Association between circulating levels of unsaturated fatty acids and risk for prediabetes in the NHANES 2003-2004 and 2011-2012.

AIMS: This study aimed to investigate the association between serum levels of common and uncommon unsaturated fatty acids and prediabetes risk. METHODS: Data were collected from the National Health and Nutrition Examination Survey for 2003-2004 and 2011-2012. Weighted proportional and multivariate logistic regression analyses were performed to assess the association of serum PUFAs and MUFAs with prediabetes risk after adjusting for potential confounders. RESULTS: A total of 3575 individuals were enrolled in this study. Serum levels of PUFAs EPA (20:5 n3) and GLA (18:3 n6) were associated with increased prediabetes risk (EPA (20:5 n3): OR = 1.878, 95% CI: 1.177-2.996, Ptrend = 0.002; GLA (18:3 n6): 1.702, 95% CI: 1.140-2.541, Ptrend = 0.016). The MUFAs PA (16:1 n7) and EA (20:1 n9) increased the risk of prediabetes (OR in quintile5: PA (16:1 n7): 1.780, 95% CI: 1.056-3.001, Ptrend = 0.003; EA (20:1 n9): 0.587, 95% CI: 0.347-0.994, Ptrend = 0.010). Moreover, nonlinear analysis revealed that serum levels of EPA (20:5 n3) and EA (20:1 n-9) were nonlinearly associated with prediabetes risk. CONCLUSION: Some serum n-3 PUFAs are positively associated with prediabetes, several serum n-6 PUFAs are inversely associated with prediabetes. Regulating individual serum USFA levels may help prevent prediabetes, thereby providing evidence for clinical and nutritional practices.

Exploring the mechanism of Jinlida granules against type 2 diabetes mellitus by an integrative pharmacology strategy.

Jinlida granule (JLD) is a Traditional Chinese Medicine (TCM) formula used for the treatment of type 2 diabetes mellitus (T2DM). However, the mechanism of JLD treatment for T2DM is not fully revealed. In this study, we explored the mechanism of JLD against T2DM by an integrative pharmacology strategy. Active components and corresponding targets were retrieved from Traditional Chinese Medicine System Pharmacology (TCMSP), SwissADME and Bioinformatics Analysis Tool for Molecular Mechanisms of Traditional Chinese Medicine Database (BATMAN-TCM) database. T2DM-related targets were obtained from Drugbank and Genecards databases. The protein-protein interaction (PPI) network was constructed and analyzed with STRING (Search Toll for the Retrieval of Interacting Genes/proteins) and Cytoscape to get the key targets. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genomes (KEGG) enrichment analyses were performed with the Database for Annotation, Visualization and Integrated Discovery (DAVID). Lastly, the binding capacities and reliability between potential active components and the targets were verified with molecular docking and molecular dynamics simulation. In total, 185 active components and 337 targets of JLD were obtained. 317 targets overlapped with T2DM-related targets. RAC-alpha serine/threonine-protein kinase (AKT1), tumor necrosis factor (TNF), interleukin-6 (IL-6), cellular tumor antigen p53 (TP53), prostaglandin G/H synthase 2 (PTGS2), Caspase-3 (CASP3) and signal transducer and activator of transcription 3 (STAT3) were identified as seven key targets by the topological analysis of the PPI network. GO and KEGG enrichment analyses showed that the effects were primarily associated with gene expression, signal transduction, apoptosis and inflammation. The pathways were mainly enriched in PI3K-AKT signaling pathway and AGE-RAGE signaling pathway in diabetic complications. Molecular docking and molecular dynamics simulation verified the good binding affinity between the key components and targets. The predicted results may provide a theoretical basis for drug screening of JLD and a new insight for the therapeutic effect of JLD on T2DM.

Germination-induced modifications of starch structure, flour-processing characteristics, and in vitro digestive properties in maize.

Current research on maize germination suffers from long sampling intervals, and the relationship between the starch structure and the processing properties of flour in maize is still unclear. This study observed the effect of germination on the structure and composition of maize starch and the processing properties of maize flour over a 72 h period using a short interval sampling method. At 36 h, the short-range ordered structure, crystallinity, and enthalpy of starch reached the highest values of 1.02, 34.30%, and 9.90 J/g, respectively. At 72 h, the ratios of rapidly-digested starch (RDS) and slowly-digested starch (SDS) enhanced to 29.37% and 28.97%; the RS content reduced to 35.37%; and the flow properties of the starch were improved. This study enhances the understanding of the effects of germination on the processing properties of maize starch and flour, determines the appropriate application, and recommends the use of germination in the food industry.

