Fatal multiple acyl-CoA dehydrogenase deficiency caused by ETFDH gene mutation:A case report

BACKGROUND Multiple acyl-CoA dehydrogenase deficiency(MADD)is a disease of rare autosomal recessive disorder.There are three types of MADD.Type I is a neonatalonset form with congenital anomalies.Type II is a neonatal-onset form without congenital anomalies.Type III is considered to a milder form and usually responds to riboflavin.However,late-onset form could also be fatal and not responsive to treatments.CASE SUMMARY We report a severe case of a young man with onset type III MADD induced by drugs and strenuous exercise characterized by rhabdomyolysis and liver dysfunction.Urine analysis indicated 12 out of 70 kinds of organic acids like glutaric acid-2 were detected.Serum analysis in genetic metabolic diseases revealed 24 out of 43 tested items were abnormal,revealing the elevation of several acylcarnitines and the reduction of carnitine in the patient.By next generation sequencing technology for gene sequencing related to fatty acid oxidation and carnitine cycle defects,a rare ETFDH gene variant was identified:NM_004453:4:C.1448C>T(p.Pro483 Leu).The patient was diagnosed with lateonset GAII.He was not responsive to riboflavin and progressively worsened into multiple organ failure that finally led to death.CONCLUSION Type III MADD can also be fatal and not responsive to treatments.

Hypomethylation of glycine dehydrogenase promoter in peripheral blood mononuclear cells is a new diagnostic marker of hepatitis B virus-associated hepatocellular carcinoma

Background: Glycine dehydrogenase(GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnostic value for hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC). Methods: We enrolled 197 patients, 111 with HBV-HCC, 51 with chronic hepatitis B(CHB), and 35 healthy controls(HCs). The methylation status of GLDC promoter in peripheral mononuclear cells(PBMCs) was identified by methylation specific polymerase chain reaction(MSP). The mRNA expression was examined using real-time quantitative polymerase chain reaction(q PCR). Results: The methylation frequency of the GLDC promoter was significantly lower in HBV-HCC patients(27.0%) compared to that in CHB patients(68.6%) and HCs(74.3%)( P < 0.001). The methylated group had lower alanine aminotransferase level( P = 0.035) and lower rates of tumor node metastasis(TNM) Ⅲ/Ⅳ( P = 0.043) and T3/T4( P = 0.026). TNM stage was identified to be an independent factor for GLDC promoter methylation. GLDC mRNA levels in CHB patients and HCs were significantly lower than those in HBV-HCC patients( P = 0.022 and P < 0.001, respectively). GLDC mRNA levels were significantly higher in HBV-HCC patients with unmethylated GLDC promoters than those with methylated GLDC promoters( P = 0.003). The diagnostic accuracy of alpha-fetoprotein(AFP) combined with GLDC promoter methylation for HBV-HCC was improved compared with that of AFP alone(AUC: 0.782 vs. 0.630, P < 0.001). In addition, GLDC promoter methylation was an independent predictor for overall survival of HBV-HCC patients( P = 0.038). Conclusions: The methylation frequency of GLDC promoter was lower in PBMCs from HBV-HCC patients than that from patients with CHB and HCs. The combination of AFP and GLDC promoter hypomethylation significantly improved the diagnostic accuracy of HBV-HCC.

Analysis of the potential biological value of pyruvate dehydrogenase E1 subunitβin human cancer

