Hypomagnesemia with Secondary Hypocalcemia (HSH): a Case Report.

BACKGROUND: Hypomagnesemia with secondary hypocalcemia (HSH) is a genetic disorder arising from the body's impaired capacity to absorb and retain magnesium (Mg2+) consumed through diet. Consequently, Mg2+ levels in blood are significantly reduced, a condition referred to as hypomagnesemia. Insufficient levels of Mg2+ and calci-um (Ca2+) can lead to neurological complications that manifest during infancy, such as painful muscle spasms (tet-any) and seizures. METHODS: We reported a case of HSH involving a 10-year-old male patient from a Han Chinese family. He was admitted due to recurrent convulsions experienced over the past two years. The patient's initial episode occurred two years prior, when he collapsed without apparent cause and exhibited limb numbness, convulsions, and a disordered state of consciousness, accompanied by hypocalcemia. Cranial CT scans revealed multiple symmetrical calcifications in the basal ganglia, corona radiata, and cerebellar dentate nucleus. RESULTS: During the hospital stay, the patient was administered the following treatments: Calcium Carbonate and Vitamin D3 Tablets (1.5 g of calcium carbonate and 125 IU of Vitamin D3 per tablet, 1 tablet/time) once daily, Calcitriol Soft Capsules (0.25 µg of calcitriol per capsule, 1 capsule/time) twice daily, Potassium Chloride Sustained-release Tablets (0.5 g of potassium chloride per tablet, 1 tablet/time) thrice daily, Potassium Aspartate and Mag-nesium Aspartate Tablets (158 mg of potassium aspartate and 140 mg of magnesium aspartate per tablet, 1 tablet/ time) thrice daily, and intravenous infusions of Magnesium Sulfate Injection (2.5 g/time) twice daily. After three days in the hospital, the patient's initial symptoms subsided, resulting in discharge with a prescription of ongoing oral medications including Calcium Carbonate and Vitamin D3 Tablets, Calcitriol Soft Capsules, and Potassium Aspartate and Magnesium Aspartate Tablets, with the same usage and dosage as the above three drugs. A month subsequent, the serum levels of Mg2+, Ca2+, potassium (K+), and phosphorus were 0.96 mmol/L, 2.52 mmol/L, 4.06 mmol/L, and 1.63 mmol/L, respectively. CONCLUSIONS: Primary HSH is an uncommon manifestation of parathyroid hypoplasia, clinically characterized by low levels of Mg2+, Ca2+, and K+ in the blood. Our findings serve to enrich and consolidate the knowledge for future case studies and follow-up investigations.

Voriconazole-induced visual abnormality based on drug interaction between voriconazole and esomeprazole: A case report.

We report a case of voriconazole-induced visual abnormality based on drug interaction of voriconazole and esomeprazole, therapeutic drug monitoring, and optimal therapy. An 81-year-old male developed visual abnormality after the blood concentration of voriconazole was up to 6.47 mg/L induced by coadministration with esomeprazole. Voriconazole is a substrate of multiple CYP450 isoenzymes including CYP2C19 (the major route), CYP3A4, and CYP2C9. Esomeprazole, a proton pump inhibitor (PPI), is also converted to inactive metabolites through CYP3A4 and CYP2C19-mediated metabolism, and is also a CYP2C19 inhibitor. The coadministration with esomeprazole inhibited the metabolism of voriconazole via CYP2C19 and promoted the elevation of voriconazole blood concentration beyond the minimum toxic level (5.5 mg/L). According to the pharmacist's advice, the adverse effects of visual abnormalities in the patient disappeared after the clinician reduced voriconazole dosage by 50% when other medication schedules remained unchanged. Therefore, therapeutic drug monitoring of voriconazole should be considered in patients receiving PPIs, especially esomeprazole, in order to adjust the dosage in time and achieve optimal therapeutic response and minimal adverse reaction.

Analgesia with reduced incidence of adverse reactions using flurbiprofen axetil in combination with half standard-dose opioids in primary total knee arthroplasty.