Woven Agarose-Cellulose Composite Aerogel Fibers with Outstanding Radial Elasticity for Personal Thermal Management.

Aerogel fibers are good thermal insulators, suitable for weaving, and show potential as the next generation of intelligent textiles that can effectively reduce heat consumption for personal thermal management. However, the production of continuous aerogel fibers from biomass with sufficient strength and radial elasticity remains a significant challenge. Herein, continuous gel fibers were produced via wet spinning using agarose (AG) as the matrix, 2,2,2,6,6-tetramethylpiperidine-1-oxyl radical-oxidized cellulose nanofibers (TOCNs) as the reinforcing agent, and no other chemical additives by utilizing the gelling properties of AG. Supercritical drying and chemical vapor deposition (CVD) were then used to produce hydrophobic AG-TOCN aerogel fibers (HATAFs). During CVD, the HATAF gel skeleton was covered with an isostructural silica coating. Consequently, the HATAFs can recover from radial compression under 60% strain. Moreover, the HATAFs have low densities (≤0.14 g cm-3), high porosities (≥91.8%), high specific surface areas (≥188 m2 g-1), moderate tensile strengths (≤1.75 MPa), excellent hydrophobicity (water contact angles of >130°), and good thermal insulating properties at different temperatures. Thus, HATAFs are expected to become a new generation of materials for efficient personal thermal management.

The elevation of red blood cell distribution width is an independent prognostic factor for juvenile myelomonocytic leukemia.

Juvenile myelomonocytic leukemia (JMML) is a disorder characterized by the simultaneous presence of myeloproliferative and myelodysplastic features, primarily affecting infants and young children. Due to the heterogeneous genetic background among patients, the current clinical and laboratory prognostic features are insufficient for accurately predicting outcomes. Thus, there is a pressing need to identify novel prognostic indicators. Red cell distribution width (RDW) is a critical parameter reflecting the variability in erythrocyte size. Recent studies have emphasized that elevated RDW serves as a valuable predictive marker for unfavorable outcomes across various diseases. However, the prognostic role of RDW in JMML remains unclear. Patients with JMML from our single-center cohort between January 2008 and December 2019 were included. Overall, 77 patients were eligible. Multivariate Cox proportional hazard models showed that patients with red cell distribution width coefficient of variation (RDW-CV) >17.35% at diagnosis were susceptible to much worse overall survival rate (hazard ratio [HR] = 5.22, confidence interval [CI] = 1.50-18.21, P = .010). Besides, the combination of RDW elevation and protein phosphatase non-receptor type 11 (PTPN11) mutation was likely to predict a subgroup with the worst outcomes in our cohort. RDW is an independent prognostic variable in JMML subjects. RDW may be regarded as an inexpensive biomarker to predict the clinical outcome in patients with JMML.

FeNi-MIL-88B-based electrochemiluminescence immunosensor for ultra-sensitive detection of CD44 protein via dual-quenching strategy.

BACKGROUND: Cluster of Differentiation 44 (CD44) is considered an important biomarker for various cancers, and achieving highly sensitive detection of CD44 is crucial, which plays a significant role in tumor invasion and metastasis, providing essential information for clinical tumor diagnosis. Commonly used methods for analysis include fluorescence spectroscopy (FL), photoelectrochemical analysis (PEC), electrochemical analysis (EC), and commercial ELISA kits. Although these methods offer high sensitivity, they can be relatively complex to perform experimentally. Electrochemiluminescence (ECL) has gained widespread research attention due to its high sensitivity, ease of operation, effective spatiotemporal control, and close to zero background signal. RESULTS: In this work, a sandwich-type ECL immunosensor for detecting CD44 was constructed using luminol as a luminophore. In this sensing platform, bimetallic MOFs (Pd@FeNi-MIL-88B) loaded with palladium nanoparticles (Pd NPs) were used as a novel enzyme mimic, exhibiting excellent catalytic performance towards the electroreduction of H2O2. The hybrids provided a strong support platform for luminol and antibodies, significantly enhancing the initial ECL signal of luminol. Subsequently, core-shell Au@MnO2 nanocomposites were synthesised by gold nanoparticles (Au NPs) encapsulated in manganese dioxide (MnO2) thin layers, as labels. In the luminol/H2O2 system, Au@MnO2 exhibited strong light absorption in the broad UV-vis spectrum, similar to the black body effect, and the scavenging effect of Mn2+ on O2•-, which achieved the dual-quenching of ECL signal. Under the optimal experimental conditions, the immunosensor demonstrated a detection range of 0.1 pg mL-1 - 100 ng mL-1, with a detection limit of 0.069 pg mL-1. SIGNIFICANCE: Based on Pd@FeNi-MIL-88B nanoenzymes and Au@MnO2 nanocomposites, a dual-quenching sandwich-type ECL immunosensor for the detection of CD44 was constructed. The proposed immunosensor exhibited excellent reproducibility, stability, selectivity, and sensitivity, and provided a valuable analytical strategy and technical platform for the accurate detection of disease biomarkers, and opened up potential application prospects for early clinical treatment.