BACKGROUND The pyruvate dehydrogenase E1 subunitβ(PDHB)gene which regulates energy metabolism is located in mitochondria.However,few studies have elucidated the role and mechanism of PDHB in different cancers.AIM To comprehensive pan-cancer analysis of PDHB was performed based on bioinformatics approaches to explore its tumor diagnostic and prognostic value and tumor immune relevance in cancer.In vitro experiments were performed to examine the biological regulation of PDHB in liver cancer.METHODS Pan-cancer data related to PDHB were obtained from the Cancer Genome Atlas(TCGA)database.Analysis of the gene expression profiles of PDHB was based on TCGA and Genotype Tissue Expression Dataset databases.Cox regression analysis and Kaplan-Meier methods were used to assess the correlation between PDHB expression and survival prognosis in cancer patients.The correlation between PDHB and receiver operating characteristic diagnostic curve,clinicopathological staging,somatic mutation,tumor mutation burden(TMB),microsatellite instability(MSI),DNA methylation,and drug susceptibility in pan-cancer was also analyzed.Various algorithms were used to analyze the correlation between PDHB and immune cell infiltration and tumor chemotaxis environment,as well as the co-expression analysis of PDHB and immune checkpoint(ICP)genes.The expression and functional phenotype of PDHB in single tumor cells were studied by single-cell sequencing,and the functional enrichment analysis of PDHB-related genes was performed.The study also validated the level of mRNA or protein expression of PDHB in several cancers.Finally,in vitro experiments verified the regulatory effect of PDHB on the proliferation,migration,and invasion of liver cancer.RESULTS PDHB was significantly and differently expressed in most cancers.PDHB was significantly associated with prognosis in patients with a wide range of cancers,including kidney renal clear cell carcinoma,kidney renal papillary cell carcinoma,breast invasive carcinoma,and brain lower grade glioma.In some cancers,PDHB expression was clearly associated with gene mutations,clinicopathological stages,and expression of TMB,MSI,and ICP genes.The expression of PDHB was closely related to the infiltration of multiple immune cells in the immune microenvironment and the regulation of tumor chemotaxis environment.In addition,single-cell sequencing results showed that PDHB correlated with different biological phenotypes of multiple cancer single cells.This study further demonstrated that down-regulation of PDHB expression inhibited the proliferation,migration,and invasion functions of hepatoma cells.CONCLUSION As a member of pan-cancer,PDHB may be a novel cancer marker with potential value in diagnosing cancer,predicting prognosis,and in targeted therapy.

Direct detection of a single[4Fe-4S]cluster in a tungsten-containing enzyme:Electrochemical conversion of CO_(2) into formate by formate dehydrogenase

The conversion of CO_(2) into fuels and valuable chemicals is one of the central topics to combat climate change and meet the growing demand for renewable energy.Herein,we show that the formate dehydrogenase from Clostridium ljungdahlii(ClFDH)adsorbed on electrodes displays clear characteristic voltammetric signals that can be assigned to the reduction and oxidation potential of the[4Fe-4S]^(2+/+)cluster under nonturnover conditions.Upon adding substrates,the signals transform into a specific redox center that engages in catalytic electron transport.ClFDH catalyzes rapid and efficient reversible interconversion between CO_(2) and formate in the presence of substrates.The turnover frequency of electrochemical CO_(2) reduction is determined as 1210 s^(-1) at 25℃ and pH 7.0,which can be further enhanced up to 1786 s^(-1) at 50℃.The Faradaic efficiency at−0.6 V(vs.standard hydrogen electrode)is recorded as 99.3%in a 2-h reaction.Inhibition experiments and theoretical modeling disclose interesting pathways for CO_(2) entry,formate exit,and OCN−competition,suggesting an oxidation-state-dependent binding mechanism of catalysis.Our results provide a different perspective for understanding the catalytic mechanism of FDH and original insights into the design of synthetic catalysts.

Combinatorial co-expression of xanthine dehydrogenase and chaperone XdhC from Acinetobacter baumannii and Rhodobacter capsulatus and their applications in decreasing purine content in food

This study investigated the combinatorial expression of xanthine dehydrogenase(XDH)and chaperone XdhC from Acinetobacter baumannii and Rhodobacter capsulatus and their applications in decreasing purine content in the beer,beef and yeast.Naturally occurring xdhABC gene clusters of A.baumannii CICC 10254 and R.capsulatus CGMCC 1.3366 as well as two refactored clusters constructed by exchanging their xdhC genes were overexpressed in Escherichia coli and purified to near homogeneity.RcXDH chaperoned by AbXdhC showed nearly the same catalytic performance as that by RcXdhC,except for the decreased substrate affinity.While the AbXDH co-expressed with RcXdhC displayed enhanced acidic adaptation but weakened catalytic activity.All the XDHs degraded purines in beer,beef and yeast extract effectively,indicating potential applications in low-purine foods to prevent hyperuricemia and gout.The study also presents a method for exploiting the better chaperone XdhC and novel XDHs by functional complement activity using existing XdhCs such as RcXdhC.

