The binding profile of SARS-CoV-2 with human leukocyte antigen polymorphisms reveals critical alleles involved in immune evasion.

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), astonished the world and led to millions of deaths. Due to viral new mutations and immune evasion, SARS-CoV-2 ranked first in transmission and influence. The binding affinity of human leukocyte antigen (HLA) polymorphisms to SARS-CoV-2 might be related to immune escape, but the mechanisms remained unclear. In this study, we obtained the binding affinity of SARS-CoV-2 strains with different HLA proteins and identified 31 risk alleles. Subsequent structural predictions identified 10 active binding sites in these HLA proteins that may promote immune evasion. Particularly, we also found that the weak binding ability with HLA class I polymorphisms could contribute to the immune evasion of Omicron. These findings suggest important implications for preventing the immune evasion of SARS-CoV-2 and providing new insights for the vaccine design.

A nomogram for predicting cause-specific mortality among patients with cecal carcinoma: a study based on SEER database.

OBJECTIVE: Classical Cox proportional hazard models tend to overestimate the event probability in a competing risk setup. Due to the lack of quantitative evaluation of competitive risk data for colon cancer (CC), the present study aims to evaluate the probability of CC-specific death and construct a nomogram to quantify survival differences among CC patients. METHODS: Data on patients diagnosed with CC between 2010 and 2015 were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. Patients were divided into a training dataset for the establishment of the model and a validation dataset to evaluate the performance the model at a ratio of 7:3. To evaluate the ability of multiple variables to predict cause-specific death in CC patients, univariate and multivariate analyses with Fine-Gray models were performed to screen the predictors of cause-specific death, and a nomogram for predicting cause-specific mortality was constructed. Then, the receiver operating characteristic (ROC) curve and the calibration curve were plotted to evaluate the prognostic performance of the nomogram. RESULTS: The dataset was randomly divided into a training (n = 16,655) dataset and a validation (n = 7,139) dataset at a ratio of 7:3. In the training dataset, variables including pathological subtypes of tumors, pathological grading (degree of differentiation), AJCC staging, T-staging, surgical type, lymph node surgery, chemotherapy, tumor deposits, lymph node metastasis, liver metastasis, and lung metastasis were identified as independent risk factors for cause-specific death of CC patients. Among these factors, the AJCC stage had the strongest predictive ability, and these features were used to construct the final model. In the training dataset, the consistency index (C-index) of the model was 0.848, and the areas under the receiver operating characteristic curve (AUC) at 1, 3, and 5 years was 0.852, 0.861, and 0.856, respectively. In the validation dataset, the C-index of the model was 0.847, and the AUC at 1 year, 3 years, and 5 years was 0.841, 0.862, and 0.852, respectively, indicating that this nomogram had an excellent and robust predictive performance. CONCLUSION: This study can help clinical doctors make better clinical decisions and provide better support for patients with CC.

Mass balance study of [14C]SHR0302, a selective and potent JAK1 inhibitor in humans.

SHR0302, a selective JAK1 inhibitor developed by Jiangsu Hengrui Pharmaceutical Co., was intended for the treatment of rheumatoid arthritis. In this study, we evaluated the pharmacokinetics, mass balance, and metabolism of SHR0302 in six healthy Chinese male subjects after a single 8 mg (80 µCi) oral dose of [14C]SHR0302.SHR0302 was absorbed rapidly (Tmax = 0.505 h), and the average t1/2 of the SHR0302-related components in plasma was approximately 9.18 h. After an oral dose was administered, the average cumulative excretion of the radioactive components was 100.56% ± 1.51%, including 60.95% ± 11.62% in urine and 39.61% ± 10.52% in faeces.A total of 16 metabolites were identified. In plasma, the parent drug SHR0302 accounted for 90.42% of the total plasma radioactivity. In urine, SHR161279 was the main metabolite, accounting for 33.61% of the dose, whereas the parent drug SHR0302 only accounted for 5.1% of the dose. In faeces, the parent drug SHR0302 accounted for 23.73% of the dose, and SHR161279 was the significant metabolite, accounting for 5.67% of the dose. In conclusion, SHR0302-related radioactivity was mainly excreted through urine (60.95%) and secondarily through faeces (39.61%).The metabolic reaction of SHR0302 in the human body is mainly through mono-oxidation and glucuronidation. The main metabolic location of SHR0302 in the human body is the pyrrolopyrimidine ring.