Hydrophobic Silk Fibroin-Agarose Composite Aerogel Fibers with Elasticity for Thermal Insulation Applications.

Aerogel fibers, characterized by their ultra-low density and ultra-low thermal conductivity, are an ideal candidate for personal thermal management as they hold the potential to effectively reduce the energy consumption of room heating and significantly contribute to energy conservation. However, most aerogel fibers have weak mechanical properties or require complex manufacturing processes. In this study, simple continuous silk fibroin-agarose composite aerogel fibers (SCAFs) were prepared by mixing agarose with silk fibroin through wet spinning and rapid gelation, followed by solvent replacement and supercritical carbon dioxide treatment. Among them, the rapid gelation of the SCAFs was achieved using agarose physical methods with heat-reversible gel properties, simplifying the preparation process. Hydrophobic silk fibroin-agarose composite aerogel fibers (HSCAFs) were prepared using a simple chemical vapor deposition (CVD) method. After CVD, the HSCAFs' gel skeletons were uniformly coated with a silica layer containing methyl groups, endowing them with outstanding radial elasticity. Moreover, the HSCAFs exhibited low density (≤0.153 g/cm3), a large specific surface area (≥254.0 m2/g), high porosity (91.1-94.7%), and excellent hydrophobicity (a water contact angle of 136.8°). More importantly, they showed excellent thermal insulation performance in low-temperature (-60 °C) or high-temperature (140 °C) environments. The designed HSCAFs may provide a new approach for the preparation of high-performance aerogel fibers for personal thermal management.

Modified cellulose nanocrystals enhanced polycaprolactone multifunctional films with barrier, UV-blocking and antimicrobial properties for food packaging.

The packaging industry demands improved eco-friendly materials with new and enhanced properties. In this context, bio-nanocomposite films with antimicrobial and UV-shielding properties based on modified cellulose nanocrystals/polycaprolactone (MCNC/PCL) were fabricated via solution casting method, and then food packaging simulation was carried out. CNCs were obtained by acid hydrolysis followed by successful functionalization with Quaternary ammonium surfactant, confirmed by FTIR, XPS, XRD, TEM, and DLS analyses. Furthermore, the morphological, physical, antibacterial, and food packaging properties of all prepared films were investigated. Results showed that the mechanical, UV blocking, barrier properties, and antibacterial activity of all composite films were remarkably improved. Particularly, the addition of 3 wt% MCNC increased the tensile strength and elongation at break by 27.5 % and 20.0 %, respectively. Moreover, the permeability of O2, CO2, and water vapor dramatically reduced by 97.6 %, 96.7 %, and 49.8% compared to the Neat PCL. Further, the UV-blocking properties of the composite films were significantly improved. The antimicrobial properties of MCNC/PCL films showed good antimicrobial properties against S. aureus. Finally, cherry packaged with 1 and 3 wt% MCNC films exhibited satisfactory freshness after 22 days of preservation. Overall, the fabricated PCL nanocomposite films can be utilized in the food packaging industry.

Early Detection of Molecular Residual Disease and Risk Stratification for Children with Acute Myeloid Leukemia via Circulating Tumor DNA.