F-box only protein 2 exacerbates non-alcoholic fatty liver disease by targeting the hydroxyl CoA dehydrogenase alpha subunit

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a major health burden with an increasing global incidence.Unfortunately,the unavailability of knowledge underlying NAFLD pathogenesis inhibits effective preventive and therapeutic measures.AIM To explore the molecular mechanism of NAFLD.METHODS Whole genome sequencing(WGS)analysis was performed on liver tissues from patients with NAFLD(n=6)and patients with normal metabolic conditions(n=6)to identify the target genes.A NAFLD C57BL6/J mouse model induced by 16 wk of high-fat diet feeding and a hepatocyte-specific F-box only protein 2(FBXO2)overexpression mouse model were used for in vivo studies.Plasmid transfection,co-immunoprecipitation-based mass spectrometry assays,and ubiquitination in HepG2 cells and HEK293T cells were used for in vitro studies.RESULTS A total of 30982 genes were detected in WGS analysis,with 649 up-regulated and 178 down-regulated.Expression of FBXO2,an E3 ligase,was upregulated in the liver tissues of patients with NAFLD.Hepatocyte-specific FBXO2 overexpression facilitated NAFLD-associated phenotypes in mice.Overexpression of FBXO2 aggravated odium oleate(OA)-induced lipid accumulation in HepG2 cells,resulting in an abnormal expression of genes related to lipid metabolism,such as fatty acid synthase,peroxisome proliferator-activated receptor alpha,and so on.In contrast,knocking down FBXO2 in HepG2 cells significantly alleviated the OA-induced lipid accumulation and aberrant expression of lipid metabolism genes.The hydroxyl CoA dehydrogenase alpha subunit(HADHA),a protein involved in oxidative stress,was a target of FBXO2-mediated ubiquitination.FBXO2 directly bound to HADHA and facilitated its proteasomal degradation in HepG2 and HEK293T cells.Supplementation with HADHA alleviated lipid accumulation caused by FBXO2 overexpression in HepG2 cells.CONCLUSION FBXO2 exacerbates lipid accumulation by targeting HADHA and is a potential therapeutic target for NAFLD。

Carbon Chain Length Determines Inhibitory Potency of Perfluoroalkyl Sulfonic Acids on Human Placental 3β-Hydroxysteroid Dehydrogenase 1:Screening,Structure-Activity Relationship,and In Silico Analysis

Objective This study aimed to compare 9 perfluoroalkyl sulfonic acids(PFSA)with carbon chain lengths(C4–C12)to inhibit human placental 3β-hydroxysteroid dehydrogenase 1(3β-HSD1),aromatase,and rat 3β-HSD4 activities.Methods Human and rat placental 3β-HSDs activities were determined by converting pregnenolone to progesterone and progesterone secretion in JEG-3 cells was determined using HPLC/MS–MS,and human aromatase activity was determined by radioimmunoassay.Results PFSA inhibited human 3β-HSD1 structure-dependently in the order:perfluorooctanesulfonic acid(PFOS,half-maximum inhibitory concentration,IC50:9.03±4.83μmol/L)>perfluorodecanesulfonic acid(PFDS,42.52±8.99μmol/L)>perfluoroheptanesulfonic acid(PFHpS,112.6±29.39μmol/L)>perfluorobutanesulfonic acid(PFBS)=perfluoropentanesulfonic acid(PFPS)=perfluorohexanesulfonic acid(PFHxS)=perfluorododecanesulfonic acid(PFDoS)(ineffective at 100μmol/L).6:2FTS(1H,1H,2H,2H-perfluorooctanesulfonic acid)and 8:2FTS(1H,1H,2H,2H-perfluorodecanesulfonic acid)did not inhibit human 3β-HSD1.PFOS and PFHpS are mixed inhibitors,whereas PFDS is a competitive inhibitor.Moreover,1–10μmol/L PFOS and PFDS significantly reduced progesterone biosynthesis in JEG-3 cells.Docking analysis revealed that PFSA binds to the steroid-binding site of human 3β-HSD1 in a carbon chain length-dependent manner.All 100μmol/L PFSA solutions did not affect rat 3β-HSD4 and human placental aromatase activity.Conclusion Carbon chain length determines inhibitory potency of PFSA on human placental 3β-HSD1 in a V-shaped transition at PFOS(C8),with inhibitory potency of PFOS>PFDS>PFHpS>PFBS=PFPS=PFHxS=PFDoS=6:2FTS=8:2FTS.