Effects of health education during public health emergencies on the health literacy, emotion and coping style of Chinese junior middle school students: a randomized controlled trial.

BACKGROUND: Schools are high incidence places for public health emergencies. Good health literacy helps students cope with public health emergencies. Overall, the health literacy of young students is relatively low. Health education can promote health literacy, but the health education related to public health emergencies for Chinese junior middle school students needs to be improved. To design and implement health education courses related to public health emergencies for junior middle school students and examine the impact on their health literacy, emotions, and coping styles. METHODS: From March to December 2022, 724 students in Grade 7 and Grade 8 of two junior middle schools in Changzhou were randomly divided into a course group (n = 359) and a control group (n = 365). The course group received an age-appropriate health education course that addressed public health emergencies; there were 12 classes, one per week. The control group received general health education. One week before and after the courses, the two groups of students were assessed with the Adolescent Health Literacy Evaluation Scale under Public Health Emergencies (AHLES-PHE), the Depression Self-Rating Scale for Children (DSRSC), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Simplified Coping Style Questionnaire (SCSQ). RESULTS: After the courses were completed, the scores of AHLES-PHE [156.0 (45.0,180.0) vs. 165.0 (54.0,180.0), P < 0. 05] in the course group increased significantly. The positive rate of DSRSC [81 (22.6%) vs. 57 (15.9%), P < 0.05] and GAD-7 [45 (12.5%) vs. 29 (8.1), P < 0.05]in the course group were significantly lower than those before courses. There was no significant difference in the above indices before and after courses in the control group (P > 0.05). CONCLUSION: This suggests that the health education courses related to public health emergencies designed in this study has an effect on improving health literacy, depression and anxiety in junior middle school students.

Reprogramming the tumor microenvironment by genome editing for precision cancer therapy.

The tumor microenvironment (TME) is essential for immune escape by tumor cells. It plays essential roles in tumor development and metastasis. The clinical outcomes of tumors are often closely related to individual differences in the patient TME. Therefore, reprogramming TME cells and their intercellular communication is an attractive and promising strategy for cancer therapy. TME cells consist of immune and nonimmune cells. These cells need to be manipulated precisely and safely to improve cancer therapy. Furthermore, it is encouraging that this field has rapidly developed in recent years with the advent and development of gene editing technologies. In this review, we briefly introduce gene editing technologies and systematically summarize their applications in the TME for precision cancer therapy, including the reprogramming of TME cells and their intercellular communication. TME cell reprogramming can regulate cell differentiation, proliferation, and function. Moreover, reprogramming the intercellular communication of TME cells can optimize immune infiltration and the specific recognition of tumor cells by immune cells. Thus, gene editing will pave the way for further breakthroughs in precision cancer therapy.

Pharmacokinetics, Mass Balance, and Metabolism of the Novel Urate Transporter 1 Inhibitor [14C]HR011303 in Humans: Metabolism Is Mediated Predominantly by UDP-Glucuronosyltransferase.

HR011303, a promising selective urate transporter 1 inhibitor, is currently being studied in a phase III clinical trial in China for the treatment of hyperuricemia and gout. In the current study, the pharmacokinetics, mass balance, and metabolism of HR011303 were examined in six healthy Chinese male subjects who received a single oral dose of 10 mg of [14C]HR011303 (80 µCi). The results showed that HR011303 was rapidly absorbed with a median time to reach C max of 1.50 hours postdose, and the arithmetic mean half-life of total radioactivity was approximately 24.2 hours in plasma. The mean blood-to-plasma radioactivity concentration ratio was 0.66, suggesting the preferential distribution of drug-related components in plasma. At 216 hours postdose, the mean cumulative excreted radioactivity was 91.75% of the dose, including 81.50% in urine and 10.26% in feces. Six metabolites were identified, and the parent drug HR011303 was the most abundant component in plasma and feces, but a minor component in urine. Glucuronidation of the carboxylic acid moiety of HR011303 was the primary metabolic pathway in humans, amounting to 69.63% of the dose (M5, 51.57% of the dose; M5/2, 18.06% of the dose) in the urine; however, it was not detected in plasma. UDP-glucuronosyltransferase (UGT) 2B7 was responsible for the formation of M5. Overall, after a single oral dose of 10 mg of [14C]HR011303 (80 µCi), HR011303 and its main metabolites were eliminated via renal excretion. The major metabolic pathway was carboxylic acid glucuronidation, which was catalyzed predominantly by UGT2B7. SIGNIFICANCE STATEMENT: This study determined the absorption and disposition of HR011303, a selective urate transporter (URAT) 1 inhibitor currently in development for the treatment of hyperuricemia and gout. This work helps to characterize the major metabolic pathways of new URAT inhibitors and identify the absorption and clearance mechanism.