PURPOSE: Patient-tailored minimal residual disease (MRD) monitoring based on circulating tumor DNA (ctDNA) sequencing of leukemia-specific mutations enables early detection of relapse for pre-emptive treatment, but its utilization in pediatric acute myelogenous leukemia (AML) is scarce. Thus, we aim to examine the role of ctDNA as a prognostic biomarker in monitoring response to the treatment of pediatric AML. EXPERIMENTAL DESIGN: A prospective longitudinal study with 50 children with AML was launched, and sequential bone marrow (BM) and matched plasma samples were collected. The concordance of mutations by next-generation sequencing-based BM-DNA and ctDNA was evaluated. In addition, progression-free survival (PFS) and overall survival (OS) were estimated. RESULTS: In 195 sample pairs from 50 patients, the concordance of leukemia-specific mutations between ctDNA and BM-DNA was 92.8%. Patients with undetectable ctDNA were linked to improved OS and PFS versus detectable ctDNA in the last sampling (both P < 0.001). Patients who cleared their ctDNA post three cycles of treatment had similar PFS compared with persistently negative ctDNA (P = 0.728). In addition, patients with >3 log reduction but without clearance in ctDNA were associated with an improved PFS as were patients with ctDNA clearance (P = 0.564). CONCLUSIONS: Thus, ctDNA-based MRD monitoring appears to be a promising option to complement the overall assessment of pediatric patients with AML, wherein patients with continuous ctDNA negativity have the option for treatment de-escalation in subsequent therapy. Importantly, patients with >3 log reduction but without clearance in ctDNA may not require an aggressive treatment plan due to improved survival, but this needs further study to delineate.

Recycling Coal Fly Ash for Super-Thermal-Insulating Aerogel Fiber Preparation with Simultaneous Al2O3 Extraction.

A large quantity of coal fly ash is generated worldwide from thermal power plants, causing a serious environmental threat owing to disposal and storage problems. In this work, for the first time, coal fly ash is converted into advanced and novel aerogel fibers and high-purity α-Al2O3. Silica-bacterial cellulose composite aerogel fibers (CAFs) were synthesized using an in situ sol-gel process under ambient pressure drying. Due to the unique "nanoscale interpenetrating network" (IPN) structure, the CAFs showed wonderful mechanical properties with an optimum tensile strength of 5.0 MPa at an ultimate elongation of 5.8%. Furthermore, CAFs with a high porosity (91.8%) and high specific surface area (588.75 m2/g) can inherit advanced features, including excellent thermal insulation, stability over a wide temperature range, and hydrophobicity (contact angle of approximately 144°). Additionally, Al2O3 was simultaneously extracted from the coal fly ash to ensure that the coal fly ash was fully exploited. Overall, low-cost woven CAFs fabrics are suitable for wearable applications and offer a great approach to comprehensively use coal fly ash to address environmental threats.

Targeted metabolic reveals different part of maize in polyphenolic metabolites during germination and hypoglycemic activity analysis.

In this study, qualitative and quantitative analyses of phenolic compounds in the maize germinating seed embryo, radicle, and germ were performed at 0, 48, and 96 h post-germination, followed by the evaluation of their hypoglycemic activity. The results revealed the accumulation of 80 phenolics in different parts of germinated maize, of which 47, 48, and 53 were present in the seed embryo, radicle, and germ. After germination 22, 26, and 34 polyphenols were found to differential accumulate in the seed embryo, radicle, and germ. At 96 h post-germination, the content of monomeric phenols in the germ was higher than that in the radicle and seed embryo. Moreover, the inhibitory activity of polyphenols in the germ towards α-glucosidase and α-amylase was higher than that in the radicle and seed embryo. These results indicate that germination can effectively improve the type and content of phenolic compounds in different parts of maize.

Pediatric acute myeloid leukemia and hyperleukocytosis with WBC count greater than 50 × 109/L.