Choline dehydrogenase interacts with SQSTM1 to activate mitophagy and promote coelomocyte survival in Apostichopus japonicus following Vibrio splendidus infection

Previous studies have shown that Vibrio splendidus infection causes mitochondrial damage in Apostichopus japonicus coelomocytes,leading to the production of excessive reactive oxygen species(ROS)and irreversible apoptotic cell death.Emerging evidence suggests that mitochondrial autophagy(mitophagy)is the most effective method for eliminating damaged mitochondria and ROS,with choline dehydrogenase(CHDH)identified as a novel mitophagy receptor that can recognize non-ubiquitin damage signals and microtubule-associated protein 1 light chain 3(LC3)in vertebrates.However,the functional role of CHDH in invertebrates is largely unknown.In this study,we observed a significant increase in the mRNA and protein expression levels of A.japonicus CHDH(AjCHDH)in response to V.splendidus infection and lipopolysaccharide(LPS)challenge,consistent with changes in mitophagy under the same conditions.Notably,AjCHDH was localized to the mitochondria rather than the cytosol following V.splendidus infection.Moreover,AjCHDH knockdown using si RNA transfection significantly reduced mitophagy levels,as observed through transmission electron microscopy and confocal microscopy.Further investigation into the molecular mechanisms underlying CHDH-regulated mitophagy showed that AjCHDH lacked an LC3-interacting region(LIR)for direct binding to LC3 but possessed a FB1 structural domain that binds to SQSTM1.The interaction between AjCHDH and SQSTM1 was further confirmed by immunoprecipitation analysis.Furthermore,laser confocal microscopy indicated that SQSTM1 and LC3 were recruited by AjCHDH in coelomocytes and HEK293T cells.In contrast,AjCHDH interference hindered SQSTM1 and LC3 recruitment to the mitochondria,a critical step in damaged mitochondrial degradation.Thus,AjCHDH interference led to a significant increase in both mitochondrial and intracellular ROS,followed by increased apoptosis and decreased coelomocyte survival.Collectively,these findings indicate that AjCHDH-mediated mitophagy plays a crucial role in coelomocyte survival in A.japonicus following V.splendidus infection.

乳酸脱氢酶/白蛋白对多发性骨髓瘤患者硼替佐米化疗耐药的影响

目的 探讨乳酸脱氢酶(LDH)/白蛋白(ALB)对多发性骨髓瘤(MM)患者硼替佐米化疗耐药的影响。方法 回顾性分析商丘市第一人民医院2021年5月至2023年5月收治的124例MM患者的临床资料。所有患者均已接受4个周期的硼替佐米联合地塞米松化疗。依据MM疗效评价标准评定化疗耐药情况,将发生耐药患者资料纳入发生组(16例),未发生耐药患者资料纳入未发生组(108例)。比较两组性别、Durie-Salmon分期、MM病程等一般资料;比较化疗前测得的LDH、ALB及其他实验室指标,并计算LDH/ALB值。通过受试者工作特征(ROC)曲线和点二列相关性分析探讨LDH/ALB对MM患者硼替佐米化疗耐药的影响。结果 发生组Ⅲ期占比、LDH、LDH/ALB高于未发生组,ALB低于未发生组,差异有统计学意义(P<0.05)。经点二列相关性分析显示,LDH/ALB、LDH、ALB与MM患者硼替佐米化疗耐药发生有关(P<0.05)。绘制ROC曲线,结果显示,LDH、ALB、LDH/ALB预测MM患者硼替佐米化疗耐药发生的曲线下面积值分别为0.791、0.780、0.849,LDH/ALB预测价值最高。结论 LDH/ALB可对MM患者硼替佐米化疗耐药产生影响,其值越高,化疗耐药发生率越高。

