JTE-522-induced apoptosis in human gastric adenocarinoma cell line AGS cells by caspase activation accompanying cytochrome C release,membrane translocation of Bax and loss of mitochondrial membrane potential

AIM: To investigate the role of the mitochondrial pathway in JTE-522-induced apoptosis and to investigate the relationship between cytochrome C release, caspase activity and loss of mitochondrial membrane potential (Deltapsim). METHODS: Cell culture, cell counting, ELISA assay, TUNEL, flow cytometry, Western blot and fluorometric assay were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanism. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Caspases 8 and 9 were activated during apoptosis as judged by the appearance of cleavage products from procaspase and the caspase activities to cleave specific fluorogenic substrates. To elucidate whether the activation of caspases 8 and 9 was required for the apoptosis induction, we examined the effect of caspase-specific inhibitors on apoptosis. The results showed that caspase inhibitors significantly inhibited the apoptosis induced by JTE-522. In addition, the membrane translocation of Bax and cytosolic release of cytochrome C accompanying with the decrease of the uptake of Rhodamin 123, were detected at an early stage of apoptosis. Furthermore, Bax translocation, cytochrome C release, and caspase 9 activation were blocked by Z-VAD.fmk and Z-IETD-CHO. CONCLUSION: The present data indicate a crucial association between activation of caspases 8, 9, cytochrome C release, membrane translocation of Bax, loss of Deltapsim and JTE-522-induced apoptosis in AGS cells.

The influence of different types of satisfaction on loyalty on C2C online shopping platform:From the perspective of sellers and the platform

With the rise and development of major types of platforms,the competition for resources has become extremely fierce,and the market share of C2C platforms has been seriously threatened by the loss of resources.Therefore,building and maintaining buyers’satisfaction and loyalty to C2C platforms is critical to the survival and sustainability of C2C platforms in China.However,the current knowledge on how platform satisfaction and loyalty are constructed in the C2C e-commerce environment is incomplete.In this study,seller-based satisfaction and platform-based satisfaction are constructed separately.We further distinguish seller-based transaction satisfaction into economic and social satisfaction and explore their antecedents and consequences.To test our research hypotheses,we conduct a survey and collect data from a real online market(Taobao website).The results show that seller-based transaction satisfaction positively affects platform-based overall satisfaction and loyalty,and that perceived product quality,perceived assurance,and perceived price fairness all have a significant effect on economic satisfaction,whereas perceived relationship quality and perceived empathy significantly influence social satisfaction.These findings help us understand the literature related to customer satisfaction in the context of C2C in China and provide inspiration for online sellers and platforms.

Fine-tuning electronic structure of N-doped graphitic carbon-supported Co-and Fe-incorporated Mo_(2)C to achieve ultrahigh electrochemical water oxidation activity

Mo_(2)C is an excellent electrocatalyst for hydrogen evolution reaction(HER).However,Mo_(2)C is a poor electrocatalyst for oxygen evolution reaction(OER).Herein,two different elements,namely Co and Fe,are incorporated in Mo_(2)C that,therefore,has a finely tuned electronic structure,which is not achievable by incorporation of any one of the metals.Consequently,the resulting electrocatalyst Co_(0.8)Fe_(0.2)-Mo_(2)C-80 displayed excellent OER catalytic performance,which is evidenced by a low overpotential of 214.0(and 246.5)mV to attain a current density of 10(and 50)mA cm^(-2),an ultralow Tafel slope of 38.4 mV dec^(-1),and longterm stability in alkaline medium.Theoretical data demonstrates that Co_(0.8)Fe_(0.2)-Mo_(2)C-80 requires the lowest overpotential(1.00 V)for OER and Co centers to be the active sites.The ultrahigh catalytic performance of the electrocatalyst is attributed to the excellent intrinsic catalytic activity due to high Brunauer-Emmett-Teller specific surface area,large electrochemically active surface area,small Tafel slope,and low chargetransfer resistance.

