BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro...BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro-gressive sensorimotor polyneuropathy,organ enlargement,endocrine disorders,darkening skin,a monoclonal plasma cell proliferative disorder,and lymph node hyperplasia.The organomegaly consists of hepatosplenomegaly and/or lym-phadenopathy;cases of cardiomyopathy are rare.Diagnoses are often delayed because of the atypical nature of the syndrome,exposing patients to possibly severe disability.Therefore,identifying atypical symptoms can improve the prognosis and quality of life among POEMS syndrome patients.lenalidomide and dexamethasone.CONCLUSION When patients with cardiomyopathy have systemic manifestations such as numb limbs and darkening skin,the POEMS syndrome is the most possible diagnosis.展开更多
BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome a...BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome are diverse.Due to the insidious onset and lack of specific early-stage manifestations,POEMS syndrome is easily misdiagnosed or never diagnosed,leading to delayed treatment.Neurological symptoms are usually the first clinical manifestation,while ascites is a rare symptom in patients with POEMS syndrome.CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom,which is a rare early-stage manifestation of the condition.After 1 year,the patient gradually developed progressive renal impairment,anemia,polyserosal effusion,edema,swollen lymph nodes on the neck,armpits,and groin,and decreased muscle strength of the lower extremities.The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion.Treatment comprised bortezomib+dexamethasone,continuous renal replacement therapy,chest and abdominal closed drainage,transfusions of erythrocytes and platelets,and other symptomatic and supportive treatments.The patient’s condition initially improved after treatment.However,then her symptoms worsened,and she succumbed to the illness and died.CONCLUSION Ascites is a potential early manifestation of POEMS syndrome,and this diagnosis should be considered for patients with unexplained ascites.Furthermore,multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.展开更多
BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevate...BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevated plasma cells,platelets,and vascular endothelial growth factor levels.Although heart disease rarely occurs in POEMS syndrome,the death rate increases sharply after heart failure.We report a patient who initially presented with an endocrine disease and developed congestive heart failure related to POEMS syndrome 9 years later.CASE SUMMARY A 23-year-old woman with no history of menstruation and a 9-year history of type I diabetes reported feeling breathless after activities.She could not lie down and rest at night.Three months prior,she experienced pain and increased tension in her left thigh accompanied by tenderness and edema in both lower extremities.The chief complaint upon hospital admission was that blood sugar has increased for more than 9 years,pain in the left thigh,and edema in both legs for more than 2 mo.After a multisystem evaluation,she was diagnosed with POEMS syndrome.Her echocardiogram showed left ventricular dilation with systolic dysfunction,and the left ventricular ejection fraction was only 38%with severely elevated brain natriuretic peptide.She received a combination of dexamethasone and thalidomide for 1 mo,but her symptoms did not improve.Therefore,we added a two-per-week bortezomib injection.After 2 wk,the patient’s heart function had improved significantly.CONCLUSION This case provides information about the treatment of POEMS syndrome with complications and highlights the challenges of developing a standardized treatment.展开更多