肇庆市68308名新生儿葡萄糖-6-磷酸脱氢酶缺乏症筛查结果综合分析

目的:分析肇庆市68308名新生儿的葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症筛查结果。方法:选取2021年1月—2022年12月在肇庆市出生的68308名新生儿为研究对象,采集全部新生儿的足跟血,以荧光分析法对G6PD缺乏症进行初筛,对可疑阳性者召回,采集静脉血以连续监测法进行确诊。结果:2021年共筛查35610名,初筛阳性3580名,占比10.05%(3580/35610);2022年共筛查32698名,初筛阳性2983名,占比9.12%(2983/32698);6563例初筛阳性者,进行确诊检查,其中2021年确诊2585例,2022年确诊2153例,共确诊4738例G6PD缺乏症,确诊率为6.94%(4738/68308)。6563例初筛阳性者中,男5186例,女1377例;男婴初筛阳性中,共确诊3829例,确诊率为5.61%(3829/68308),女婴初筛阳性者中,共确诊909例,确诊率为1.33%(909/68308),男婴初筛阳性确诊率高于女婴初筛阳性确诊率,差异有统计学意义(χ^(2)=33.148,P<0.05);4738例G6PD缺乏症中,重度缺乏1130例,占比23.85%(1130/4738),中度缺乏1067例,占比22.52%(1067/4738),轻度缺乏2541例,占比53.63%(2541/4738)。结论:肇庆市68308名新生儿中,G6PD缺乏症以男婴为主,病情多为轻度缺乏。

不同诱导物对白地霉中高级醇脱氢酶的影响

化学或物理因子作为诱导物,能够直接或间接影响菌体基因转录表达。为探索高级醇底物对白地霉的诱导效果,以分离自土壤的白地霉S12为对象,采用五种高级醇(正丙醇、正丁醇、异丁醇、正己醇和异戊醇)作为诱导物,研究不同高级醇的诱导剂量、诱导时间对菌体S12降解不同高级醇活性及脱氢酶活力的影响。结果表明,当正己醇和异丁醇分别作为诱导剂时,胞内酶活力较高。正丙醇、正丁醇、异丁醇和正己醇作为诱导剂时,最适诱导时间均为6 h;而以异戊醇为诱导剂时,最佳诱导时间为12 h。以正丙醇和正己醇为诱导剂时,最适的诱导浓度为1.5 g/L;以正丁醇、异丁醇和异戊醇为诱导剂时,最适诱导浓度分别为1.0、0.5和2.5 g/L。NativePAGE电泳结果表明,以五种高级醇为诱导剂均能使菌体合成分子量为223 kDa左右的脱氢酶。其中,以正己醇为诱导剂时所得菌体同时降解多种高级醇的能力最强,其降解产物均为其相应的酸类和酯类物质。

碱性磷酸酶、乳酸脱氢酶及Gleason分级用于评估低风险转移性激素敏感型前列腺癌预后的价值

目的探究碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)及Gleason分级用于评估低风险转移性激素敏感型前列腺癌(mHSPC)预后的价值,为低风险mHSPC患者的诊疗提供科学参考。方法回顾性分析2015年至2021年丽水市人民医院低风险mHSPC患者,以出现去势抵抗性前列腺癌(CRPC)作为不良预后的主要结局指标,将48例出现CRPC的患者纳入观察组,未出现CRPC的48例患者纳入对照组。比较两组患者ALP、LDH和Gleason分级状况,采用受试者工作特征(ROC)曲线分析ALP、LDH、Gleason分级对mHSPC出现不良预后的预测作用。结果观察组患者ALP和LDH水平明显高于对照组,观察组Gleason分级4~5级患者占比明显高于对照组(P<0.05)。高ALP(≥300 U/L)、高LDH(≥200 U/L)、高Gleason分级(4~5级)三者联合曲线下面积为0.879,灵敏度为92.1%,特异度为87.6%。结论高ALP、高LDH、高Gleason分级是低风险mHSPC患者发生不良预后的相关因素,联合使用可为低风险mHSPC患者的临床诊治方案提供重要参考。

