Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.

Objective:Factors influencing the prognosis of hemophagocytic lymphohistiocytosis (HLH) in adults were analyzed based on multicentric data.Methods:Clinical data of 124 adult patients with HLH diagnosed in eight medical centers in the Huaihai Lymphoma Working Group from March 2014 to July 2020 were collected. The optimal truncation value of continuous variables was obtained based on the Maxstat algorithm, X-Tile software, and restricted cubic spline. Cox proportional risk regression model was used to construct the adult HLH risk prediction model, and the visualization of the model was realized through the histogram. The bootstrap resampling method was used to verify the model, C-index and calibration curve was used to verify the histogram, and the prediction accuracy was checked. Kaplan-Meier analysis was used to calculate the survival rate and draw the survival curve. Furthermore, the differences between groups were tested by log-rank.Results:The median age of the 124 patients was 55 (18-84) years, including 61 (49.19%) males. The most common etiology was infection. Serum ferritin increased in 110 cases (88.71%) , hepatosplenomegaly in 57 cases (45.97%) . Of the 124 patients, 77 (62.10%) died, and the median survival time of the patients was 7.07 months. Univariate results showed that the prognosis of adult HLH was influenced by sex, age, fibrinogen, serum creatinine, alanine aminotransferase, and albumin ( P<0.05) . The results of multivariate analysis showed that gender, platelet, albumin, alanine aminotransferase, and treatment regimens were independent influencing factors for prognosis. Based on the above five risk factors, the prediction model of the histogram was established, and the C-index of the model was 0.739. Finally, the calibration chart showed good consistency between the observed and predicted values of HLH. Conclusion:The prognosis of the adult hemophagocytic syndrome is influenced by many factors. Gender, platelet, albumin, alanine aminotransferase, and treatment regimens are independent risk factors. Therefore, the established histogram provides a visual tool for clinicians to evaluate the prognosis of adult HLH.

Objective T o explore the genetic variation sites of caveolin (C A V ) and their correlation w ith sudden unexplained death (SU D ).Methods The blood sam ples w ere collected from SU D group (71 cases), coronary artery disease (C A D ) group (62 cases) and control group (60 cases), respectively. T he genom e D N A w ere extracted and sequencing w as perform ed directly by am plifying gene coding region and exon-intron splicing region of CAV1 and CAV3 using PC R . T he type of heritable variation of CVA w as con-firm ed and statistical analysis w as perform ed. Results A total of 4 variation sites that m aybe significa-tive w ere identified in SU D group, and tw o w ere new found w hich w ere CAV1: c.45C>T (T 15T ) and CAV1:c.512G>A (R 171H ), and tw o w ere SN P loci w hich w ere CAV1:c.246C>T (rs35242077) and CAV3:c.99C>T (rs1008642) and had significant difference (P<0.05) in allele and genotype frequencies betw een SU D and control groups. Forem entioned variation sites w ere not found in C A D group. Conclu-sion T he variants of CAV1 and CAV3 m ay be correlated w ith a part of SU D group.

D ue to the negative autopsy and w ithout cardiac structural abnorm alities, unexpected sudden cardiac death (U SC D ) is alw ays a tough issue for forensic pathological expertise. U SC D m ay be asso-ciated w ith parts of fatal arrhythm ic diseases. T hese arrhythm ic diseases m ay be caused by disorders of cardiac ion channels or channel-related proteins. C aveolin can com bine w ith m ultiple m yocardial ion channel proteins through its scaffolding regions and plays an im portant role in m aintaining the depolar-ization and repolarization of cardiac action potential. W hen the structure and function of caveolin are af-fected by gene m utations or abnorm al protein expression, the functions of the regulated ion channels are correspondingly im paired, w hich leads to the occurrence of m ultiple channelopathies, arrhythm ia or even sudden cardiac death. It is im portant to study the effects of caveolin on the functions of ion channels for exploring the m echanism s of m alignant arrhythm ia and sudden cardiac death.

OBJECTIVETo explore the relationship between the renal dysfunction rate and metabolic syndrome(MS), stratified by age.

METHODSPeople took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012, were enrolled in this study. Estimated glomerular filtration rate (eGFR), -a renal dysfunction indicator, was calculated by modified MDRD equation [<60 ml/min(1.73 m(2))]. Associations between the renal dysfunction rate and factors as age, gender and MS traits, were assessed by stratified analysis.

RESULTSEligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%, 1.68% in 18 to 44 year-olds (youth), 45 to 59 year-olds (middle) and 60 year-olds or above (old), respectively. Participants with MS showed a significantly higher risk than those without, in the elderly only (P < 0.05)but not in the other 2 groups (P > 0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P < 0.05), but no significant differences seen in other subgroups (P > 0.05). Increasing trend was not seen in all the 3 groups (P > 0.05). Elevated blood pressure (BP+) in youth and middle-aged groups, decreased high density lipoprotein (HDL-C) in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+) in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis (P < 0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyceride (TG)/obesity was not identified.

CONCLUSIONThe prevalence of renal dysfunction was found low, in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C, however, indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR% of increased BP seemed to be the most important factors which might lead to renal dysfunction.

Adolescent ; Adult ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; physiopathology ; Male ; Metabolic Syndrome ; physiopathology ; Middle Aged ; Risk Factors ; Young Adult

OBJECTIVETo investigate the roles of Domain I and Domain II of hepatitis C virus (HCV) 5' untranslated region (UTR) in the translation initiation activity of HCV 5'UTR in different host cell lines.

