comparison of body weight, brain weight and H&E staining. Subsequently, immunohistochemistry and immunofluorescence analyses were used to detect the expression of various neural cell-specific markers in the aged control mice and Ythdf2 cKO mice. Finally, behavioral tests, including the open field test, new object recognition, and water maze, were used to assess the levels of anxiety, depression, learning and memory abilities.Results:Immunofluorescence staining showed that YTHDF2 was mainly expressed in the neurons. Compared with the age-matched control mice, there was no significant change in the body weight of the Ythdf2 cKO mice, but the brain weight decreased significantly ( P<0.05). The immunostaining showed that Ythdf2 cKO mice had fewer neurons, fewer astrocytes with defective morphology, more microglia and activation of microglia ( P<0.05). Behavioral tests showed that the aged Ythdf2 cKO mice exhibited impaired movement, learning and memory abilities ( P<0.05). Conclusions:YTHDF2 is mainly expressed in the neurons of the aged brain. Conditional knockout of Ythdf2 causes quantitative and structural abnormalities in hippocampal neuronal cells, and impairs motor ability and learning and memory of the aged mice, suggesting that YTHDF2 plays an important role in neurodegeneration of the aged mice.
		                        		
		                        		
		                        		
		                        	
4.Surgical Options for Appropriate Length of J-Pouch Construction for Better Outcomes and Long-term Quality of Life in Patients with Ulcerative Colitis after Ileal Pouch-Anal Anastomosis
Weimin XU ; Wenbo TANG ; Wenjun DING ; Zhebin HUA ; Yaosheng WANG ; Xiaolong GE ; Long CUI ; Xiaojian WU ; Wei ZHOU ; Zhao DING ; Peng DU ;
Gut and Liver 2024;18(1):85-96
		                        		
		                        			 Background/Aims:
		                        			Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is widely accepted as a radical surgery for refractory ulcerative colitis (UC). Definite results on the appropriate pouch length for an evaluation of the risk-to-benefit ratio regarding technical complications and long-term quality of life (QOL) are still scarce. 
		                        		
		                        			Methods:
		                        			Data on UC patients who underwent IPAA from 2008 to 2022 in four well-established pouch centers affiliated to China UC Pouch Center Union were collected. 
		                        		
		                        			Results:
		                        			A total of 208 patients with a median follow-up time of 6.0 years (interquartile range, 2.3 to 9.0 years) were enrolled. The median lengths of the patients’ short and long pouches were 14.0 cm (interquartile range, 14.0 to 15.0 cm) and 22.0 cm (interquartile range, 20.0 to 24.0 cm), respectively. Patients with a short J pouch configuration were less likely to achieve significantly improved long-term QOL (p=0.015) and were prone to develop late postoperative complications (p=0.042), such as increased defecation frequency (p=0.003) and pouchitis (p=0.035). A short ileal pouch was an independent risk factor for the development of late postoperative complications (odds ratio, 3.100; 95% confidence interval, 1.519 to 6.329; p=0.002) and impaired longterm QOL improvement (odds ratio, 2.221; 95% confidence interval, 1.218 to 4.050, p=0.009). 
		                        		
		                        			Conclusions
		                        			The length of the J pouch was associated with the improvement in long-term QOL and the development of late post-IPAA complications. A long J pouch configuration could be a considerable surgical option for pouch construction.  
		                        		
		                        		
		                        		
		                        	
5.Prediction Model for Unfavorable Outcome in Spontaneous Intracerebral Hemorrhage Based on Machine Learning
Shengli LI ; Jianan ZHANG ; Xiaoqun HOU ; Yongyi WANG ; Tong LI ; Zhiming XU ; Feng CHEN ; Yong ZHOU ; Weimin WANG ; Mingxing LIU
Journal of Korean Neurosurgical Society 2024;67(1):94-102
		                        		
		                        			 Objective:
		                        			: The spontaneous intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. The purpose of this retrospective study is to develop multiple models for predicting ICH outcomes using machine learning (ML). 
		                        		
