Acute hemolytic anemia in a 34-year-old man after inhalation of a volatile nitrite “popper” product

Inhaled nitrites have been used recreationally for centuries,particularly among men who have sex with men (MSM).^([1])After inhalation,this substance quickly enters the blood;within seconds,it can produce a temporary sense of warmth and pleasure,and relax the anal sphincter to relieve the pain of anal sex.^([2,3])“Popper”and“rush”are slang terms given to drugs of the chemical class called amyl nitrite or isobutyl nitrite.Nitrites oxidize hemoglobin to methemoglobins and may increase proteolytic susceptibility of hemoglobin,leading to oxidative hemolysis.Thus,their use is associated with methemoglobinemia and hemolytic anemia,^([4])although nitrite-induced hemolytic anemia has been described only in rare cases (supplementary Table 1).^([4-9])Herein,we report a case of acute hemolytic anemia associated with the use of amyl nitrite.

Lower synaptic density associated with gaming disorder:an^(18)F-SynVesT-1 PET imaging study

Background Internet gaming disorder(IGD)is an ideal model to study the mechanisms underlying synaptic deficits in addiction as it eliminates the confounding effects of substance use.Synaptic loss and deficits are hypothesised to underlie the enduring maladaptive behaviours and impaired cognitive function that contribute to IGD.Aims This study aimed to determine whether subjects with IGD have lower synaptic density than control subjects and the relationship between synaptic density and IGD severity.Methods Eighteen unmedicated subjects diagnosed with current IGD according to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria and 16 demographically matched healthy controls(HCs)participated in the study and underwent 18F-labelled difluoro-analogue of UCB-J(18F-SynVesT-1)positron emission tomography scans to assess the density of synaptic vesicle glycoprotein 2A(SV2A).The Internet Gaming Disorder Scale-Short Form(IGDS9-SF),Hamilton Rating Scale for Depression(HAMD),Hamilton Anxiety Rating Scale(HAMA),Barratt Impulsiveness Scale Version 11(BIS-11),Stroop Colour-Word Test(SCWT),stop-signal paradigms and N-back tasks were administered to all subjects.Results Patients with IGD had significantly higher scores on the IGDS9-SF,HAMD,HAMA and BIS-11 than HCs.HCs performed better on the two-back and SCWT tests as well as in terms of stop-signal reaction times(SSRTs)in the stop-signal paradigms than patients with IGD.Lower uptake was found in the bilateral putamen,right pregenual anterior cingulate cortex and Rolandic operculum of patients with IGD compared with HCs.Furthermore,in the IGD group,IGDS9-SF scores and daily gaming hours were negatively correlated with the standardised uptake value ratios of 18F-SynVesT-1 in the bilateral putamen.Longer SSRTs were significantly associated with lower SV2A density in the right pregenual anterior cingulate cortex and right Rolandic operculum.Conclusions The in vivo results in this study suggest that lower synaptic density contributes to the severity and impairments in inhibitory control of IGD.These findings may provide further incentive to evaluate interventions that restore synaptic transmission and plasticity to treat IGD.

Human umbilical cord mesenchymal stem cells for psoriasis:a phase 1/2a,single-arm study

Psoriasis is a common,chronic immune-mediated systemic disease that had no effective and durable treatment.Mesenchymal stem cells(MSCs)have immunomodulatory properties.Therefore,we performed a phase 1/2a,single-arm clinical trial to evaluate the safety and efficacy of human umbilical cord-derived MSCs(UMSCs)in the treatment of psoriasis and to preliminarily explore the possible mechanisms.Seventeen patients with psoriasis were enrolled and received UMsC infusions.Adverse events,laboratory parameters,PASl,and PGA were analyzed.We did not observe obvious side effects during the treatment and 6-month follow-up.A total of 47.1%(8/17)of the psoriasis patients had at least 40%improvement in the PASl score,and 17.6%(3/17)had no sign of disease or minimal disease based on the PGA score.And the efficiency was 25%(2/8)for males and 66.7%(6/9)for females.After UMSC transplantation(UMSCT),the frequencies of Tregs and CD4^(+)memory T cells were significantly increased,and the frequencies of T helper(Th)17 and CD4^(+)naive T cells were significantly decreased in peripheral blood(PB)of psoriasis patients.And all responders showed significant increases in Tregs and CD4^(+)memory T cells,and significant decreases in Th17 cells and serum IL-17 level after UMsCT.And baseline level of Tregs in responders were significantly lower than those in nonresponders.In conclusion,allogeneic UMSCT is safe and partially effective in psoriasis patients,and level of Tregs may be used as a potent biomarker to predict the clinical efficacy of UMSCT.Trial registration Clinical Trials NCT03765957.

lncRNA cytoskeleton regulator RNA(CYTOR):Diverse functions in metabolism,inflammation and tumorigenesis,and potential applications in precision oncology

Long non-coding RNAs(lncRNAs)are a novel class of non-coding RNA(ncRNA),that have been studied extensively in the field of tumor research in recent years.In the case of tumor-associated lncRNAs,lncRNA cytoskeleton regulator RNA(CYTOR)displays extensive functions in tumorigenesis,including invasion,metastasis,malignant proliferation,glycolysis,and inflammatory response.Moreover,the dysregulation of CYTOR is closely related to clinicopathological characteristics,such as tumor stage,lymph node metastasis and infiltration,and poor prognosis of tumor patients.In this review,we provide a novel strategy to summarize the biological functions and clinical value of CYTOR in tumors through an overview of the literature combined with gene set enrichment analysis.A deeper understanding of the role of CYTOR in tumorigenesis may provide new diagnostic,prognostic and therapeutic markers for human tumors.

Female Gender Was Associated With Increased Odds of Sleep Disturbance in Adult Chinese With Moderate-to-Severe Psoriasis:A Cross-Sectional Study

Objective:Up to 85.3%of patients with psoriasis experience sleep disturbance(SD).However,SD has not been characterized in Chinese patients with psoriasis,and the factors that affect SD among adult patients with psoriasis remain unclear.This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis.Methods:This was a cross-sectional,questionnaire-based,case-control study involving 142 adult participants with psoriasis and 142 healthy controls.The Pittsburgh Sleep Quality Index(PSQI)was administered to assess SD.Mild psoriasis was defined by Psoriasis Area and Severity Index and body surface area cut-offs of<10,and mild to severe psoriasis was determined by Psoriasis Area and Severity Index and body surface area cut-offs of≥10.Logistic regression was performed to investigate the associations.Results:The prevalence of SD(PSQI score of≥6)was 47.9%in adult patients with psoriasis.The mean PSQI score in patients with psoriasis was 6.1±3.7,which was higher than that in the control group(4.9±2.5,P<0.001).The risk of SD in the psoriasis group was 1.669 times higher(95%confidence interval,1.008-2.761;P=0.046)than that in the healthy group.Female sex(adjusted odds ratio,4.130;95%confidence interval,1.306-13.058;P=0.016)was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis,whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis.Conclusion:Patients with psoriasis were more likely than healthy controls to develop SD.In patients with moderate to severe psoriasis,but not in those with mild psoriasis,female sex was associated with a higher likelihood of SD.

Suicide Prevention:More Actions Are Needed

Suicide has long been a significant global public health issue.Annually,approximately 800,000 individuals succumb to suicide worldwide,resulting in more fatalities than those caused by malaria,breast cancer,or war and homicide(1).A striking 79%of these suicide-related deaths transpire in low-and middle-income countries(LMICs)(1).Remarkably,suicide ranks as the second leading cause of death among young individuals aged 15–29 years for both males and females,with 90%of adolescents who died by suicide originating from LMICs(1).