METHODSThe eukaryotic expression plasmid pCMVNCRLuc (pCN1), in which full-length HCV 5'UTR regulates firefly luciferase expression, was modified by deleting Domain I and the downstream single-stranded sequence (43 bp in total) from the UTR (pCNl-d2), Domain I with the downstream single-stranded sequence and Domain II (118 bp in total) from the UTR (pCNl-d3), or the total UTR (pCNl-d5). The modified plasmids were transfected via liposome into different cell lines with pRL-TK plasmid co-transfected as the normalization control. At 36 h after the transfection, the total cellular RNA was harvested for semi-quantitative RT-PCR, and the relative expression activities of luciferase were assayed with a dual luciferase reporter gene assay system. The translation initiation activities of the truncated HCV 5'UTRs in different translation systems were analyzed.

RESULTSDeletion of Domain I and the downstream single-stranded sequence caused no significant changes of the translational activity of HCV 5'UTR in Hela or C6 cells, but decreased the translational activity by 46% in L-02 cells and increased the translational activity by 46% in 293T cells. Deletion of both Domain I and Domain II resulted in decreased translational activity of HCV 5'UTR by 51% in HeLa cells, but increased the translational activity by 40% in L-02 cells, 60% in C6 cells and 135% in 293T cells.

CONCLUSIONSDomain I and Domain II of HCV 5'UTR perform cell type-specific roles in HCV IRES-driven translation initiation.

5' Untranslated Regions ; Genes, Reporter ; HeLa Cells ; Hepacivirus ; genetics ; Humans ; Luciferases ; Plasmids ; Protein Biosynthesis ; genetics ; RNA, Viral ; genetics ; Transfection

Atherosclerosis ; prevention & control ; Cholesterol, LDL ; blood ; Humans ; Hypercholesterolemia ; drug therapy ; United States

Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012,were enrolled in this study. Estimated glomerular filtration rate(eGFR),-a renal dysfunction indicator,was calculated by modified MDRD equation[<60 ml/min(1.73 m2)]. Associations between the renal dysfunction rate and factors as age,gender and MS traits,were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%,1.68%in 18 to 44 year-olds(youth),45 to 59 year-olds(middle)and 60 year-olds or above(old),respectively. Participants with MS showed a significantly higher risk than those without,in the elderly only(P<0.05)but not in the other 2 groups(P>0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P<0.05),but no significant differences seen in other subgroups(P>0.05). Increasing trend was not seen in all the 3 groups(P>0.05). Elevated blood pressure(BP+)in youth and middle-aged groups,decreased high density lipoprotein(HDL-C)in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+)in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis(P<0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride(TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low,in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C,however,indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR%of increased BP seemed to be the most important factors which might lead to renal dysfunction.

Objective To investigate the spatial distribution and growing trend of 438 human infection with the H7N9 avian influenza virus in mainland China,and to provide evidence for developing scientific prevention and control strategies.Methods 438 human infection with the avian influenza A (H7N9) cases from February 2013 to May 2014 in mainland China were studied and data collected to establish a database for the development of geographic information system.Trend surface analysis and spatial autocorrelation analysis were used to study the spatial distribution.Descriptive epidemiological method was utilized to analyze the demographic characteristic.Results From June 2013 to May 2014,cases had an overall national increase,but significantly decreasing in Shanghai.A trend surface was established for human infection with avian influenza A (H7N9) in the mainland of China,showing that the incidence was increasing obviously from north to south and the line slope declined from west to east.Distribution pattern of the cases varied within different time series and regional levels.The overall Moran' s I coefficient of the provincial level from February to May in 2013 and the coefficient of the city level from June 2013 to May 2014 were 0.144 718 and 0.117 468,respectively,with the differences statistically significant (P＜0.05).According to the analysis of the local autocorrelation and hot spot,northern Zhejiang and southern Guangdong showed high spatial clusters of human infection with avian influenza A(H7N9) (Z＞2.58).Conclusion From February 2013 to May 2014,the spatial correlation at the provincial level decreased.However,the spatial correlation and the numbers of hot spots at the city level were both increasing.Effective measures should be taken accordingly,following the distributive characteristics.

Objective To investigate the roles of Domain I and Domain II of hepatitis C virus (HCV) 5' untranslated region (UTR) in the translation initiation activity of HCV 5'UTR in different host cell lines. Methods The eukaryotic expression plasmid pCMVNCRLuc (pCN1), in which full-length HCV 5'UTR regulates firefly luciferase expression, was modified by deleting Domain I and the downstream single-stranded sequence (43 bp in total) from the UTR (pCNl-d2), Domain I with the downstream single-stranded sequence and Domain II (118 bp in total) from the UTR (pCNl-d3), or the total UTR (pCNl-d5). The modified plasmids were transfected via liposome into different cell lines with pRL-TK plasmid co-transfected as the normalization control. At 36 h after the transfection, the total cellular RNA was harvested for semi-quantitative RT-PCR, and the relative expression activities of luciferase were assayed with a dual luciferase reporter gene assay system. The translation initiation activities of the truncated HCV 5'UTRs in different translation systems were analyzed. Results Deletion of Domain I and the downstream single-stranded sequence caused no significant changes of the translational activity of HCV 5'UTR in Hela or C6 cells, but decreased the translational activity by 46%in L-02 cells and increased the translational activity by 46%in 293T cells. Deletion of both Domain I and Domain II resulted in decreased translational activity of HCV 5'UTR by 51%in HeLa cells, but increased the translational activity by 40%in L-02 cells, 60%in C6 cells and 135%in 293T cells. Conclusions Domain I and Domain II of HCV 5'UTR perform cell type-specific roles in HCV IRES-driven translation initiation.