Correction: Lipoprotein Receptor LRP1 Regulates Leptin Signaling and Energy Homeostasis in the Adult Central Nervous System.

[This corrects the article DOI: 10.1371/journal.pbio.1000575.].

Stable and Bright CsPbX3 Nanocrystals in Metal-Organic Frameworks for White Light-Emitting Diodes.

The stability of metal halide perovskite (CsPbX3, X = Cl, Br, and I) nanocrystals (NCs) is crucial for their practical applications. In this paper, perovskite NCs were synthesized in situ in lead-based metal-organic frameworks (Pb-MOFs: [Pb2(1,3,5-HBTC)2(H2O)4]·H2O), and we obtained stable and bright luminescence composites with different colors. Namely, CsPbBr3@Pb-MOF composites were created by the in situ growth of CsPbBr3 crystals (NCs) on Pb-MOF, which had high ion resistance, bright photoluminescence (PL), and excellent stability. The composites still had bright luminescence after 11 months of storage. The PL intensity of green-emitting CsPbBr3@Pb-MOF composites was increased compared with as-prepared CsPbBr3 NCs. Bright and stable blue- and red-emitting CsPbX3@Pb-MOF composites were obtained by adjusting the amount of PbX2 (X = Cl, Br, and I) in the synthesis process. These CsPbX3 NCs were homogeneously distributed in Pb-MOF substrates. The growth of CsPbX3 NCs in Pb-MOFs prevented NC aggregation and decreased surface defects against nonradiative recombination during emitting. Thus, the PL lifetime and stability were improved. Furthermore, white light-emission diodes were prepared using three color CsPbX3@Pb-MOF composites with Commission Internationale de I'Eclairage color coordinates of (0.296, 0.316). This result provided an efficient way to overcome the limitation of chemical solution synthesis and improve the stability of CsPbX3 NCs.

Absorption, metabolism, and excretion of [14C]YY-20394, a highly selective PI3K-Delta inhibitor in humans.

YY-20394, a highly selective PI3Kδ inhibitor, is under NDA submission for treating follicular lymphoma in China. The absorption, metabolism, and excretion of YY-20394 were evaluated in healthy Chinese male subjects following a single oral dose of 80 mg [14C]YY-20394 (100 µCi).Within 264 h post-dose, 92.1% of the administered dose was recovered, with 58.1% from urine and 34.0% from faeces. YY-20394 was rapidly absorbed in humans, and the peak plasma concentrations occurred at 1.0 h. The absorbed drug fraction was at least 58.1% according to urine recovery.In addition to the parent drug, nine metabolites were identified in plasma, urine, and faeces. Unchanged YY-20394 was the predominant drug-related component in plasma (accounting for 68.4% of the total radioactivity), urine (accounting for 90.0% of the urinary radioactivity) and faeces (accounting for 41.7% of the faecal radioactivity). In humans, the major metabolic sites were the morphine ring and side chains of piperidine rings. The major metabolic pathways involved N-dealkylation, O-dealkylation, glucuronidation and acetylation.Overall, renal elimination played a significant role in the disposition of YY-20394, and the morphine ring and the side chain of the piperidine ring was the predominant metabolic sites.

Association study of the pneumatization degree of mastoid air cells and postoperative complications after microvascular decompression in hemifacial spasm.