		                        			Methods:
		                        			: Between January 2014 and October 2021, we included ICH patients identified by computed tomography or magnetic resonance imaging and treated with surgery. At the 6-month check-up, outcomes were assessed using the modified Rankin Scale. In this study, four ML models, including Support Vector Machine (SVM), Decision Tree C5.0, Artificial Neural Network, Logistic Regression were used to build ICH prediction models. In order to evaluate the reliability and the ML models, we calculated the area under the receiver operating characteristic curve (AUC), specificity, sensitivity, accuracy, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR). 
		                        		
		                        			Results:
		                        			: We identified 71 patients who had favorable outcomes and 156 who had unfavorable outcomes. The results showed that the SVM model achieved the best comprehensive prediction efficiency. For the SVM model, the AUC, accuracy, specificity, sensitivity, PLR, NLR, and DOR were 0.91, 0.92, 0.92, 0.93, 11.63, 0.076, and 153.03, respectively. For the SVM model, we found the importance value of time to operating room (TOR) was higher significantly than other variables. 
		                        		
		                        			Conclusion
		                        			: The analysis of clinical reliability showed that the SVM model achieved the best comprehensive prediction efficiency and the importance value of TOR was higher significantly than other variables. 
		                        		
		                        		
		                        		
		                        	
6.Long-term outcome of hematopoietic stem cell transplantation in two children with Mucopolysaccharidosis.
Jianmin WANG ; Jing CHEN ; Changying LUO ; Huiwen ZHANG ; Xuefan GU ; Weimin ZHANG
Chinese Journal of Medical Genetics 2023;40(12):1489-1495
		                        		
		                        			OBJECTIVE:
		                        			To explore the long-term efficacy of allogeneic hematopoietic stem cell transplantation (alloHSCT) in patients with Mucopolysaccharidosis (MPS), which has rarely been reported in China.
		                        		
		                        			METHODS:
		                        			A 18-month-old boy and a 23-month-old girl undergoing alloHSCT for MPS VI and MPS IH Shanghai Children's Medical Center on March 30, 2006 and September 6, 2006 were selected as the study subjects. A busulfan-based myeloablative regimen was used as the conditioning regimen. Peripheral stem cells were respectively collected from a human leucocyte antigen (HLA) matched sibling carrier donor and a HLA 9/10 matched unrelated donor. Both patients were followed up for more than 15 years. The functions of internal organs before and after the transplantation were compared, and child 1 was also compared with his untreated brother and healthy brother.
		                        		
		                        			RESULTS:
		                        			Both children have achieved full donor chimerism after the transplantation, and their enzymatic activities have remained stable. The enzymatic activity of the child 1 was slightly lower than normal but similar to that of his carrier donor, whilst that of the child 2 was normal. Both children have attended schools with good academic performance. Compared with his untreated brother, the respiratory function and hearing of child 1 have significantly improved. However, his orthopedic and cardiac disorders have still remained and required medical intervention. For child 2, her obstructive pulmonary disease was resolved and cognitive development was well preserved after the HSCT. Her heart disease has become stabilized and even improved with time, though her corneal clouding and skeletal malformation still required surgery.
		                        		
		                        			CONCLUSION
		                        			MPS patients can sustain long-term and stable enzymatic activities after successful alloHSCT. Compared with untreated patients, their health can be significantly improved, along with considerably prolonged survival, though the long-term efficacy of HSCT for different organs may vary to a certain extent.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Graft vs Host Disease/etiology*
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Hematopoietic Stem Cell Transplantation/adverse effects*
		                        			;
		                        		
		                        			Mucopolysaccharidoses/etiology*
		                        			;
		                        		
		                        			Busulfan
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
7.METTL3-mediated m6A RNA methylation regulates dorsal lingual epithelium homeostasis.
Qiuchan XIONG ; Caojie LIU ; Xin ZHENG ; Xinyi ZHOU ; Kexin LEI ; Xiaohan ZHANG ; Qian WANG ; Weimin LIN ; Ruizhan TONG ; Ruoshi XU ; Quan YUAN
International Journal of Oral Science 2022;14(1):26-26
		                        		
