Objective:To analyze the pathological findings of ultrasound-guided transplant kidney puncture after renal transplantation and the pathogenesis of different types of diseases.Methods:A retrospective study was conducted to select 257 patients who underwent ultrasound-guided transplant kidney puncture pathology biopsy due to abnormal tests or uncomfortable symptoms at Beijing Friendship Hospital, Capital Medical University from June 2020 to April 2022, and to analyze the pathological results of puncture and the pathogenesis of different types of diseases and puncture-related complications in the post-transplantation patients after transplant kidney puncture biopsy. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used to compare different types of diseases; measurement data did not conform to normal distribution were expressed as median (interquartile distance) [ M( Q1, Q3)], and the comparison between different types of diseases was conducted by non-parametric test. The count data were compared among different types of diseases using Chi-squre test. Results:Among the 257 patients who underwent transplant renal puncture, 93 cases (36.2%) suffered from antibody-mediated rejection (ABMR), 76 cases (29.6%) suffered from IgA nephropathy, 63 cases (24.5%) suffered from T cell-mediated rejection (TCMR), 21 cases (8.2%) suffered from polyomavirus-associated nephropathy (PVAN), and 4 cases (1.6%) suffered from thrombotic microangiopathy (TMA), 16 cases (6.2%) suffered from diabetic nephropathy, and 12 cases (4.7%) suffered from calcineurin inhibitor (CNI) nephropathy. TCMR, TMA and PVAN occurred significantly in the early post-transplantation period (within about 4 years) ( P<0.001), and ABMR occurred significantly in the late post-transplantation period (after about 8 years) ( P<0.001). In terms of time distribution, creatinine abnormality and proteinuria were the main reasons for puncture. Among those diagnosed with PVAN, the time to transplantation was significantly shorter in those who underwent puncture for creatinine abnormality than in those who underwent puncture for proteinuria ( P=0.011). In terms of puncture-related complications, a total of 8 cases were found to have arteriovenous fistulae at the time of review, 2 cases had perinephric hematomas, and 1 case had both of these two puncture-related complications. Conclusions:Transplant renal complications in renal transplant patients mainly include ABMR, IgA nephropathy, TCMR, PVAN, diabetic nephropathy, CNI nephropathy and TMA. In terms of the pathogenesis of different types of diseases after transplantation, post-transplantation PVAN, TMA, and TCMR mostly occur in the early post-transplantation period, while ABMR occurs at a later time. However, it is worth noting that the clinical symptoms of different types of transplantation kidney-related diseases are similar and not typical.

Objective:To explore the clinical and genetic characteristics of three children with Leguis syndrome.Methods:Three children suspected as Legius syndrome at the Henan Children′s Hospital for precocious puberty or short stature from June 6, 2019 to August 25, 2022 were selected as the study subjects. Clinical data of the children were collected. All children were subjected to whole exome sequencing, and candidate variants were verified by Sanger sequencing.Results:All of the children (including 2 females and 1 male, and aged 4 years and 6 months, 8 years, and 14 years and 8 months, respectively) had typical café de lait spots. Child 1 also had precocious puberty, and children 2 and 3 had short statures. Genetic testing revealed that all of them had harbored heterozygous variants of the SPRED1 gene, including c. 751C>T (p.Arg251Ter194) in child 1, c. 229A>T (p.Lys77Ter368) in child 2, and c. 1044_1046delinsC (p.R349fs *11) in child 3. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c. 751C>T (p.Arg251Ter194) variant was predicted to be likely pathogenic, whilst the other two were known pathogenic variants. Conclusion:All of the three children were diagnosed with Leguis syndrome due to variants of the SPRED1 gene, which had manifested as multiple café de lait spots in conjunct with precocious puberty or short statures.