BACKGROUND: This study aimed to analyse the association between the degree of pneumatization of mastoid air cells (MACs) and postoperative complications after microvascular decompression in hemifacial spasm. METHODS: We retrospectively reviewed 308 patients with hemifacial spasm who underwent surgery at our institute between January 2017 and March 2021. The degree of pneumatization of MACs was classified into four grades (grades 1, 2, 3, and 4) according to method of Han et al. The clinical data of the four grades were analysed and statistically examined. RESULTS: There were no statistically significant differences between the four grades in terms of the operative time, intraoperative blood loss, and postoperative hospital stay (all, P > 0.05). The incidence of hearing loss was higher in grade 4 MACs (26.56%) than in grades 1 and 2 MACs (5.41% and 2.89%, respectively; P < 0.05). The incidence of facial paralysis was higher in grade 4 MACs (28.13%) than in grades 1 and 2 MACs (5.41% and 9.18%, respectively; P < 0.001). The incidence of intracranial infection was higher in grade 3 MACs (17.65%) than in grade 2 MACs (3.89%) (P < 0.05). All four patients with cerebrospinal fluid leakage belonged to grade 4 MACs. The incidence of cerebrospinal fluid leakage was higher in grade 4 MACs (5.13%) than in grade 2 MACs (P < 0.05). CONCLUSIONS: This study found that the degree of pneumatization of MACs was closely related to the postoperative complications after MVD surgeries. Well-pneumatized MACs increase the risk of cerebrospinal fluid leakage and intracranial infection. However, insufficient exposure increases the risk of facial paralysis and hearing loss. For patients with well-pneumatized MACs, sufficient surgical exposure is the top priority when locating the bone hole. For those who may have a latent MAC opening, preventive occlusion should be considered.

Zinc Ion-Based Switch-on Fluorescence-Sensing Probes for the Detection of Tetracycline.

Tetracycline (TC) is an antibiotic that has been widely used in the animal husbandry. Thus, TC residues may be found in animal products. Developing simple and sensitive methods for rapid screening of TC in complex samples is of great importance. Herein, we demonstrate a fluorescence-sensing method using Zn2+ as sensing probes for the detection of TC. Although TC can emit fluorescence under the excitation of ultraviolet light, its fluorescence is weak because of dynamic intramolecular rotations, leading to the dissipation of excitation energy. With the addition of Zn2+ prepared in tris(hydroxymethyl)amino-methane (Tris), TC can coordinate with Zn2+ in the Zn2+-Tris conjugates to form Tris-Zn2+-TC complexes. Therefore, the intramolecular motions of TC are restricted to reduce nonradiative decay, resulting in the enhancement of TC fluorescence. Aggregation-induced emission effects also play a role in the enhancement of TC fluorescence. Our results show that the linear dynamic range for the detection of TC is 15-300 nM. Moreover, the limit of detection was ~7 nM. The feasibility of using the developed method for determination of the concentration of TC in a complex chicken broth sample is also demonstrated in this work.

Engrafted primary type-2 astrocytes improve the recovery of the nigrostriatal pathway in a rat model of Parkinson's disease.

Parkinson's disease (PD) is a disorder characterized by a progressive loss of the dopaminergic neurons in the substantia nigra and a depletion of the neurotransmitter dopamine in the striatum. Our published results indicate that fasciculation and elongation protein zeta-1 (FEZ1) plays a role in the astrocyte-mediated protection of dopamine neurons and regulation of the neuronal microenvironment during the progression of PD. In this study, we examined the effects of engrafted type-2 astrocytes (T2As) with high expression of FEZ1 on the improvement of the symptoms and functional reconstruction of PD rats. T2As were stereotactically transplanted into the striatum of rats with PD induced by 6-hydroxydopamine (6-OHDA). An examination of apomorphine (APO)-induced rotations was performed to evaluate dopamine neuron damage and motor functions. Remarkably, the grafted cells survived in the lesion environment for six weeks or longer after implantation. In addition, the transplantation of T2As decrease the average velocity and the duration time of the APO-induced rotations, and increase the actuation time, as measured in the rotation behavioural tests. In the substantia nigra, the transplantation of T2As reduced the PD-induced GFAP, TH and FEZ1 downregulation. The grafted cells exclusively migrated to other regions near the injection site in the striatum and differentiated into GFAP+ astrocytes or TH+ neurons. Furthermore, by detecting monoamine neurotransmitters through high-performance liquid chromatography, we found that the nigrostriatal pathway had been repaired to some extent. Taken together, these results suggest that engrafted T2As with high expression of FEZ1 improved the symptoms and functional reconstruction of PD rats, providing a theoretical basis for FEZ1 as a potential target and engraftment of T2As as a therapeutic strategy in the treatment of PD.

Pharmacokinetics, mass balance, and metabolism of [14C]vicagrel, a novel irreversible P2Y12 inhibitor in humans.