		                        			
		                        			The dorsal lingual epithelium, which is composed of taste buds and keratinocytes differentiated from K14+ basal cells, discriminates taste compounds and maintains the epithelial barrier. N6-methyladenosine (m6A) is the most abundant mRNA modification in eukaryotic cells. How METTL3-mediated m6A modification regulates K14+ basal cell fate during dorsal lingual epithelium formation and regeneration remains unclear. Here we show knockout of Mettl3 in K14+ cells reduced the taste buds and enhanced keratinocytes. Deletion of Mettl3 led to increased basal cell proliferation and decreased cell division in taste buds. Conditional Mettl3 knock-in mice showed little impact on taste buds or keratinization, but displayed increased proliferation of cells around taste buds in a protective manner during post-irradiation recovery. Mechanically, we revealed that the most frequent m6A modifications were enriched in Hippo and Wnt signaling, and specific peaks were observed near the stop codons of Lats1 and FZD7. Our study elucidates that METTL3 is essential for taste bud formation and could promote the quantity recovery of taste bud after radiation.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Epithelium/metabolism*
		                        			;
		                        		
		                        			Homeostasis
		                        			;
		                        		
		                        			Methylation
		                        			;
		                        		
		                        			Methyltransferases/metabolism*
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			RNA
		                        			;
		                        		
		                        			Taste Buds/metabolism*
		                        			
		                        		
		                        	
8.The substitution of SERCA2 redox cysteine 674 promotes pulmonary vascular remodeling by activating IRE1α/XBP1s pathway.
Weimin YU ; Gang XU ; Hui CHEN ; Li XIAO ; Gang LIU ; Pingping HU ; Siqi LI ; Vivi KASIM ; Chunyu ZENG ; Xiaoyong TONG
Acta Pharmaceutica Sinica B 2022;12(5):2315-2329
		                        		
		                        			
		                        			Pulmonary hypertension (PH) is a life-threatening disease characterized by pulmonary vascular remodeling, in which hyperproliferation of pulmonary artery smooth muscle cells (PASMCs) plays an important role. The cysteine 674 (C674) in the sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) is the critical redox regulatory cysteine to regulate SERCA2 activity. Heterozygous SERCA2 C674S knock-in mice (SKI), where one copy of C674 was substituted by serine to represent partial C674 oxidative inactivation, developed significant pulmonary vascular remodeling resembling human PH, and their right ventricular systolic pressure modestly increased with age. In PASMCs, substitution of C674 activated inositol requiring enzyme 1 alpha (IRE1α) and spliced X-box binding protein 1 (XBP1s) pathway, accelerated cell cycle and cell proliferation, which reversed by IRE1α/XBP1s pathway inhibitor 4μ8C. In addition, suppressing the IRE1α/XBP1s pathway prevented pulmonary vascular remodeling caused by substitution of C674. Similar to SERCA2a, SERCA2b is also important to restrict the proliferation of PASMCs. Our study articulates the causal effect of C674 oxidative inactivation on the development of pulmonary vascular remodeling and PH, emphasizing the importance of C674 in restricting PASMC proliferation to maintain pulmonary vascular homeostasis. Moreover, the IRE1α/XBP1s pathway and SERCA2 might be potential targets for PH therapy.
		                        		
		                        		
		                        		
		                        	
9.Analysis of the clinical effects and outcome of patients with double-hit high-risk multiple myeloma
Shan LIU ; Jin SHANG ; Yun LIN ; Zhihong WANG ; Tiannan WEI ; Ling LIN ; Tong YANG ; Weimin CHEN
Chinese Journal of Oncology 2021;43(11):1209-1214
		                        		