Evaluating new biomarkers for diabetic nephropathy:Role ofα2-macroglobulin,podocalyxin,α-L-fucosidase,retinol-binding protein-4,and cystatin C

BACKGROUND The intricate relationship between type 2 diabetes mellitus(T2DM)and diabetic nephropathy(DN)presents a challenge in understanding the significance of various biomarkers in diagnosis.AIM To elucidate the roles and diagnostic values ofα2-macroglobulin(α2-MG),podocalyxin(PCX),α-L-fucosidase(AFU),retinol-binding protein-4(RBP-4),and cystatin C(CysC)in DN.METHODS From December 2018 to December 2020,203 T2DM patients were enrolled in the study.Of these,115 were diagnosed with DN(115 patients),while the remaining 88 patients were classified as non-DN.The urinary levels ofα2-MG,PCX,and AFU and the serum concentrations RBP-4 and CysC were measured in conjunction with other relevant clinical indicators to evaluate their potential correlations and diagnostic utility.RESULTS After adjustments for age and gender,significant positive correlations were observed between the biomarkers CysC,RBP-4,α2-MG/urinary creatinine(UCr),PCX/UCr,and AFU/UCr,and clinical indicators such as urinary albumin-to-creatinine ratio(UACR),serum creatinine,urea,24-h total urine protein,and neutrophil-to-lymphocyte ratio(NLR).Conversely,these biomarkers exhibited negative correlations with the estimated glomerular filtration rate(P<0.05).Receiver operating characteristic(ROC)curve analysis further demonstrated the diagnostic performance of these biomarkers,with UACR showcasing the highest area under the ROC curve(AUC^(ROC))at 0.97.CONCLUSION This study underscores the diagnostic significance ofα2-MG,PCX,and AFU in the development of DN.The biomarkers RBP-4,CysC,PCX,AFU,andα2-MG provide promising diagnostic insights,while UACR is the most potent diagnostic biomarker in assessing DN.

Effect of(Cr,V)_(2)(C,N)on the Microstructure and Mechanical Properties of WC-10Co Cemented Carbides

WC-10Co cemented carbides with finer WC and narrower grain size distributions are produced by using(Cr,V)_(2)(C,N)as grain growth inhibitors.As a result,with the increase of(Cr_(0.9),V_(0.1))_(2)(C,N)and(V_(0.9),Cr_(0.1))_(2)(C,N),the grains size of WC and mean free path of Co phase decrease,and adjacency of WC increases.Refinement and homogenization of grains enhance the transverse rupture strength(TRS)and the hardness.Meanwhile,the deflection and bridging of cracks keep the fracture toughness at a respectable level.The WC-10Co-0.6(Cr_(0.9),V_(0.1))_(2)(C,N)-0.025(V_(0.9),Cr_(0.1))_(2)(C,N)cemented carbides exhibit excellent comprehensive mechanical properties with the TRS of 4602.6 MPa,hardness of 1835 kg/mm^(2),and fracture toughness of 10.39 MPa·m^(1/2),respectively.However,the large pores are caused by excess N larger than 0.03 wt%and deteriorates the mechanical properties.We provide a new approach to WC-Co cemented carbides preparation with a narrow grain size distribution by adding novel grain growth inhibitors.

CYP2C19和ABCB1 C3435T基因多态性与氯吡格雷给药后ADP抑制率的关系

目的 分析CYP2C19和ABCB1 C3435T基因多态性与氯吡格雷个体化给药后二磷酸腺酐(ADP)抑制率的关系。方法 选取2017年12月—2021年1月中山大学附属第五医院神经内科和脑血管病科确诊的脑梗死或短暂性脑缺血并服用氯吡格雷抗血小板治疗的住院患者138例,所有患者均给予氯吡格雷75 mg治疗7 d后,检测患者ADP抑制率,同时利用荧光原位杂交法,检测患者CYP2C19和ABCB1 C3435T基因多态性,分析基因多态性与ADP抑制率的关系。结果 男性患者与女性患者对氯吡格雷的反应性存在显著差异(χ^(2)=6.807,P=0.033),男性患者ADP抑制率高于女性患者(t=2.686,P=0.008)。CYP2C19超快代谢型、快代谢型、中间代谢型和慢代谢型的ADP抑制率差异无统计学意义(F=1.129,P=0.340)。CYP2C19*1/*17型、*1/*1型、*1/*2型、*1/*3型、*2/*2型和*2/*3型的ADP抑制率有逐步下降的趋势,但差异无统计学意义(F=1.756,P=0.126),组间两两比较显示,*1/*1型的ADP抑制率高于*2/*2型(t=2.257,P=0.036)。ABCB1 C3435T的CC型、CT型和TT型的ADP抑制率比较差异无统计学意义(F=0.555,P=0.576)。CYP2C19快代谢型、中间代谢型和慢代谢型中ABCB1 C3435T不同基因型(CC型、CT型和TT型)的ADP抑制率比较差异均无统计学意义(F/P=0.192/0.826、0.525/0.594、0.666/0.540)。男性患者与女性患者在CYP2C19各代谢型中的分布无显著差异(U=2 146.50,P=0.608)。结论 在氯吡格雷个体化治疗中,CYP2C19基因多态性与ADP抑制率存在一定的相关性,ABCB1 C3435T基因多态性与ADP抑制率无相关性。