为了给深入研究猪繁殖与呼吸综合征病毒(porcine reproductive and respiratory syndromevirus,PRRSV)ORF6基因编码的M蛋白的生物学功能提供重要试验材料,本研究首先利用慢病毒包装系统构建了过表达PRRSVORF6基因的重组慢病毒质粒,将该...为了给深入研究猪繁殖与呼吸综合征病毒(porcine reproductive and respiratory syndromevirus,PRRSV)ORF6基因编码的M蛋白的生物学功能提供重要试验材料,本研究首先利用慢病毒包装系统构建了过表达PRRSVORF6基因的重组慢病毒质粒,将该质粒连同辅助质粒共同转染至HEK293T细胞获得重组慢病毒;之后将重组慢病毒感染MARC-145细胞,利用嘌呤霉素结合有限稀释法进行筛选,连续筛选3轮后建立了稳定表达PRRSVM蛋白的MARC-145ORF6细胞系;并使用CCK-8试验评估过表达PRRSVM蛋白对MARC-145细胞生长的影响。利用RT-PCR、蛋白免疫印迹(Westernblot)和间接免疫荧光(IFA)评估MARC-145ORF6细胞系的传代稳定性并鉴定M蛋白的亚细胞定位,进一步利用RT-qPCR评估过表达M蛋白对MARC-145细胞的干扰素及相关调节基因的影响;此外,还测定了PRRSV在MARC-145ORF6细胞系、MARC-145Flag细胞系和MARC-145细胞中的病毒滴度并绘制多步生长曲线以比较其差异。CCK-8试验结果表明,过表达PRRSVM蛋白对MARC-145细胞活力无显著影响;RT-qPCR、Westernblot和IFA等试验结果表明,MARC-145ORF6细胞系能够表达PRRSV的M蛋白且在传代过程中稳定。此外,稳定表达PRRSVM蛋白显著下调了细胞系的Ⅰ型干扰素及其相关调节基因;多步生长曲线表明,MARC-145ORF6细胞系促进PRRSV增殖,提高其病毒滴度。综上,本研究构建了可以稳定表达PRRSVM蛋白的MARC-145ORF6细胞系,发现其Ⅰ型干扰素水平显著下调且促进PRRSV复制。本研究构建的MARC-145ORF6细胞系将为M蛋白功能的深入研究提供重要生物材料。展开更多
胃癌是消化系统最常见的恶性肿瘤之一,多数患者发现时已处于晚期,预后不佳。外科手术及化学治疗(化疗仍是目前胃癌的主要治疗方式。N6-甲基腺嘌呤(N6-methyladenosine,m^(6)A)是近年来肿瘤研究的热点。m^(6)A作为真核生物中最常见的RNA...胃癌是消化系统最常见的恶性肿瘤之一,多数患者发现时已处于晚期,预后不佳。外科手术及化学治疗(化疗仍是目前胃癌的主要治疗方式。N6-甲基腺嘌呤(N6-methyladenosine,m^(6)A)是近年来肿瘤研究的热点。m^(6)A作为真核生物中最常见的RNA修饰形式,可以调控RNA循环的各个阶段,包括RNA剪接、加工、降解和翻译等,从而调控RNA的表达和功能,在细胞分化、发育和代谢等各个环节中发挥关键作用。m^(6)A去甲基化酶可去除RNA上的甲基基团,确保m^(6)A甲基化是一个动态的可逆的过程。作为m^(6)A甲基化过程的关键酶,m^(6)A去甲基化酶——脂肪和肥胖相关蛋白(fat mass and obesity-associated protein,FTO)、AlkB同系物5(AlkB homolog 5,ALKBH5)、ALKBH3的失调能通过多种机制调控胃癌的演进过程,与胃癌的发生发展密切相关。m^(6)A去甲基化酶通过调节信号通路,改变胃癌细胞的增殖和侵袭能力,影响胃癌对化疗药物的耐药性,参与调控胃癌的免疫应答及线粒体代谢,从而影响胃癌细胞的生长,有望成为一个全新的治疗靶点。该文综述了m^(6)A去甲基化酶参与胃癌发生发展的分子机制,以及其表达和功能与胃癌生物学特性的关系,旨在为胃癌的早期诊断和靶向治疗提供新的研究思路。展开更多
文摘BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro-gressive sensorimotor polyneuropathy,organ enlargement,endocrine disorders,darkening skin,a monoclonal plasma cell proliferative disorder,and lymph node hyperplasia.The organomegaly consists of hepatosplenomegaly and/or lym-phadenopathy;cases of cardiomyopathy are rare.Diagnoses are often delayed because of the atypical nature of the syndrome,exposing patients to possibly severe disability.Therefore,identifying atypical symptoms can improve the prognosis and quality of life among POEMS syndrome patients.lenalidomide and dexamethasone.CONCLUSION When patients with cardiomyopathy have systemic manifestations such as numb limbs and darkening skin,the POEMS syndrome is the most possible diagnosis.
文摘BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome are diverse.Due to the insidious onset and lack of specific early-stage manifestations,POEMS syndrome is easily misdiagnosed or never diagnosed,leading to delayed treatment.Neurological symptoms are usually the first clinical manifestation,while ascites is a rare symptom in patients with POEMS syndrome.CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom,which is a rare early-stage manifestation of the condition.After 1 year,the patient gradually developed progressive renal impairment,anemia,polyserosal effusion,edema,swollen lymph nodes on the neck,armpits,and groin,and decreased muscle strength of the lower extremities.The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion.Treatment comprised bortezomib+dexamethasone,continuous renal replacement therapy,chest and abdominal closed drainage,transfusions of erythrocytes and platelets,and other symptomatic and supportive treatments.The patient’s condition initially improved after treatment.However,then her symptoms worsened,and she succumbed to the illness and died.CONCLUSION Ascites is a potential early manifestation of POEMS syndrome,and this diagnosis should be considered for patients with unexplained ascites.Furthermore,multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.