Vicagrel, a novel irreversible P2Y12 receptor inhibitor, is undergoing phase III trials for the treatment of acute coronary syndromes in China. In this study, we evaluated the pharmacokinetics, mass balance, and metabolism of vicagrel in six healthy male Chinese subjects after a single oral dose of 20 mg [14C]vicagrel (120 µCi). Vicagrel absorption was fast (Tmax = 0.625 h), and the mean t1/2 of vicagrel-related components was ~38.0 h in both plasma and blood. The blood-to-plasma radioactivity AUCinf ratio was 0.55, suggesting preferential distribution of drug-related material in plasma. At 168 h after oral administration, the mean cumulative excreted radioactivity was 96.71% of the dose, including 68.03% in urine and 28.67% in feces. A total of 22 metabolites were identified, and the parent vicagrel was not detected in plasma, urine, or feces. The most important metabolic spot of vicagrel was on the thiophene ring. In plasma pretreated with the derivatization reagent, M9-2, which is a methylated metabolite after thiophene ring opening, was the predominant drug-related component, accounting for 39.43% of the radioactivity in pooled AUC0-8 h plasma. M4, a mono-oxidation metabolite upon ring-opening, was the most abundant metabolite in urine, accounting for 16.25% of the dose, followed by M3-1, accounting for 12.59% of the dose. By comparison, M21 was the major metabolite in feces, accounting for 6.81% of the dose. Overall, renal elimination plays a crucial role in vicagrel disposition, and the thiophene ring is the predominant metabolic site.

A validated HPLC-MS/MS method for determination of simmitecan and its metabolite chimmitecan in human plasma and its application to a pharmacokinetic study in Chinese patients with advanced solid tumor.

Simmitecan is a new ester anticancer prodrug which can exert the antiproliferation activity through its active metabolite, chimmitecan. In the current study, a simple and reliable liquid chromatography-tandem mass spectrometry method was developed and validated for simultaneous determination of simmitecan and chimmitecan in human plasma. Both irinotecan and 7-ethyl-10-hydroxycamptothecin were used as the internal standards. Plasma samples were protein precipitated by acetonitrile (0.2% formic acid, v/v) and processed samples were chromatographed on a Hypersil GOLDTM C18 column (100 × 4.6 mm, i.d. 3.0 µm) with acetonitrile and 10 mM ammonium acetate (0.1% formic acid, v/v) as the mobile phase. The calibration curves showed good linearity (R ≥ 0.99) over the concentration range of 1-500 ng/mL and 0.25-125 ng/mL for simmitecan and chimmitecan, respectively. Intra- and inter-run precisions (CV%) were ≤10.2% for simmitecan and ≤12.1% for chimmitecan. The accuracies were 99.4-103.5% for simmitecan and 95.4-103.5% for chimmitecan. This method was further successfully applied to a pharmacokinetic study of simmitecan in Chinese advanced solid cancer patients after administration of simmitecan hydrochloride injection.

Effects of Percutaneous Neuromuscular Electrical Stimulation for Neck Pain in Patients With Cervical Spondylosis.

CONTEXT: Cervical spondylosis (CS) is a very common, age-related, chronic, disc-degeneration condition. Alternative medicine has been widely used to treat neck pain in CS. However, no randomized controlled trials have focused on the effects and safety of percutaneous neuromuscular electrical stimulation (PNMES) for neck-pain relief in patients with CS. OBJECTIVE: The study aimed to evaluate the effects and safety of PNMES for treating neck pain in patients with cervical spondylosis (CS). DESIGN: The research team designed a two-arm, double-blinded, randomized, sham-controlled trial. SETTING: The study was conducted at the People's Hospital of Yan'an in Yan'an, China. PARTICIPANTS: Participants were 124 patients with neck pain from CS at the hospital. INTERVENTION: Participants were randomly divided into an intervention group and a control group in a ratio of 1:1. The intervention group received PNMES (PNMES group), and the control group received sham PNMES for 30 minutes daily 3 times weekly, for 12 weeks. OUTCOME MEASURES: The outcome measures included: (1) a visual analog scale (VAS), (2) a test of cervical range of motion (ROM), and (3) the neck disability index (NDI) score. All outcome measurements were measured immediately postintervention and in a follow-up at 4 weeks postintervention. In addition, AEs were also recorded duration the period of treatment. RESULTS: Immediately postintervention and at the follow-up, the PNMES group exhibited decreases in the mean VAS (P < .01) and NDI score (P < .01) that were significantly greater than those of the control group. Additionally, the increase in the mean ROM was significantly higher in the PNMES group than that in the control group, both immediately postintervention and at the follow-up (P < .01). No AEs were found in either group. CONCLUSIONS: The results of this study have demonstrated that PNMES is more effective than sham PNMES for neck-pain relief in patients with CS.