华法林相关基因CYP2C9、VKORC1、CYP4F2的多态性分布

目的研究CYP2C9、VKORC1、CYP4F2基因多态性在陕西省宝鸡地区汉族人群中的分布情况,为华法林个体化用药提供遗传依据。方法选取2022年1月至2023年5月在宝鸡市中医医院心内科接受华法林治疗并进行相关基因检测的住院患者475例,采用飞行时间质谱仪对华法林药物相关基因CYP2C9、VKORC1、CYP4F2分别进行检测,然后对检测结果的基因多态性进行分析。结果华法林药物相关各基因分布频率符合Hardy-Weinberg equilibrium规律,475例患者VKORC1基因型分别是AA型、AG型、GG型,基因频率分别为83.79%,15.58%,0.63%;CYP2C9基因型分别是*1/*1型、*1/*3型、*1/*2型,基因频率分别为95.17%,4.74%,0.11%,未检出*2/*2、*2/*3、*3/*3基因型;CYP4F2基因型分别是*1/*1型、*1/*3型、*3/*3型,基因频率分别为52.40%,39.37%,8.21%。各基因型分布在患者不同性别、年龄之间无统计学差异。结论陕西宝鸡地区汉族人群华法林药物基因VKORC1(c.-1639G>A)以变异型为主,包括纯合变异和杂合变异,而CYP2C9(*1、*2、*3)和CYP4F2(*1,*3)以野生型为主。

Ablation behaviour and mechanical performance of ZrB_(2)-ZrC-SiC modified carbon/carbon composites prepared by vacuum infiltration combined with reactive melt infiltration

The development of advanced aircraft relies on high performance thermal-structural materials,and carbon/carbon com-posites(C/C)composited with ultrahigh-temperature ceramics are ideal candidates.However,the traditional routes of compositing are either inefficient and expensive or lead to a non-uniform distribution of ceramics in the matrix.Compared with the traditional C/C-ZrC-SiC composites prepared by the reactive melt infiltration of ZrSi_(2),C/C-ZrB_(2)-ZrC-SiC composites prepared by the vacuum infiltration of ZrB_(2) combined with reactive melt infiltration have the higher content and more uniform distribution of the introduced ceramic phases.The mass and linear ablation rates of the C/C-ZrB_(2)-ZrC-SiC composites were respectively 68.9%and 29.7%lower than those of C/C-ZrC-SiC composites prepared by reactive melt infiltration.The ablation performance was improved because the volatilization of B_(2)O_(3),removes some of the heat,and the more uniformly distributed ZrO_(2),that helps produce a ZrO2-SiO2 continu-ous protective layer,hinders oxygen infiltration and decreases ablation.

UBE2C as an Immune-Related Biomarker for Breast Cancer:A Study Based on Multiple Databases

Objective To screen the target genes that are associated with survival of breast cancer(BRCA) and explore their prognostic values and immune correlations with BRCA using multiple databases..Methods The microarray expression datasets of BRCA were downloaded from the Gene Expresssion Omnibus database(GEO) and analyzed to obtain differentially expressed genes(DEGs). Hub genes were obtained by constructing and visualizing the protein-protein interaction network of DEGs. The key gene was determined using R language, STRING, and Cytoscape, and the differential expression of the key gene was verified using external datasets The Cancer Genome Atlas(TCGA) and quantitative real-time PCR(q RT-PCR) for BRCA tissues of 37 patients. The prognostic value and immunological correlation of UBE2C in BRCA were explored using R language, TIMER, and Gene Set Enrichment Analysis(GSEA).Results Of 10 hub genes seleceed from 302 DEGS, UBE2C was identified as the gene associated with BRCA survival. The expression of UBE2C was differentially upregulated in BRCA, as verified by TCGA and q RT-PCR. Prognostic analysis revealed that UBE2C served as an independent prognostic factor. High expression of UBE2C was associated with decreased immune infiltration levels of B cells, CD4+ T cells, CD8+ T cells, macrophages, and myeloid dendritic cells in BRCA tissue. The expression of UBE2C in BRCA showed a significant correlation with immune checkpoints genes PDCD1, CD274, and CTLA4 expressions. There was a positive correlation between the expression of UBE2C and the tumor mutational burden and microsatellite instability. GSEA demonstrated that UBE2C expression significantly enriched 786 immune-related gene sets.Conclusions UBE2C expression in BRCA tissues is closely related to the BRCA immune microenvironment and showes predictive values on the survivals and prognosis of BRCA patients and the effecacy of immunotherapy. UBE2C may be an potential immune-related prognostic biomarker for BRCA.