磷化氢的毒理及害虫对磷化氢的抗性机制研究进展

近60年来,熏蒸剂磷化氢被广泛用于储藏物害虫的防治。但是,长期、不合理地使用磷化氢,导致储藏物害虫抗药性的广泛产生。了解磷化氢的毒理机制可以为磷化氢抗性机制研究提供思路。早期的研究发现,磷化氢通过干扰神经传导、抑制能量代谢和破坏氧化还原系统,引起害虫死亡;但近年的研究表明,磷化氢致死害虫的主要机制是抑制能量生成和通过干扰氧化还原系统来增加氧化损伤。早期的研究发现,害虫对磷化氢的抗性机制主要包括主动排斥磷化氢、保护性昏迷和增强解毒酶活性。近年来,随着基因组学、蛋白组学和代谢组学的应用,相继出现一些新的磷化氢抗性机制,如穿透抗性、磷化氢作用靶标敏感性降低、能量代谢模式调整。越来越多的研究表明,靶标二氢硫辛酰胺脱氢酶突变以及抗氧化酶和解毒酶活性增强是主要的抗性机制,而能量代谢模式调整可能是抗性形成初期抵抗磷化氢不良影响的重要机制。采用基因渐渗的方法研究害虫磷化氢抗性突变的适合度代价可以更精准地预测抗性突变的进化方向。研究害虫的磷化氢抗性机制和抗性突变的进化潜力不仅有助于理解害虫抗药性的形成和生物的进化,同时对害虫的磷化氢抗性监测和治理有重要的意义。

血清HCY、CRP及 LDH在鼻咽癌患者中的水平及意义

目的探讨血清同型半胱氨酸(HCY)、C反应蛋白(CRP)和乳酸脱氢酶(LDH)在鼻咽癌患者中的水平及意义。方法选择2021年12月至2022年7月梧州市红十字会医院收治的222例初诊鼻咽癌患者为鼻咽癌组,102例鼻咽炎患者为鼻咽炎组,100例体检健康者为对照组。比较各组受试者血清HCY、CRP及LDH水平。采用Spearman相关分析患者血清HCY、CRP及LDH水平与TNM分期的相关性。结果鼻咽癌组血清HCY水平明显高于鼻咽炎组、对照组(P<0.001)。鼻咽炎组、鼻咽癌组患者血清CRP水平高于对照组(P<0.001),而鼻咽炎组与鼻咽癌组间CRP水平比较,差异无统计学意义(P>0.05)。各组间血清LDH水平比较,差异均无统计学意义(P>0.05)。不同TNM分期鼻咽癌患者血清HCY、CRP及LDH水平比较,差异有统计学意义(P<0.05);Ⅲ期患者血清HCY水平明显高于Ⅰ~Ⅱ期(P<0.05),CRP水平明显低于ⅣB期(P<0.05);ⅣA、ⅣB期患者血清HCY、CRP及LDH水平明显高于Ⅰ~Ⅱ期(P<0.05)。Spearman相关分析显示,鼻咽癌患者血清CRP、LDH水平与TNM分期呈正相关(r=0.231、0.212,P<0.01),但HCY水平与TNM分期无相关性(P>0.05)。结论鼻咽癌患者伴有血清HCY、CRP水平的升高,TNM分期Ⅳ期患者HCY、CRP及LDH水平明显升高。