BACKGROUND: Acute myeloid leukemia (AML) and hyperleukocytosis have an unfavorable prognosis, but the impact of hyperleukocytosis on the prognosis of pediatric AML remains uncertain. We investigated the clinical characteristics and prognosis of pediatric AML with hyperleukocytosis, defined as WBC ≥ 50 × 109/L. METHODS: A total of 132 patients with newly diagnosed childhood AML with hyperleukocytosis were consecutively enrolled at our center from September 2009 to August 2021 to investigate prognostic factors and clinical outcomes. RESULTS: Hyperleukocytosis occurred in 27.4% of AML patients. Pediatric patients with hyperleukocytosis had similar CR and OS rates to those without hyperleukocytosis, but had a lower EFS rate. In our study, rates of CR1, mortality, relapsed/refractory disease, and HSCT were comparable between AML patients with WBC counts of 50-100 × 109/L and ≥ 100 × 109/L. AML patients with a WBC count of 50-100 × 109/L had a similar 5-year OS rate to patients with a WBC count ≥ 100 × 109/L (74.6% vs. 75.4%, P = 0.921). Among all patients with hyperleukocytosis, the FAB M5 subtype was associated with significantly inferior survival, and the prognosis of CBF-AML was good. CONCLUSIONS: Pediatric AML patients with hyperleukocytosis have the similar prognosis regardless of whether their WBC count is 50-100 × 109/L or ≥ 100 × 109/L.

High risk of bloodstream infection of carbapenem-resistant enterobacteriaceae carriers in neutropenic children with hematological diseases.

BACKGROUND: Neutropenic children with hematological diseases were associated with higher morbidity of carbapenem-resistant enterobacteriaceae (CRE) blood-stream infection (BSI) or colonization. But it was still murky regarding clinical characteristics, antimicrobial susceptibility, and outcomes of CRE-BSI in these patients. We aimed to identify the potential risk factors for subsequent bacteremia and clinical outcome caused by CRE-BSI. METHODS: Between 2008 and 2020, 2,465 consecutive neutropenic children were enrolled. The incidence and characteristics of CRE-BSI were explored in CRE-colonizers versus non-colonizers. Survival analysis was performed and risk factors for CRE-BSI and 30-day mortality were evaluated. RESULTS: CRE-carriers were identified in 59/2465 (2.39%) neutropenic children and19/59 (32.2%) developed CRE-BSI, while 12/2406 (0.5%) of non-carriers developed CRE-BSI (P < 0.001). The 30-day survival probability was significantly lower in patients with CRE-BSI than in non-BSI (73.9% vs. 94.9%, P = 0.050). Moreover, the 30-day survival probability of patients with CRE-BSI was also poorer in CRE-carriers versus non-carriers (49.7% vs. 91.7%, P = 0.048). Tigecycline and amikacin exhibited satisfactory antimicrobial activity against all isolated strains. Fluoroquinolone sensitivity was lower in E. coli (26.3%) strains versus satisfactory susceptibility of E. cloacae and other CRE-strains (91.2%). CRE-BSI accompanying intestinal mucosal damage were independent risk factors for 30-day survival probability (both P < 0.05), while combined antibiotic therapy and longer duration of neutropenia were more prone to developed CRE-BSI (P < 0.05). CONCLUSION: CRE-colonizers were prone to subsequent BSI and CRE-BSI was regarded as an independent predictor predisposing to high mortality in neutropenic children. Moreover, individualized antimicrobial therapy should be adopted due to different features of patients with separate CRE strains.

[Safety and short-term effectiveness of blinatumomab in the treatment of childhood relapsed/refractory acute lymphoblastic leukemia]. / 贝林妥欧单抗治疗儿童复发/éš¾æ²»æ€¥æ€§æ·‹å·´ç»†èƒžç™½è¡€ç— çš„å®‰å ¨æ€§åŠè¿‘æœŸç–—æ•ˆåˆ†æž.

OBJECTIVES: To study the safety and short-term effectiveness of blinatumomab in the treatment of childhood relapsed/refractory acute lymphoblastic leukemia (R/R-ALL). METHODS: Six children with R/R-ALL who received blinatumomab treatment from August 2021 to August 2022 were included as subjects, and a retrospective analysis was performed for their clinical data. RESULTS: Among the six children, there were three boys and three girls, with a median age of 10.5 (5.0-13.0) years at the time of inclusion. Of all six children, one had refractory ALL and did not achieve remission after several times of chemotherapy, and 5 relapsed for the first time, with a median time of 30 (9-60) months from diagnosis to relapse. Minimal residual disease (MRD) before treatment was 15.50% (0.08%-78.30%). Three children achieved complete remission after treatment, among whom two had negative conversion of MRD. Five children had cytokine release syndrome (CRS), among whom 3 had grade 1 CRS and 2 had grade 2 CRS. Four children were bridged to allogeneic hematopoietic stem cell transplantation, with a median interval of 50 (40-70) days from blinatumomab treatment to transplantation. The six children were followed up for a median time of 170 days, and the results showed an overall survival rate of 41.7% (95%CI: 5.6%-76.7%) and a median survival time of 126 (95%CI: 53-199) days. CONCLUSIONS: Blinatumomab has good short-term safety and effectiveness in the treatment of childhood R/R-ALL, and its long-term effectiveness needs to be confirmed by studies with a larger sample size.