Complement activation targeted inhibitor C2-FH ameliorates acetaminophen-induced liver injury in mice

BACKGROUND Complement activation is recognized as an important factor in the progression of liver damage caused by acetaminophen(APAP).However,the role of the complement inhibitor C2-FH in APAP-induced liver injury remains unclear.AIM To explore C2-FH in protecting against APAP-induced liver injury by inhibiting complement activation.METHODS A model of APAP-induced liver injury was used to study the protective effect of C2-FH on liver injury.C2-FH was administered through intraperitoneal injection 30 minutes after APAP treatment.We detected the effects of C2-FH on liver function,inflammatory response and complement activation.Additionally,RNA-sequencing(RNA-Seq)analysis was conducted to understand the mechanism through which C2-FH provides protection against APAP-induced liver injury.RESULTS C2-FH inhibited the increase in serum alanine aminotransferase activity,aspartate aminotransferase activity and lactate dehydrogenase,and reduced liver tissue necrosis caused by APAP.Moreover,it attenuated the inflammatory response and inhibited complement activation in APAP-induced liver injury.RNA-Seq analysis provided additional explanations for the protective role of C2-FH against APAP-induced liver injury.CONCLUSION C2-FH attenuates APAP-induced liver injury by inhibiting complement activation.

PCR-HRM for Genomic Surveillance of SARS-CoV-2: A Variant Detection Tool in Côte d’Ivoire, West Africa

The rise of new viruses, like SARS-CoV-2 causing the COVID-19 outbreak, along with the return of antibiotic resistance in harmful bacteria, demands a swift and efficient reaction to safeguard the health and welfare of the global population. It is crucial to have effective measures for prevention, intervention, and monitoring in place to address these evolving and recurring risks, ensuring public health and international security. In countries with limited resources, utilizing recombinant mutation plasmid technology in conjunction with PCR-HRM could help differentiate the existence of novel variants. cDNA synthesis was carried out on 8 nasopharyngeal samples following viral RNA extraction. The P1 segment of the SARS-CoV-2 Spike S protein was amplified via conventional PCR. Subsequently, PCR products were ligated with the pGEM-T Easy vector to generate eight recombinant SARS-CoV-2 plasmids. Clones containing mutations were sequenced using Sanger sequencing and analyzed through PCR-HRM. The P1 segment of the S gene from SARS-CoV-2 was successfully amplified, resulting in 8 recombinant plasmids generated from the 231 bp fragment. PCR-HRM analysis of these recombinant plasmids differentiated three variations within the SARS-CoV-2 plasmid population, each displaying distinct melting temperatures. Sanger sequencing identified mutations A112C, G113T, A114G, G214T, and G216C on the P1 segment, validating the PCR-HRM findings of the variations. These mutations led to the detection of L452R or L452M and F486V protein mutations within the protein sequence of the Omicron variant of SARS-CoV-2. In summary, PCR-HRM is a vital and affordable tool for distinguishing SARS-CoV-2 variants utilizing recombinant plasmids as controls.