Objective:To investigate the safety of early antiplatelet therapy for non-cardioembolic mild stroke patients with thrombocytopenia.Methods:Data of acute ischemic stroke patients with baseline National Institutes of Health Stroke Scale(NIHSS)score≤3 and a platelet count<100×109/L were obtained from a multicenter register.Those who required anticoagulation or had other contraindications to antiplatelet therapy were excluded.Short-term safety outcomes were in-hospital bleeding events,while the long-term safety outcome was a 1-year all-cause death.The short-term neurological outcomes were evaluated by modified Rankin scale(mRS)score at discharge.Results:A total of 1868 non-cardioembolic mild stroke patients with thrombocytopenia were enrolled.Multivariate regression analyses showed that mono-antiplatelet therapy significantly increased the proportion of mRS score of 0-1 at discharge(OR=1.657,95%CI:1.253-2.192,P<0.01)and did not increase the risk of intracranial hemorrhage(OR=2.359,95%CI:0.301-18.503,P>0.05),compared with those without antiplatelet therapy.However,dual-antiplatelet therapy did not bring more neurological benefits(OR=0.923,95%CI:0.690-1.234,P>0.05),but increased the risk of gastrointestinal bleeding(OR= 2.837,95%CI:1.311-6.136,P<0.01)compared with those with mono-antiplatelet therapy.For patients with platelet counts≤75×109/L and>90×109/L,antiplatelet therapy significantly improved neurological functional outcomes(both P<0.05).For those with platelet counts(>75-90)×109/L,antiplatelet therapy resulted in a significant improvement of 1-year survival(P<0.05).For patients even with concurrent coagulation abnormalities,mono-antiplatelet therapy did not increase the risk of various types of bleeding(all P>0.05)but improved neurological functional outcomes(all P<0.01).There was no significant difference in the occurrence of bleeding events,1-year all-cause mortality risk,and neurological functional outcomes between aspirin and clopidogrel(all P>0.05).Conclusions:For non-cardioembolic mild stroke patients with thrombocytopenia,antiplatelet therapy remains a reasonable choice.Mono-antiplatelet therapy has the same efficiency as dual-antiplatelet therapy in neurological outcome improvement with lower risk of gastrointestinal bleeding.

OBJECTIVE: In order to distinguish the traditional Chinese medicine Bupleurum falcatum and its adulterants effectively and develop a better understanding of the factors affecting synonymous codon usage, codon usage patterns of chloroplast genome, we determine the complete chloroplast (cp) genome of B. falcatum and clarify the main factors that influence codon usage patterns of 78 genes in B. falcatum chloroplast genome. METHODS: The total genomic DNA of fresh leaves from a single individual of B. falcatum was extracted with EASYspin plus Total DNA Isolation Kit and 2 μg genome DNA was sequenced using Illumina Hiseq 2500 Sequencing Platform. The cp genome of B. falcatum was reconstructed with MITObim v1.8 and annotated in the program CPGAVAS2 with default parameters. Python script and Codon W were used to calculate the codon usage bias parameters. RESULTS: The full length of B. falcatum cp genome was 155 851 bp, 132 different genes were annotated in this cp genome containing 80 protein-coding genes, 30 tRNA genes, and four rRNA genes. The codon usage models tended to use A/T-ending codons. The neutrality plot, ENC plot, PR2-Bias plot and correspondence analysis showed that both compositional constraint under selection and mutation could affect the codon usage models in B. falcatum cp genome. Furthermore, three optimal codons were identified and most of these three optimal codons ended with G/U. CONCLUSION The cp genome of B. falcatum has been characterized and the codon usage bias in B. falcatum cp genome is influenced by natural selection, mutation pressure and nucleotide composition. The results will provide much more barcode information for species discrimination and lay a foundation for future research on codon optimization of exogenous genes, genetic engineering and molecular evolution in B. falcatum.