文摘BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevated plasma cells,platelets,and vascular endothelial growth factor levels.Although heart disease rarely occurs in POEMS syndrome,the death rate increases sharply after heart failure.We report a patient who initially presented with an endocrine disease and developed congestive heart failure related to POEMS syndrome 9 years later.CASE SUMMARY A 23-year-old woman with no history of menstruation and a 9-year history of type I diabetes reported feeling breathless after activities.She could not lie down and rest at night.Three months prior,she experienced pain and increased tension in her left thigh accompanied by tenderness and edema in both lower extremities.The chief complaint upon hospital admission was that blood sugar has increased for more than 9 years,pain in the left thigh,and edema in both legs for more than 2 mo.After a multisystem evaluation,she was diagnosed with POEMS syndrome.Her echocardiogram showed left ventricular dilation with systolic dysfunction,and the left ventricular ejection fraction was only 38%with severely elevated brain natriuretic peptide.She received a combination of dexamethasone and thalidomide for 1 mo,but her symptoms did not improve.Therefore,we added a two-per-week bortezomib injection.After 2 wk,the patient’s heart function had improved significantly.CONCLUSION This case provides information about the treatment of POEMS syndrome with complications and highlights the challenges of developing a standardized treatment.
文摘为了给深入研究猪繁殖与呼吸综合征病毒(porcine reproductive and respiratory syndromevirus,PRRSV)ORF6基因编码的M蛋白的生物学功能提供重要试验材料,本研究首先利用慢病毒包装系统构建了过表达PRRSVORF6基因的重组慢病毒质粒,将该质粒连同辅助质粒共同转染至HEK293T细胞获得重组慢病毒;之后将重组慢病毒感染MARC-145细胞,利用嘌呤霉素结合有限稀释法进行筛选,连续筛选3轮后建立了稳定表达PRRSVM蛋白的MARC-145ORF6细胞系;并使用CCK-8试验评估过表达PRRSVM蛋白对MARC-145细胞生长的影响。利用RT-PCR、蛋白免疫印迹(Westernblot)和间接免疫荧光(IFA)评估MARC-145ORF6细胞系的传代稳定性并鉴定M蛋白的亚细胞定位,进一步利用RT-qPCR评估过表达M蛋白对MARC-145细胞的干扰素及相关调节基因的影响;此外,还测定了PRRSV在MARC-145ORF6细胞系、MARC-145Flag细胞系和MARC-145细胞中的病毒滴度并绘制多步生长曲线以比较其差异。CCK-8试验结果表明,过表达PRRSVM蛋白对MARC-145细胞活力无显著影响;RT-qPCR、Westernblot和IFA等试验结果表明,MARC-145ORF6细胞系能够表达PRRSV的M蛋白且在传代过程中稳定。此外,稳定表达PRRSVM蛋白显著下调了细胞系的Ⅰ型干扰素及其相关调节基因;多步生长曲线表明,MARC-145ORF6细胞系促进PRRSV增殖,提高其病毒滴度。综上,本研究构建了可以稳定表达PRRSVM蛋白的MARC-145ORF6细胞系,发现其Ⅰ型干扰素水平显著下调且促进PRRSV复制。本研究构建的MARC-145ORF6细胞系将为M蛋白功能的深入研究提供重要生物材料。
文摘胃癌是消化系统最常见的恶性肿瘤之一,多数患者发现时已处于晚期,预后不佳。外科手术及化学治疗(化疗仍是目前胃癌的主要治疗方式。N6-甲基腺嘌呤(N6-methyladenosine,m^(6)A)是近年来肿瘤研究的热点。m^(6)A作为真核生物中最常见的RNA修饰形式,可以调控RNA循环的各个阶段,包括RNA剪接、加工、降解和翻译等,从而调控RNA的表达和功能,在细胞分化、发育和代谢等各个环节中发挥关键作用。m^(6)A去甲基化酶可去除RNA上的甲基基团,确保m^(6)A甲基化是一个动态的可逆的过程。作为m^(6)A甲基化过程的关键酶,m^(6)A去甲基化酶——脂肪和肥胖相关蛋白(fat mass and obesity-associated protein,FTO)、AlkB同系物5(AlkB homolog 5,ALKBH5)、ALKBH3的失调能通过多种机制调控胃癌的演进过程,与胃癌的发生发展密切相关。m^(6)A去甲基化酶通过调节信号通路,改变胃癌细胞的增殖和侵袭能力,影响胃癌对化疗药物的耐药性,参与调控胃癌的免疫应答及线粒体代谢,从而影响胃癌细胞的生长,有望成为一个全新的治疗靶点。该文综述了m^(6)A去甲基化酶参与胃癌发生发展的分子机制,以及其表达和功能与胃癌生物学特性的关系,旨在为胃癌的早期诊断和靶向治疗提供新的研究思路。