负载型CoMnNa催化剂对合成气制低碳烯烃CO_(2)选择性的抑制研究

FTO(Fischer-Tropsch to olefins)作为合成气制备低碳烯烃(C_(2)^(=)~C_(4)^(=))的代替路径在工业上具有重要意义。CoMnNa作为FTO反应催化剂而备受关注,但由于反应过程中CO_(2)C活性相的形成,导致CO_(2)选择性较高。引入AlO(OH)载体,制备了Co_(1)Mn_(1)Na/AlO(OH)催化剂,通过XRD、STEM、EDX-mapping、N_(2)吸附-脱附等温线、孔径分布曲线对催化剂进行了表征,通过H_(2)-TPR对催化剂的还原性进行了分析,并对催化剂的FTO反应性能进行了评价。结果表明,利用载体与CoMn的相互作用,降低了CoMn氧化物的还原性,有效抑制了CoMn中Co的析出及CO_(2)C的形成,减少了CoMn体系中Co和CO_(2)C活性相;在低碳烯烃选择性高达32.4%的情况下,成功将CO_(2)选择性降至10%以下。

CO、CO_(2)及其混合物加氢转化制甲烷的热力学平衡研究

由CO和CO_(2)加氢制甲烷是现今氢能储存及燃料和化学品可持续生产的有效途径之一,但目前对该反应过程(尤其是针对CO和CO_(2)混合物加氢)的一些细节尚不明晰。为此,作为前期有关CO和CO_(2)加氢制烃和醇研究工作的补充,本工作对CO和CO_(2),尤其是两者混合物的加氢制甲烷反应过程进行了热力学分析。结果证实,与单独CO或CO_(2)相比,两者混合物加氢制甲烷更为合适,总碳基甲烷收率可作为评估甲烷合成反应过程效率的重要指标。CO加氢的甲烷平衡收率比CO_(2)加氢的高,而CO和CO_(2)混合物加氢的总碳基甲烷平衡收率位于两者之间;对于CO和CO_(2)混合物加氢,尽管CO和CO_(2)的平衡转化率随进料组成不同会有很大的变化,但其总碳基甲烷平衡收率随着原料中CO_(2)/(CO+CO_(2))物质的量比的增大而线形降低。整体上看,在温度低于400℃和压力高于0.1 MPa时,无论是CO、CO_(2)、还是两者混合物的化学计量比加氢,其总碳基甲烷平衡收率均高于85%。这些结果无疑对高效CO和CO_(2)加氢制甲烷催化剂研制及反应过程的设计和操作优化有重要的参考价值。

Cys C、C1q、β_(2)-MG、Urea、UA检测对初诊多发性骨髓瘤患者合并肾损伤的诊断价值

目的探讨肾功能指标胱抑素C(cystatin C,Cys C)、补体C1q(complement C1q)、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)、尿素(Urea)、尿酸(uric acid,UA)对初诊多发性骨髓瘤(multiplemyeloma,MM)患者合并肾损伤(renal impairment,RI)的诊断价值。方法回顾性分析2021年8月~2022年12月首都医科大学附属北京积水潭医院血液科收治的93例初诊MM患者的病例资料,按照血肌酐水平将MM患者分为RI组[血肌酐>176.80mmol/L(2mg/dl),n=19]及非RI组[血肌酐≤176.80mmol/L(2mg/dl),n=74],对RI组和非RI组的临床资料及实验室指标进行分析。采用单因素和多因素Logistic回归分析评价MM患者发生RI的危险因素,应用受试者工作特征(receiver operating characteristic,ROC)曲线评估危险因素对MM患者发生RI的预测价值。结果93例初诊MM患者发生RI者占25.68%,RI组轻链型占比最高(36.84%,7/19),IgG-λ型和IgA-κ型比例最低(10.53%,2/19);非RI组IgA-κ型比例最高(29.73%,22/74),IgG-λ型比例最低(12.16%,9/74)。DS分期中,RI组19例全部为Ⅲ期,非RI组72例全部为Ⅲ期。ISS分期中,RI组Ⅲ期最多(68.42%,13/19),非RI组中Ⅰ期最多(41.89%,31/74)。RISS分期中,RI组Ⅱ期和Ⅲ期最多(36.84%,7/19),非RI组Ⅱ期最多(58.11%,43/74)。DS分期和ISS分期组间差异有统计学意义(P<0.05)。RI组中Cys C、β_(2)-MG、Urea、UA水平均高于非RI组,差异均有统计学意义(P<0.05)。单因素分析结果显示,Cys C、Urea、β_(2)-MG水平异常升高是MM患者发生RI的危险因素(P<0.05),C1q对MM患者发生RI没有影响(P>0.05);多因素Logistic回归分析结果显示,Cys C、Urea、β_(2)-MG水平异常升高均是MM患者发生RI的独立影响因素(P<0.05)。Cys C、Urea、β_(2)-MG预测MM患者发生RI的敏感度分别为88.9%、50.0%、94.4%,特异性分别为90.4%、100.0%、84.9%;Cys C、Urea、β_(2)-MG联合检测预测MM患者发生RI的敏感度为100.0%,特异性为87.7%。结论Cys C、Urea、β_(2)-MG均能较好地预测初诊MM患者发生RI的可能性,3项指标联合检测对MM患者发生RI具有更高的预测价值。