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (M^pro) and papain like protease (PL^pro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851M^pro inhibitors and 205 PL^pro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both M^pro and PL^pro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of M^pro inhibitors and over 20% of PL^pro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 M^pro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.
Humans ; Antiviral Agents/chemistry* ; COVID-19 ; COVID-19 Drug Treatment ; High-Throughput Screening Assays ; Molecular Docking Simulation ; Protease Inhibitors/chemistry* ; SARS-CoV-2/enzymology* ; Viral Nonstructural Proteins

BACKGROUND: Lung cancer is the leading cause of death worldwide, and lung adenocarcinoma is the main subtype of lung cancer. DEP domain-containing 1 (DEPDC1) has been proved to be closely related to the occurrence and development of most tumors, and the overexpression of DEPDC1 in lung adenocarcinoma has been preliminarily confirmed. This study aims to explore the relationship between the expression of DEPDC1 and the clinical prognosis of lung adenocarcinoma, and to preliminarily explore the possibility of DEPDC1 as a potential biomarker and therapeutic target of lung adenocarcinoma. METHODS: The bioinformatics website GEPIA database was used to collect relevant information, and the prognostic was analyzed online. Patient data were collected for statistical analysis, and immunohistochemical staining was performed on the collected samples. Subsequently, lung adenocarcinoma cells were cultured in vitro, and the knockout efficiency was verified by Western blot and reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and cell proliferation experiments were performed. RESULTS: The expression of DEPDC1 in lung adenocarcinoma tissues is significantly higher than that in adjacent normal tissues. The high expression of DEPDC1 is correlated with the tumor size and clinical stage of lung adenocarcinoma and knocking down DEPDC1 inhibits the proliferation of A549 and H1975 cells. CONCLUSIONS DEPDC1 plays an important role in the progression and evolution of lung adenocarcinoma. And it is expected to become an important therapeutic target and a potential new biomarker for lung adenocarcinoma.

Objective To explore the clinical features,causes of misdiagnosis and preventive measures of hepatic myelopathy (HM). Methods The clinical data of 24 cases of HM admitted to Xijing Hospital from November 2009 to June 2019 were analyzed retrospectively,and relevant literatures were reviewed. Results All the 24 patients had a history of cirrhosis,and the clinical manifestations were decreased muscle strength of both lower limbs. Laboratory and imaging examinations were abnormal in some patients. Currently,there is no unified diagnostic standard for HM. According to the patient’s history,clinical manifestations,laboratory examination and imaging examination results,combined with literatures and expert opinions,hepatic myelopathy was diagnosed. One patient was treated with liver transplantation,and all patients were given symptomatic treatment and rehabilitation exercise. Scores of Modified Rankin Scale (mRS) improved in 3 patients at discharge. Follow-up of 3 months after discharge showed scores of mRS improved in 6 patients. The prognosis may be correlated with the course of disease. Conclusion HM has a low incidence and the clinical manifestations lack specificity.Detailed medical history,careful physical examination,timely examination of liver function and abdominal ultrasound can help early diagnosis and improve the clinical symptoms and prognosis of patients.

OBJECTIVE: To analyze the prognosis of fetuses with cystic hygroma (CH) or nuchal translucency (NT) or nuchal fold (NF) thickening detected by prenatal echography. METHODS: From January 2014 to December 2015, 124 fetuses with CH and NT/NF thickening on prenatal echography were enrolled from Women's Hospital of Zhejiang University School of Medicine. The basic clinical information, ultrasonic results, pregnancy outcomes and newborn follow-ups were analyzed. The cases were grouped by prognosis and the factors affecting prognosis were analyzed with logistic regression. RESULTS: There were 85 cases of labor induction including one stillbirth and 39 cases delivered. Except one infant who died after birth, all live births survived with good prognosis. Univariate analysis showed that the gestational age at diagnosis of poor prognosis group was earlier than that of good prognosis group (<0.01); and the former group also had higher hydrops fetalis rate and additional structural anomalies rate (all <0.01). Multivariate regression analysis showed that hydrops fetalis (=90.105, <0.05) and additional structural anomalies (=61.854, <0.05) were risk factors of poor prognosis in fetuses with CH and NT/NF thickening. CONCLUSIONS Fetuses with diagnosed CH or NT/NF thickening on prenatal ultrasonography are likely to be associated with chromosomal abnormality. Early gestational weeks, hydrops fetalis and additional structural anomalies may indicate poor prognosis.
Female ; Fetus ; Humans ; Hydrops Fetalis ; etiology ; Infant, Newborn ; Lymphangioma, Cystic ; complications ; diagnosis ; Nuchal Translucency Measurement ; Pregnancy ; Pregnancy Outcome ; Prognosis ; Ultrasonography, Prenatal