[Clinical features and prognosis of juvenile myelomonocytic leukemia: an analysis of 63 cases]. / 63ä¾‹å¹¼å¹´åž‹ç²’å•æ ¸ç»†èƒžç™½è¡€ç— çš„ä¸´åºŠç‰¹å¾ä¸Žé¢„åŽåˆ†æž.

OBJECTIVES: To investigate the clinical features of juvenile myelomonocytic leukemia (JMML) and their association with prognosis. METHODS: Clinical and prognosis data were collected from the children with JMML who were admitted from January 2008 to December 2016, and the influencing factors for prognosis were analyzed. RESULTS: A total of 63 children with JMML were included, with a median age of onset of 25 months and a male/female ratio of 3.2∶1. JMML genetic testing was performed for 54 children, and PTPN11 mutation was the most common mutation and was observed in 23 children (43%), among whom 19 had PTPN11 mutation alone and 4 had compound PTPN11 mutation, followed by NRAS mutation observed in 14 children (26%), among whom 12 had NRAS mutation alone and 2 had compound NRAS mutation. The 5-year overall survival (OS) rate was only 22%±10% in these children with JMML. Of the 63 children, 13 (21%) underwent hematopoietic stem cell transplantation (HSCT). The HSCT group had a significantly higher 5-year OS rate than the non-HSCT group (46%±14% vs 29%±7%, P<0.05). There was no significant difference in the 5-year OS rate between the children without PTPN11 gene mutation and those with PTPN11 gene mutation (30%±14% vs 27%±10%, P>0.05). The Cox proportional-hazards regression model analysis showed that platelet count <40×109/L at diagnosis was an influencing factor for 5-year OS rate in children with JMML (P<0.05). CONCLUSIONS: The PTPN11 gene was the most common mutant gene in JMML. Platelet count at diagnosis is associated with the prognosis in children with JMML. HSCT can improve the prognosis of children with JMML.

Nanostructure Mediated Piezoelectric Effect of Tetragonal BaTiO3 Coatings on Bone Mesenchymal Stem Cell Shape and Osteogenic Differentiation.

In recent years, porous titanium (Ti) scaffolds with BaTiO3 coatings have been designed to promote bone regeneration. However, the phase transitions of BaTiO3 have been understudied, and their coatings have yielded low effective piezoelectric coefficients (EPCs < 1 pm/V). In addition, piezoelectric nanomaterials bring many advantages in eliciting cell-specific responses. However, no study has attempted to design a nanostructured BaTiO3 coating with high EPCs. Herein, nanoparticulate tetragonal phase BaTiO3 coatings with cube-like nanoparticles but different effective piezoelectric coefficients were fabricated via anodization combining two hydrothermal processes. The effects of nanostructure-mediated piezoelectricity on the spreading, proliferation, and osteogenic differentiation of human jaw bone marrow mesenchymal stem cells (hJBMSCs) were explored. We found that the nanostructured tetragonal BaTiO3 coatings exhibited good biocompatibility and an EPC-dependent inhibitory effect on hJBMSC proliferation. The nanostructured tetragonal BaTiO3 coatings of relatively smaller EPCs (<10 pm/V) exhibited hJBMSC elongation and reorientation, broad lamellipodia extension, strong intercellular connection and osteogenic differentiation enhancement. Overall, the improved hJBMSC characteristics make the nanostructured tetragonal BaTiO3 coatings promising for application on implant surfaces to promote osseointegration.

Clinical Impact of Drug Adherence of Tyrosine Kinase Inhibitors in Children with Ph-Positive Acute Lymphoblastic Leukemia.