C反应蛋白对不同CYP2C19基因型患者伏立康唑血药浓度的影响分析

目的分析炎性指标C反应蛋白(CRP)与伏立康唑血药浓度的相关性,并进一步探究CRP对不同CYP2C19基因型患者伏立康唑血药浓度的影响。方法选取2020年3月—2023年4月使用伏立康唑静脉注射治疗侵袭性真菌感染的患者,采用LC-MS/MS法测定稳态血药浓度,采用荧光原位杂交技术检测患者CYP2C19基因多态性,同时收集患者的临床资料。根据CRP将患者分为非/轻度炎症组和中度炎症组,采用SPSS 22.0软件进行统计分析。结果共纳入122例患者,中度炎症患者伏立康唑血药浓度显著大于非/轻度炎症患者(P<0.0001);非/轻度炎症患者中,超出治疗范围上限5.0μg/ml的比例为21.05%,而中度炎症患者中该比例高达41.67%(P=0.035)。多因素线性回归分析结果显示,血小板计数、年龄、CRP及CYP2C19基因表型是伏立康唑血药浓度的独立影响因素(P<0.001)。对于快代谢及中间代谢患者,中度炎症患者的血药浓度显著大于非/轻度炎症患者(P<0.05),而慢代谢患者,CRP对伏立康唑血药浓度的影响无统计学意义(P>0.05)。结论CRP是影响伏立康唑血药浓度因素之一,且与患者CYP2C19基因表型显著相关,快代谢及中间代谢患者炎症期间使用伏立康唑应加强监测血药浓度,以避免不良反应的发生。

Aldo-keto reductase family member C3(AKR1C3)promotes hepatocellular carcinoma cell growth by producing prostaglandin F2α

Hepatocellular carcinoma(HCC)is a leading cause of death worldwide.Current therapies are effective for HCC patients with early disease,but many patients suffer recurrence after surgery and have a poor response to chemotherapy.Therefore,new therapeutic targets are needed.We analyzed gene expression profiles between HCC tissues and normal adjacent tissues from public databases and found that the expression of genes involved in lipid metabolism was significantly different.The analysis showed that AKR1C3 was upregulated in tumors,and high AKR1C3 expression was associated with a poorer prognosis in HCC patients.In vitro,assays demonstrated that the knockdown of AKR1C3 or the addition of the AKR1C3 inhibitor indomethacin suppressed the growth and colony formation of HCC cell lines.Knockdown of AKR1C3 in Huh7 cells reduced tumor growth in vivo.To explore the mechanism,we performed pathway enrichment analysis,and the results linked the expression of AKR1C3 with prostaglandin F2 alpha(PGF2a)downstream target genes.Suppression of AKR1C3 activity reduced the production of PGF2a,and supplementation with PGF2a restored the growth of indomethacin-treated Huh7 cells.Knockdown of the PGF receptor(PTGFR)and treatment with a PTGFR inhibitor significantly reduced HCC growth.We showed that indomethacin potentiated the sensitivity of Huh7 cells to sorafenib.In summary,our results indicate that AKR1C3 upregulation may promote HCC growth by promoting the production of PGF2α,and suppression of PTGFR limited HCC growth.Therefore,targeting the AKR1C3-PGF2a-PTGFR axis may be a new strategy for the treatment of HCC.