OBJECTIVES: To determine the analgesic effect of flurbiprofen axetil (FBA) combined with half standard-dose opioids in patients undergoing primary unilateral total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 100 patients undergoing primary TKA were randomly divided into two groups, namely a control group and an experimental group, with 50 patients in each group. All patients received the same dose of FBA in the form of a patient-controlled intravenous analgesia but in the control group this was combined with a standard-dose of opioids and in the experimental group with a half standard-dose of opioids. RESULTS: A visual analogue scale, used to assess the level of pain 8 hours, 48 hours, and 5 days after TKA, showed that pain relief in the experimental group was equal to that in the control group (difference non-significant: p > 0.05). The knee flexion and extension activity in both groups reached target levels on the fifth day after TKA where differences were also not significant: p > 0.05. The incidence of nausea and vomiting after TKA in the experimental group was significantly less than in the control group (p < 0.05). CONCLUSION: The analgesic effect of FBA in combination with half standard-dose opioids was similar to that of FBA in combination with conventional standard-dose opioids, but the incidence of adverse effects involving nausea/vomiting in the experimental group were significantly reduced.

Legionella micdadei Aquaticum Infection: a Case Report and Literature Review.

BACKGROUND: The goal of the study was to analyze the clinical characteristics of Legionella cases caused by Legionella micdadei and explore the diagnosis and treatment. METHODS: The pathogen was identified by routine isolation and culture, biochemical identification, serum agglutination test, mass spectrometry identification, and routine PCR. Combined with the related literature review, the clinical diagnosis and treatment of Legionella micdadei were analyzed. RESULTS: The patient suffered from pulmonary infection caused by Legionella micdadei. After treatment with moxi-floxacin for 2 weeks, the body temperature dropped and the shadow of the lung was completely absorbed after 2 months. Combined with literature analysis, 8 cases of Legionella micetidis, including 7 males and 1 female, aged from 27 to 57 years old, 6 cases with basic diseases, which were treated with azithromycin, erythromycin or levofloxacin, and all of them achieved good therapeutic effect. CONCLUSIONS: The detection of Legionella should be strengthened in patients with pneumonia whose symptoms have no obvious improvement after antibiotic treatment. Azithromycin, erythromycin or levofloxacin are effective in the treatment of Legionella spp.

Liver failure caused by intravenous amiodarone and effective intervention measures: A case report.

WHAT IS KNOWN AND OBJECTIVE: We present a case of intravenous amiodarone-induced liver injury, pharmacy monitoring and its therapy. CASE SUMMARY: A 76-year-old male patient developed acute liver injury 24 h after starting intravenous amiodarone. His liver enzymes improved after discontinuing amiodarone and anti-inflammatory liver therapy, which used reduced glutathione, magnesium isoglycyrrhizinate and ademetionine1,4-butanedisulfonate for injection. WHAT IS NEW AND CONCLUSION: Amiodarone is a highly effective antiarrhythmic agent for the treatment and prevention of atrial and ventricular arrhythmias. Acute liver damage after intravenous amiodarone is rare but potentially harmful. Amiodarone loading should be adapted to the necessity of an immediate effect of the drug, and liver function should be monitored closely in critically ill patients. Timely stopped suspected drug and anti-inflammatory liver therapy may reduce the occurrence of drug-induced diseases.

Constant-wavelength synchronous fluorescence spectrometry for simultaneous and rapid determination of five polycyclic aromatic hydrocarbon residues in dairy products.