To explore the effect of adipose-derived mesenchymal stem cells (ADMSCs) on ovarian damage induced by cyclophosphamide (CTX) and its mechanism.
 Methods: ADMSCs isolated from adipose tissue of female SD rats were cultured and divided into a blank group and a CTX group (n=15 in each group). CTX (75 mg/kg) was injected intraperitoneally to establish a model of ovarian damage in rats. A total of 45 female SD rats were also divided into 3 groups: Group A (15 rats, only injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline), Group B [15 rats, injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline, after 4 estrus cycles, injected 0.6 mL ADMSCs (6×105 cells) by the tail vein], and Group C [15 rats, injected intraperitoneally with 75 mg/kg CTX diluted with 1 mL 0.9% saline, after 4 estrus cycles, injected 40 mL ADMSCs (20 mL per side, 2×104 cells) in situ ovarian]. After 4 estrus cycles, the changes of quality of life, ponderal growth were recorded, the sex hormone levels [estradiol (E2), follicle-stimulating hormone (FSH)] were tested by ELISA, and the morphology of ovarian tissue and follicle count were observed by HE staining. The expression of BMP-15, Bcl-2 and Bax in ovarian tissues were tested by immunohistochemistry, real-time PCR or Western blotting. The apoptosis rate of follicular cells was detected by TdT-mediated dUTP nick end labeling (TUNEL) assay.
 Results: After transplantation of ADMSCs, compared with the Group A, their quality of life of rats in the Group B and C was improved, and the ponderal growth was increased (both P<0.01). Compared with the Group A, the serum E2 levels in the Group B and the Group C were increased (P<0.01, P<0.05), and the FSH levels in the Group B and C were decreased (both P<0.01). The granular cell layer, the number of corpus lutein and the count of various grade follicles were significantly increased, and many new follicles and mature oocytes were observed in the Group B and C. Compared with Group A, the count of primitive follicles, sinusoidal follicles, pre-ovulation follicles and total follicles, and pre-sinusoidal follicles were dramatically increased in the Group B. The follicle at all levels count was increased in the Group C than that in the Group A (all P<0.01). Comparing with the Group A, the expressions of BMP-15 and Bcl-2 were increased (all P<0.01), the expressions of Bax was decreased (both P<0.01), and the apoptosis rates of follicular cells were decreased in the Group B and C (both P<0.01). However, there was no difference between the Group B and the Group C in the above indexes (all P>0.05).
 Conclusion: ADMSCs transplantation can effectively repair ovarian damage induced by CTX in rats, which may be achieved by inhibiting mitochondrial apoptosis of granulosa cells.
Animals ; Cyclophosphamide ; Female ; Mesenchymal Stem Cells ; Ovary ; Quality of Life ; Rats ; Rats, Sprague-Dawley

Different endophytes isolated from the seeds of Sophora flavescens were tested for their ability to produce matrine production. Response surface methodology (RSM) was applied to optimize the medium components for the endophytic fungus. Results indicated that endophyte Aspergillus terreus had the ability to produce matrine. The single factor tests demonstrated that potato starch was the best carbon source and the combination of peptone and NH₄NO₃ was the optimal nitrogen source for A. terreus. The model of RSM predicted to gain the maximal matrine production at 20.67 µg/L, when the potato starch was 160.68 g/L, peptone was 24.96 g/L and NH₄NO₃ was 2.11 g/L. When cultured in the optimal medium, the matrine yield was an average of 20.63 ± 0.11 µg/L, which was consistent with the model prediction. This study offered an alternative source for the matrine production by endophytic fungus fermentation and may have far-reaching prospect and value.
Aspergillus* ; Carbon ; Endophytes ; Fermentation* ; Fungi* ; Nitrogen ; Peptones ; Solanum tuberosum ; Sophora* ; Starch