Perspectives and experiences of Chinese nurses on quality improvement initiatives: A mixed-methods study.

AIM: To investigate Chinese nurses' views and experiences in relation to quality improvement implementation, as well as to determine the impact of contextual factors on nursing quality improvement initiatives. BACKGROUND: Nurses play a major role in carrying out quality improvement initiatives. Contextual factors influence the implementation and success of quality improvement initiatives. Studies that investigated the impact of contextual factors on Chinese nurses' practice in quality improvement remain limited. METHODS: A sequential explanatory mixed-methods design was used for this study. A quantitative cross-sectional survey was used to assess the context of quality improvement initiatives. Simple random sampling was used to recruit quality improvement teams. The sample included 356 nurses from tertiary teaching hospitals; 291 (81.7%) of them completed questionnaires. Nursing managers and nurses (n = 18) were purposively selected to participate in semi-structured interviews; their experiences and perceptions regarding the contextual factors of quality improvement initiatives were obtained. RESULTS: In the quantitative phase, the "microsystem" (mean=5.24) and "QI team" (mean = 4.97) contexts were reported as supportive contexts. The organizational context was weak, with a mean score of 3.92. In the qualitative phase, three themes related to the contextual challenges emerged: (1) nurses' attitudes and satisfaction, (2) team efficacy, and (3) organizational infrastructure and culture. CONCLUSIONS: Efforts to elevate organizational culture and reward systems are needed in Chinese hospitals. Further education aimed at increasing skills and knowledge should be provided, to ensure effective quality improvement implementation. IMPLICATIONS FOR NURSING MANAGEMENT: During quality improvement initiatives, management tasks should focus on increasing nurses' satisfaction, solving skill and knowledge deficits, and clarifying nurses' roles in relation to quality improvement.

Impacts of CYP2C19 genetic polymorphisms on bioavailability and effect on platelet adhesion of vicagrel, a novel thienopyridine P2Y12 inhibitor.

AIMS: We investigated the impacts of CYP2C19 polymorphisms on pharmacokinetics and pharmacodynamics of vicagrel in healthy Chinese subjects. METHODS: CYP2C19 extensive metabolizers (EMs), intermediate metabolizers (IMs) and poor metabolizers (PMs; 16 subjects/group) participated in a randomized, open-label, 2-period cross-over study. Each study period lasted 7 days, with a loading dose of 24 mg of vicagrel or 300 mg of clopidogrel on day 1, and maintenance doses of 6 mg of vicagrel or 75 mg of clopidogrel daily from day 2 to day 7. The pharmacokinetics and pharmacodynamics were assessed on day 1 and day 7. RESULTS: After a loading dose, the AUC0-t of the active metabolite H4 by vicagrel was slightly lower in IMs and PMs (decreased by 21 and 27%, respectively) compared to EMs. Similar results were found after maintenance doses. In EMs, the AUC0-t of H4 by vicagrel was somewhat higher than clopidogrel after the loading dose, and comparable with clopidogrel (90% confidence interval 0.94, 1.21) after the maintenance doses. However, it was much higher than clopidogrel in PMs, with a 1.28-fold (loading dose) and a 73% (maintenance doses) increases compared to clopidogrel (P < 0.001). Consequently, the inhibition of platelet aggregation by vicagrel was greater than clopidogrel after both loading dose (28.2 vs 12.4% at 4 hours, P < 0.01) and maintenance doses (42.8 vs 24.6% at 4 hours, P < 0.001) in PMs. CONCLUSIONS: CYP2C19 polymorphisms have less impact on vicagrel as compared to clopidogrel. Drug exposure and response to vicagrel in PMs were even higher than to clopidogrel in IMs.

A simple enzyme-catalyzed reaction induced "switch" type fluorescence biosensor based on carbon nitride nanosheets for the assay of alkaline phosphatase activity.