PURPOSE: This study aimed to explore the impact of ABL1-tyrosine kinase inhibitors (TKIs) adherence on the survival of chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) children and clarify the potential predictors of patients' prognosis from TKIs intake practices. Materials and Methods: Ninety newly diagnosed Ph+ ALL patients who received TKIs were enrolled. We collected the baseline characteristics and adverse events in all children; moreover, TKIs adherence was measured by an eight-item Morisky medication adherence scale (MMAS-8). Progression-free survival (PFS) and overall survival (OS) analysis were performed, and risk factors for PFS and OS were evaluated. RESULTS: Among all patients, 69 cases were regarded as adherers, while 21 were non-adherers. The median duration of TKIs interruption was significantly prolonged in the non-adherence group than in the adherence group (13 [0-101] vs. 56 [11-128], p < 0.001). Additionally, dose reduction occurred in 55.2% of non-adherers versus 23.0% of adherers (p=0.002). The PFS and OS in adherers were significantly higher versus non-adherers (p=0.020 and p=0.039). MMAS-8 score was an independent risk factor for PFS (p=0.010) and OS (p=0.031). Among non-adherers, the median OS was only 23.1% (4.2%-42%) in patients aged ≤ 10 years versus 54.4% (38.8%-70%) in adolescents. Most of the patients who experienced TKIs non-adherence suffered pancytopenia. CONCLUSION: TKIs adherence during treatment significantly influenced the survival of pediatric Ph+ ALL patients, and non-adherers with age ≤ 10 years were more vulnerable to TKIs disruption. The cumulative TKIs dose should be especially emphasized to patients with age ≤ 10 years, which may result in an inferior achievement of relevant treatment milestones.

A digital workflow to predict facial aesthetics in patients with maxillofacial trauma with implant retained prostheses.

Purpose To introduce a digital workflow for the prediction of facial aesthetics, especially in patients with dentation deformity caused by maxillofacial trauma.Methods Cone-beam computed tomography (CBCT) and three-dimensional facial scans of patients with radiographic prostheses were collected. The aforementioned data were uploaded to ProPlan CMF software and merged to generate a virtual patient with craniofacial hard tissue, realistic facial soft tissue, and remaining dentition. The radiographic prostheses were scanned to form a digital cast, which was fitted with its CBCT image to create the virtual prostheses. Postoperative facial soft tissue was simulated according to the movement of the virtual prostheses. An appropriate virtual diagnostic prosthesis plan was selected by the patient and dentist. Subsequently, prosthetically driven implant guide and restoration were designed and fabricated.Conclusions A virtual patient was successfully constructed. A 4-mm protrusion of the virtual prosthesis was chosen. Subsequently, implant surgery was performed, and dental prostheses were fabricated based on this location. The fusion of the postoperative facial scan and preoperative facial prediction was found to be coincident. This technique can effectively predict facial aesthetic features of patients with maxillofacial trauma, facilitate communication with patients, reduce chairside time, and guide the multidisciplinary design of implant placement and restoration fabrication.

Phenotypic and genotypic correlation evaluation of 148 pediatric patients with Fanconi anemia in a Chinese rare disease cohort.

BACKGROUND: Fanconi anemia (FA) is a rare autosomal recessive, X-linked or autosomal dominant disease. Few large-scale FA investigations of rare disease cohorts have been conducted in China. METHODS: We enrolled 148 patients diagnosed with FA according to evidence from the clinical phenotype, family history, and a set of laboratory tests. Next, the clinical manifestations and correlation between the genotype and phenotype of FA pediatric cases were investigated. RESULTS: The most common FA subtype in our cohort was FA-A (51.4 %), followed by FA-D2 and FA-P. Finger (26 %) and skin (25 %) deformities were the most common malformations. Based on family history, blood system diseases (51 %) had the highest incidence rate, followed by digestive system tumours. A set of new or prognosis-related mutation sites was identified. For example, c.2941 T > G was a new most common missense mutation site for FANCA. FANCP gene mutation sites were mainly concentrated in exons 12/14/15. The mutations of FANCI/FANCD2 were mainly located at the α helix and ß corners of the protein complex. FA-A/D1 patients with splicing or deletion mutations showed more severe disease than those with missense mutations. Chromosome 1/3/7/8 abnormalities were closely linked to the progression of FA to leukemia. CONCLUSION: Our study investigated the clinical features and genotype/phenotype correlation of 148 Chinese pediatric FA patients, providing new insight into FA.