CYP2C19基因多态性联合血小板功能检测指导抗血小板药物选择对老年ACS患者PCI术后消化道出血的影响分析

目的:探究CYP2C19基因多态性联合血小板功能检测指导抗血小板药物选择对老年急性冠脉综合征(acute coronary syndrom,ACS)患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后对患者消化道出血的影响。方法:研究选取2021年4月至2022年12月在我院就诊的老年ACS患者并成功完成PCI术216例,并按照随机数表法分为研究组和对照组,每组各108例。术前所有患者均连续4 d服用相同剂量阿司匹林联合氯吡格雷抗血小板治疗;术后对研究组进行CYP2C19基因型检测得到基因型分组,以区分不同的代谢型,将中间代谢型患者进行血栓弹力图(thromboelastogram,TEG)检测根据结果挑选出血小板抑制率低于50%(氯吡格雷抵抗型)的患者,改用阿司匹林和替格瑞洛;对照组则一直采用阿司匹林和氯吡格雷治疗。观察PCI术后5周患者血清的心肌肌钙蛋白(cardiac troponin,cTnI)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、超敏C-反应蛋白(hypersensitive Creactive protein,hs-CRP)水平,并进行观察患者术后第1、6个月的不良心血管事件(major adverse cardiovascular events,MACE);比较两组患者用药前以及用药7 d和14 d的血小板CD62P、纤维蛋白原受体1(fibrinogen receptor 1,PAC-1)表达情况;并且比较两组的血小板聚集率;治疗后患者消化道出血事件以及记录心脏急症发生情况。结果:患者经过基因检测可知氯吡格雷超快代谢型有21例(19.44%)和快代谢型有25例(23.15%)和异常代谢型包括中间代谢型有42例(基因型分别占比为10.19%、13.89%、9.26%和5.56%)和慢代谢型有20例(基因型分别占比8.33%、7.41%和2.78%)。患者术后5周后,研究组的血清cTnI、hs-CRP及CK-MB水平均低于对照组(P<0.05,P<0.01)。术后1个月,观察组和对照组MACE总发生率变化相近(P>0.05);术后6个月,观察组MACE总发生率较对照组降低(P<0.05);研究组治疗后7 d和14 d的CD62P和PAC-1表达水平较对照组降低(P<0.01);研究组的最大血小板聚集率较对照组降低(P<0.01);两组心脏急症发生情况变化相近(P>0.05);两组患者术后消化道出血比较,研究组消化道出血例数较对照组对照组降低(χ^(2)=9.479,P<0.01)结论:通过CYP2C19基因型联合血小板功能检测共同筛选出的氯吡格雷低反应患者给予阿司匹林联合替格瑞洛抗血小板治疗可以降低血小板的活性以及聚集率和消化道出血事件。

OCA2基因c.1441G>A(p.Ala481Thr)位点变异的生育遗传咨询探讨

目的对OCA2基因c.1441G>A(p.Ala481Thr)位点变异白化病家系的遗传咨询和生育指导。方法丈夫,26岁,轻度白化病表现,毛发偏黄,皮肤白皙,视力正常,无白化病相关系统受累表现。妻子,27岁,G_(0)P_(0),身体良好。夫妇属非近亲婚配。现备孕咨询,评估生育白化病患儿风险。遗传咨询后,建议其进行遗传性白化病相关基因的测序检测。以“OCA2基因,c.1441G>A位点”为检索词,检索Pubmed、OMIM、Clinvar数据库、中国知网、万方数据库(建库至2023年10月),选取OCA2基因c.1441G>A(p.Ala481Thr)变异相关的白化病病例相关资料文献。结果结果显示,丈夫OCA2基因存在2个变异,分别为NM_000275.3:c.182G>A(p.Trp61*)和NM_000275.3:c.1426A>G(p.Asn476Asp),妻子OCA2基因有1个杂合变异,为NM_000275.3:c.1441G>A(p.Ala481Thr)。Sanger溯源验证,丈夫所携无义变异c.182G>A(p.Trp61*)来源其母亲,所携错义变异c.1426A>G(p.Asn476Asp)变异来源其父亲。妻子所携错义变异c.1441G>A(p.Ala481Thr)并非来源其父亲,其母亲信息不详。使用数据库搜索c.1441G>A变异的表型效应,得知c.1441G>A(p.Ala481Thr)属于一种亚等效变异,Ala481Thr在黑色素形成中有70%的野生型功能,纯合子无表现,表型正常。据c.1441G>A的亚等效作用,遗传咨询后,夫妇知情同意选择自然怀孕方式。随访这对夫妇怀孕并分娩1表型正常女儿。经测序验证,女儿遗传了父亲c.1426A>G(p.Asn476Asp)变异和母亲正常OCA2基因。结论报道一例白化病OCA2基因c.1441G>A变异相关的生育遗传咨询案例,复习文献,总结c.1441G>A(p.Ala481Thr)白化病的亚等效作用所产生的表型特异性,帮助临床医生正确认识合理运用恰当的遗传学检测手段和深刻理解临床决策前充分遗传咨询的重要性,从而提高对该类变异的遗传咨询能力,有效地避免了过度医疗。