An enzyme-catalyzed fluorescence "switch" type sensor was constructed for the determination of alkaline phosphatase (ALP) activity by combining the fluorescence quenching effect of Ag+ on ultrathin g-C3N4 nanosheets (CNNSs) with the simple redox reaction of AA and Ag+. Briefly, Ag+ exhibits a significant quenching effect on the fluorescence of CNNSs. Thus the fluorescence signal of the CNNS-Ag+ system is extremely weak even in the presence of l-ascorbic acid-2-phosphate (AAP) ("off" state). When ALP coexists in the system, the enzyme can specifically catalyze the hydrolysis of AAP to form ascorbic acid (AA), which reduces Ag+ to Ag0. In this case, the fluorescence signal of the system is recovered ("on" state). Based on this principle, a signal-enhanced CNNS fluorescence sensor was developed to determine the activity of alkaline phosphatase. The experimental results show that the detection range of alkaline phosphatase is 0.5-20 U L-1, and the detection limit is 0.05 U L-1 (S/N = 3). Meanwhile, this method was used to assay ALP in serum samples.

Inhibitory effects of glucagon-like peptide-1 receptor on epilepsy.

Glucagon-like peptide-1 (GLP-1) and its receptor, GLP-1R, are valuable tools in the therapy of type 2 diabetes mellitus. Although GLP-1R stimulation is also potentially applicable to neurological disorders, few investigators have evaluated its beneficial effects in neurological disease models. Thus, we aimed to look into the antiepileptic effects of GLP-1R on epilepsy and its underlying mechanisms. The cerebral cortex of 22 patients with temporal lobe epilepsy (TLE) and 16 patients with trauma were collected to the epilepsy and control groups, respectively. Seizures were induced by pentylenetetrazole (PTZ) in rats. Liraglutide was used to up-regulate GLP-1R, and exendin fragment 9-39 (ex9-39) was used to down-regulate GLP-1R. The motor responses and scalp electroencephalograms of rats were recorded, and the interaction between GLP-1R and neuronal receptors (GABAARß2/3, GluA1-4, GluNR1, GluN2A and GluN2B) was evaluated by coimmunoprecipitation. GLP-1R expression was investigated by immunohistochemistry and immunofluorescence staining, and the levels of GLP-1R and neuronal receptors were evaluated by western blotting. The results indicated that GLP-1R was decreased in patients with TLE and in PTZ-treated rats and the administration of liraglutide decreased seizure severity, which indicates that liraglutide exerts antiepileptic effects. Moreover, liraglutide significantly up-regulated GLP-1R and GABAARß2/3 and down-regulated GluA1-4, GluNR1, GluN2A and GluN2B. In addition, ex9-39 exerted adverse effects and weakened the effects of liraglutide. Therefore, GLP-1R might suppress seizures by regulating the levels of neuronal receptors.

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study.

BACKGROUND: Elevated levels of plasma D-dimer increase the risk of ischemic stroke, stroke severity, and the progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. The aim of this study is to investigate whether plasma D-dimer level is a determinant of short-term poor functional outcome in patients with acute ischemic stroke (AIS). METHODS: This prospective study included 877 Chinese patients with AIS admitted to Renmin Hospital of Wuhan University within 72 h of symptom onset. Patients were categorized by plasma D-dimer level: Quartile 1(≤0.24 mg/L), Quartile 2 (0.25-0.56 mg/L), Quartile 3 (0.57-1.78 mg/L), and Quartile 4 (> 1.78 mg/L). The medical record of each patient was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted. Functional outcome at 90 days was assessed with the modified Rankin Scale. RESULTS: Poor outcome was present in 302 (34.4%) of the 877 patients that were included in the study (mean age, 64 years; male, 68.5%). After adjustment for potential confounding variables, higher plasma D-dimer level on admission was associated with poor outcome (adjusted odds ratio 2.257, 95% confidence interval 1.349-3.777 for Q4:Q1; P trend = 0.004). According to receiver operating characteristic (ROC) analysis, the best discriminating factor for poor outcome was a plasma D-dimer level ≥ 0.315 mg/L (area under the ROC curve 0.657; sensitivity 83.8%; specificity 41.4%). CONCLUSION: Elevated plasma D-dimer levels on admission are significantly associated with poor outcome after admission for AIS, suggesting the potential role of plasma D-dimer level as a predictive marker for short-term poor outcome in patients with AIS.