血清乳酸脱氢酶、β2微球蛋白、铁蛋白联合改良WHO预后积分系统预测骨髓增生异常综合征预后不良的价值

目的探讨血清乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)、铁蛋白(SF)联合改良WHO预后积分系统(WPSS)评分对骨髓增生异常综合征(MDS)预后不良的预测价值。方法选取110例MDS患者作为研究对象,均检测血清LDH、β2-MG、SF水平。根据生存情况将患者分为病死组与存活组,比较2组血清LDH、β2-MG、SF水平和改良WPSS评分。分析MDS预后不良的危险因素及血清LDH、β2-MG、SF水平和改良WPSS评分单独及联合对MDS预后不良的预测价值。结果MDS预后不良发生率为40.20%(41/102)。病死组血清LDH、β2-MG、SF、改良WPSS评分和染色体核型预后不良比率均高于存活组,差异有统计学意义(P<0.05)。Cox回归模型分析结果显示,血清LDH、β2-MG、SF水平和改良WPSS评分升高、染色体核型预后不良是MDS预后不良的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清LDH、β2-MG、SF水平联合改良WPSS评分预测MDS预后不良的灵敏度和曲线下面积(AUC)分别为95.12%、0.918,均显著高于各指标单独预测(P<0.05)。结论血清LDH、β2-MG、SF水平和改良WPSS评分对MDS预后不良均具有一定的预测价值,但4项指标联合预测价值更高。

存在肺外表现的成人肺炎支原体肺炎临床特征及误诊分析

目的分析存在肺外表现的成人肺炎支原体肺炎(AMP)患者的临床特征及误诊情况。方法回顾性分析2022年1月至2023年6月经肺炎支原体DNA检测阳性的AMP 60例临床资料,根据是否存在肺外表现分为无肺外表现组(n=29)和存在肺外表现组(n=31)。比较2组凝血功能、生化指标、院外病程、住院时间、误诊占比、误诊时间。结果60例AMP中存在肺外表现31例(51.67%),常见肺外表现有乏力18例(30.00%),关节肌肉痛16例(26.67%),头痛、纳差、腹泻各7例(11.67%),嗜睡4例(6.67%),皮疹3例(5.00%),恶心2例(3.33%),腰痛、黑便各1例(1.67%)。存在肺外表现组C反应蛋白、天冬氨酸转氨酶、乳酸脱氢酶、α-羟丁酸脱氢酶、纤维蛋白原水平均高于无肺外表现组(P<0.05)。存在肺外表现组住院时间以及误诊时间均长于无肺外表现组(P<0.05)。2组院外病程比较差异无统计学意义(P>0.05)。存在肺外表现组误诊占比高于无肺外表现组(P<0.05)。结论AMP存在较高的肺外表现发生率。存在肺外表现的AMP炎症反应程度更高,住院时间更长,误诊占比更高,临床应注意对这部分人群生化指标、凝血功能的监测,及时发现病情变化,避免误诊漏诊发生,延误治疗。

NDUFS6蛋白生物信息学分析及过表达质粒的构建与鉴定

目的 应用生物信息学方法分析线粒体呼吸链复合体Ⅰ结构亚基烟酰胺腺嘌呤二核苷酸脱氢酶(泛素)铁硫蛋白6(NDUFS6)的理化性质,构建pCV702-NDUFS6过表达质粒并进行鉴定,为进一步研究NDUFS6蛋白功能奠定基础。方法 利用Expasy、UniProtKB、NCBI、SOPMA等生物信息学工具分析NDUFS6蛋白的理化性质、二级结构等;根据NDUFS6 cDNA序列构建携带NDUFS6基因的过表达质粒pCV702-NDUFS6,转染大鼠心肌细胞H9C2,并设置阴性对照(NC)组和相应空载体CON520作为阳性对照(PC)组,经嘌呤霉素筛选后,采用RT-qPCR和Western blot检测NDUFS6 mRNA和蛋白表达水平。结果 NDUFS6蛋白由116个氨基酸组成,理论等电点pI为9.37。蛋白二级结构以无规则卷曲(占50%)为主。酶切鉴定和基因测序结果显示,pCV702-NDUFS6表达质粒构建成功。RT-qPCR和Western blot结果显示,相较于NC组和PC组,过表达组NDUFS6表达水平均上调(P均<0.05)。结论 成功构建了能在心肌细胞H9C2中有效过表达NDUFS6基因的过表达质粒。