		                        			
		                        			Objective:To compare the clinical features, clinical efficacy, and prognosis of patients with double-hit and non-double-hit high-risk multiple myeloma (MM) and explored the clinical significance of high-risk cell karyotype in MM development.Methods:The clinical data of 73 high-risk MM patients admitted to the Department of Hematology of Fujian Provincial Hospital from January 2011 to February 2019 were retrospectively analyzed. Interphase fluorescence in situ hybridization was used to detect their karyotypes. Based on mSMART 3.0 risk stratification, we divided the patients into a double-hit group (28 cases) and a non-double-hit group (45 cases).Results:Fifteen patients in the double-hit group and 26 in the non-double-hit group received bortezomib-based chemotherapy. The median progression-free survival (PFS) in the double-hit and the non-double-hit groups was 8.0 months and 22.0 months, and the median overall survival (OS) was 10.0 months and not reached, respectively. Ten patients in the double-hit group and 12 in the non-double-hit group received bortezomib combined with lenalidomide (RVD) chemotherapy. The median PFS in the double-hit group and the non-double-hit group was 12.0 months and 24.0 months, and the median OS was 14.0 months and not reached, correspondingly. Both the PFS and OS of the double-hit group were significantly shorter than those of the non-double-hit group ( P<0.05). Univariate analysis results indicated that cytogenetic abnormalities, revised-international staging system (R-ISS), β2 microglobulin, and calcium had significant effects on PFS in high-risk MM patients ( P<0.05). The cytogenetic abnormalities, R-ISS, and β2 microglobulin were associated with OS in high-risk MM patients ( P=0.001). Multivariate Cox regression analysis showed that the cytogenetic grouping was an independent prognostic factor for OS and PFS in high-risk MM patients. The risk of disease progression was 3.160 times (95% CI: 1.364-7.318) and the risk of death was 2.966 times higher (95% CI: 1.205-7.306) in the double-hit group than those in the non-double-hit group. Calcium was an independent risk factor for PFS in the high-risk MM patients. Notably, the risk of disease progression in patients with calcium levels≥ 2.75 mmol/L was 2.667 times higher than that in patients with calcium<2.75 mmol/L (95% CI: 1.209-5.883). Conclusions:Double-hit patients are a highly specific group with worse high-risk MM prognosis. In such patients, the relapse is more common, the disease progression is faster, and the survival time is shorter than those in the non-double-hit patients.
		                        		
		                        		
		                        		
		                        	
10.Analysis of the clinical effects and outcome of patients with double-hit high-risk multiple myeloma
Shan LIU ; Jin SHANG ; Yun LIN ; Zhihong WANG ; Tiannan WEI ; Ling LIN ; Tong YANG ; Weimin CHEN
Chinese Journal of Oncology 2021;43(11):1209-1214
		                        		
		                        			
		                        			Objective:To compare the clinical features, clinical efficacy, and prognosis of patients with double-hit and non-double-hit high-risk multiple myeloma (MM) and explored the clinical significance of high-risk cell karyotype in MM development.Methods:The clinical data of 73 high-risk MM patients admitted to the Department of Hematology of Fujian Provincial Hospital from January 2011 to February 2019 were retrospectively analyzed. Interphase fluorescence in situ hybridization was used to detect their karyotypes. Based on mSMART 3.0 risk stratification, we divided the patients into a double-hit group (28 cases) and a non-double-hit group (45 cases).Results:Fifteen patients in the double-hit group and 26 in the non-double-hit group received bortezomib-based chemotherapy. The median progression-free survival (PFS) in the double-hit and the non-double-hit groups was 8.0 months and 22.0 months, and the median overall survival (OS) was 10.0 months and not reached, respectively. Ten patients in the double-hit group and 12 in the non-double-hit group received bortezomib combined with lenalidomide (RVD) chemotherapy. The median PFS in the double-hit group and the non-double-hit group was 12.0 months and 24.0 months, and the median OS was 14.0 months and not reached, correspondingly. Both the PFS and OS of the double-hit group were significantly shorter than those of the non-double-hit group ( P<0.05). Univariate analysis results indicated that cytogenetic abnormalities, revised-international staging system (R-ISS), β2 microglobulin, and calcium had significant effects on PFS in high-risk MM patients ( P<0.05). The cytogenetic abnormalities, R-ISS, and β2 microglobulin were associated with OS in high-risk MM patients ( P=0.001). Multivariate Cox regression analysis showed that the cytogenetic grouping was an independent prognostic factor for OS and PFS in high-risk MM patients. The risk of disease progression was 3.160 times (95% CI: 1.364-7.318) and the risk of death was 2.966 times higher (95% CI: 1.205-7.306) in the double-hit group than those in the non-double-hit group. Calcium was an independent risk factor for PFS in the high-risk MM patients. Notably, the risk of disease progression in patients with calcium levels≥ 2.75 mmol/L was 2.667 times higher than that in patients with calcium<2.75 mmol/L (95% CI: 1.209-5.883). Conclusions:Double-hit patients are a highly specific group with worse high-risk MM prognosis. In such patients, the relapse is more common, the disease progression is faster, and the survival time is shorter than those in the non-double-hit patients.
		                        		
		                        		
		                        		
		                        	
            
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