脊髓背根神经节ZXDC介导CCL2对慢性压迫性 神经损伤小鼠神经性疼痛的作用

目的探讨脊髓背根神经节(dorsal root ganglion,DRG)中转录因子锌指X连锁复制C(zinc finger X-linked duplicated C,ZXDC)介导CCL2/CCR2信号通路对慢性压迫性神经损伤(chronic construction injury model,CCI)诱导神经性疼痛的作用及机制。方法构建小鼠坐骨神经慢性压迫性损伤模型,免疫荧光染色、Western blot法和实时荧光定量PCR(RT-qPCR)检测正常情况和CCI造模后DRG中ZXDC及CCL2表达变化;将实验动物分为假手术(Sham)组、CCI+AAV-NC组和CCI+AAV-ZXDC siRNA组;Western blot法和免疫荧光染色检测各组小鼠CCI造模后各时间点DRG中ZXDC、CCL2和CCR2表达,RT-qPCR检测DRG中促炎性细胞因子TNF-α和IL-1βmRNA表达,机械性缩足反射测试检测神经性疼痛行为改变。结果ZXDC表达定位在DRG大、中、小神经元。CCI损伤后1~3天DRG中ZXDC和CCL2蛋白和mRNA表达显著增高,CCI后7天二者表达显著降低,ZXDC和CCL2mRNA表达量呈正相关(P均<0.05)。CCI后3天,与Sham组比较,CCI+AAV-NC组和CCI+AAV-ZXDC siRNA组ZXDC、CCL2、CCR2蛋白表达、TNF-α和IL-1βmRNA表达显著增高,其中CCI+AAV-ZXDC siRNA组较CCI+AAV-NC组ZXDC、CCL2、CCR2蛋白表达、TNF-α和IL-1βmRNA显著降低(P均<0.05)。与Sham组比较,CCI+AAV-ZXDC siRNA组和CCI+AAV-NC组CCI后各时间点机械缩足阈值均显著降低,其中CCI后7天,CCI+AAV-ZXDC siRNA组机械缩足阈值显著高于CCI+AAV-NC组(P均<0.05)。结论脊髓背根神经节ZXDC基因敲减通过抑制CCL2/CCR2信号通路介导CCI诱导的神经性疼痛。

立体定向手术治疗脑胶质瘤患者的疗效及其对血清泛素偶联酶2C、CXC趋化因子配体10水平的影响

目的分析立体定向手术治疗脑胶质瘤患者的疗效及其对血清泛素偶联酶2C(UBE2C)、CXC趋化因子配体10(CXCL10)水平的影响。方法收集2018年1月至2023年2月新乡医学院第三附属医院收治的45例脑胶质瘤患者的临床资料,依照手术方式不同分为2组,对照组22例接受传统开颅手术治疗,观察组23例接受立体定向手术治疗,比较2组疗效、术后1 a生存率、术前及术后6个月神经功能[神经功能缺损程度量表(NIHSS)]、免疫细胞[辅助性T细胞(Th)1、Th2、Th17]、生活能力[Barthel指数(BI)]以及血清UBE2C、CXCL10、炎症细胞因子[肿瘤坏死因子-α(TNF-α)、白介素-17(IL-17)、IL-2、IL-6]水平。结果观察组总有效率(100.00%)高于对照组(72.73%;χ^(2)=5.070,P=0.024);观察组术后1 a生存率(86.96%)高于对照组(54.55%;χ^(2)=5.750,P=0.017)。术后6个月,观察组NIHSS评分低于对照组,而BI评分高于对照组(t=6.728,P<0.001;t=5.339,P<0.001);观察组Th1高于对照组,而Th2、Th17均低于对照组(t=3.793,P<0.001;t=4.691,P<0.001;t=5.293,P<0.001);观察组血清UBE2C、CXCL10、TNF-α、IL-17、IL-2、IL-6水平均低于对照组(t=8.778,P<0.001;t=3.543,P=0.001;t=9.831,P<0.001;t=11.148,P<0.001;t=11.516,P<0.001;t=10.954,P<0.001)。结论立体定向手术治疗脑胶质瘤的效果显著,能有效改善患者神经功能、免疫功能、生活能力,抑制炎症细胞因子、UBE2C、CXCL10表达,延长患者生存。