H型高血压合并冠心病患者24h动态血压变异系数及乳酸脱氢酶水平与冠状动脉粥样硬化病变程度的相关性

目的 探究H型高血压合并冠心病患者24 h动态血压变异系数及乳酸脱氢酶(LDH)水平与冠状动脉粥样硬化病变程度的相关性。方法 对40例H型高血压合并冠心病患者进行冠状动脉造影检查,以Gensini积分表示冠状动脉粥样硬化病变严重程度,以酶联免疫吸附法检测患者LDH水平,监测患者24 h动态血压,计算24 h动态血压变异系数。比较不同冠状动脉病变程度患者24 h动态血压变异系数及LDH水平。24 h动态血压变异系数及LDH水平与动脉粥样硬化病变程度的相关性采用Pearson相关分析,对重度冠状动脉粥样硬化的影响因素行多因素Logistic回归分析。结果 入组冠状动脉粥样硬化轻度病变患者12例,中度和重度病变患者各14例。重度及中度病变患者血清同型半胱氨酸(Hcy)、LDH水平及24 h血压变异系数均高于轻度病变患者(P<0.01),重度病变患者血清Hcy、LDH水平及24 h血压变异系数均高于中度病变患者(P<0.01)。Pearson相关分析显示,血压变异系数、LDH水平与Gensini积分均呈正相关(P<0.05或0.01)。多因素Logistic回归分析显示,24h血压变异系数(OR=1.326,95%CI为1.040~1.691,P<0.05)及LDH水平(OR=1.311,95%CI为1.048~1.639,P<0.05)为重度冠状动脉粥样硬化发生的危险因素。结论 H型高血压合并冠心病患者24 h动态血压变异系数及LDH水平较高,且可能与冠状动脉粥样硬化病变程度加重有关。

极长链酰基辅酶A脱氢酶缺乏症1例基因突变分析

目的对1例极长链酰基辅酶A脱氢酶缺乏症(VLCADD)病儿进行可疑致病基因突变分析,并探讨基因突变与该疾病表型的关系。方法选择1例VLCADD病儿为实验组,200例健康者为对照组,采用串联质谱法检测VLCADD的酰基肉碱谱,全部外显子测序技术(WES)进行突变筛查,与gnomAD和1000Genomes数据库中的人类基因组序列进行比对,寻找可疑基因突变位点,并在病儿及其父母中进行Sanger测序验证。结果病儿串联质谱结果显示,VLCADD相关特征性指标十四烯酰基肉碱(C14∶1)升高,尤其是升高值>1.0μmol/L可明确诊断。WES发现病儿ACADVL基因存在复合杂合突变,第8外显子c.664G>A和第13外显子c.1276G>A。Sanger测序验证c.664G>A来源于母亲,c.1276G>A来源于父亲。200例正常对照者中未发现该突变。结论ACADVL基因c.664G>A和c.1276G>A复合杂合突变可能是VLCADD的致病突变,串联质谱检测结合高通量基因测序可为VLCADD的临床早期筛查和诊断提供重要依据。

异柠檬酸脱氢酶基因突变在软骨肉瘤中的研究进展及展望

人类代谢基因中异柠檬酸脱氢酶(IDH)是较易发生突变的基因。在烟酰胺腺嘌呤二核苷酸磷酸(NADPH)的作用下,突变的IDH可与α-酮戊二酸(α-KG)结合并将其还原为2-羟基戊二酸(2-HG),参与肿瘤发生的多种生物过程。IDH在脑胶质瘤及急性髓系白血病中研究较多,在软骨肉瘤中的研究甚少。软骨肉瘤中存在IDH基因高频突变,易出现复发和转移,复发或转移后治疗方案有限,患者预后较差,临床迫切需要寻找新的治疗方案。本文就IDH基因突变在软骨肉瘤发生、预后、鉴别诊断及治疗中的作用予以综述,通过进一步阐述IDH基因突变在软骨肉瘤发生、发展中的生物学作用,并对强效的IDH抑制剂及抗癌药物研发进行展望,为临床治疗方案的制订及预后判断提供参考依据。