A new method for simultaneously determining five polycyclic aromatic hydrocarbons (PAHs) (fluorene, benzofluorene, pyrene, benzo(a)pyrene, and perylene) in dairy products using constant-wavelength synchronous fluorescence spectrometry (CWSFS) was established in this study. Acetonitrile was chosen as the extraction solvent to extract the five PAHs from the dairy products, and an ultrasound extraction method was adopted. The supernatants were filtered using a 0.45-µm microporous filter membrane and concentrated to dryness with a nitrogen dryer. The extracts were then re-dissolved in cyclohexane for analysis. To overcome interference from the background matrix and between PAHs, the difference in wavelength (Δλ) at 40 nm was chosen for CWSFS scanning. With only one single scan, the five PAHs in dairy products could be distinguished and determined using the standard curve method without the need for previous chromatographic separation of the analyte solution. Detection limits of fluorene, benzofluorene, pyrene, benzo(a)pyrene, and perylene were 0.0051 µg·L-1 , 0.016 µg·L-1 , 0.021 µg·L-1 , 0.0056 µg·L-1 , and 0.0062 µg·L-1 , respectively. Recoveries were between 85.60% and 98.42%. These five PAHs in dairy products were determined with good results and therefore expected to be a routine detection method for PAHs in dairy products.

Fibroblast Growth Factor (FGF) Signaling Protects Against Acute Pancreatitis-Induced Damage by Modulating Inflammatory Responses.

BACKGROUND Acute pancreatitis (AP) is a symptom of sudden pancreas inflammation, which causes patients severe suffering. In general, fibroblast growth factor (FGF) levels are increased and amylase and lipase activities are elevated during AP pathogenesis, but protein concentration are low. However, the mechanism through which FGF signaling regulates AP pathogenesis remains elusive. MATERIAL AND METHODS The concentrations of PGE2, TNF-alpha, sCRP, FGF1, and FGF2 in the serum samples of the AP group and healthy control group were detected by enzyme-linked immunosorbent assay. In addition, IkappaBalpha and p-IkappaBalpha levels were analyzed in the serum samples. Subsequently, the AP rat model was established, and FGF1, FGF2, anti-FGF1, and anti-FGF2 antibodies and Bay11-7082 were injected into AP rats. TNF-alpha, PAI-1 JNK, p-JNK, IkappaBalpha, and p-IkappaBalpha levels were also examined. RESULTS Results showed that levels of PGE2, TNF-alpha, sCRP, p-IkappaBalpha, FGF1, and FGF2, as well as amylase and lipase activity were increased in patients with AP compared with those in healthy people. In addition, protein concentrations were lower in patients with AP than in the healthy group. Activation of FGF signaling by injecting FGF1 or FGF2 also inhibited AP-induced inflammation response in the pancreas and increased amylase and lipase activities, as well as protein concentration. However, the injection of FGF1 and FGF2 antibodies accelerated AP-mediated inflammation responses in the serum. In addition, Bay11-7082 injection inhibited AP activation of inflammation response and amylase and lipase activities. Protein concentration were also increased in AP rats. CONCLUSIONS FGF signaling protects against AP-mediated damage by inhibition of AP-activating inflammatory responses.

An Electrochemical Sense Array Based on Aptamer and Biotin-Avidin System for the Selective Detection of Glucagon-Like Peptide-1.

BACKGROUND: GLP-1 as an incretin, has the ability to decrease blood sugar levels in a glucose-dependent manner by enhancing the secretion of insulin. Besides the insulinotropic effects, GLP-1 has been associated with numerous regulatory and protective effects. Thus, the action of GLP-1 is preserved in patients with type 2 diabetes and substantial pharmaceutical research has therefore been directed towards the development of GLP-1-based treatment. METHODS: In this work, we reported an electrochemical sense array based on the aptamer and biotin-avidin system for the detection of glucagon-like peptide-1 (GLP-1). The sense array employed a "stem-loop" conformation ap-tamer which was immobilized on the electrode of the 16-unit gold array via pre-labeled thiol group (-SH). Pre-labeled biotin serves as an affinity tag for the binding of avidin-horseradish peroxidase (avidin-HRP). The stem-loop structure of the aptamer kept the biotin from being approached by a bulky avidin-HRP by means of the steric hindrance. After the interaction of the target (GLP-1) and the aptamer, the aptamer would undergo a significant conformational change to force biotin away from the electrode, giving the avidin-HRP easy access to the labeled biotin. The HRP in the substrate could sensitively transduce the concentration of GLP-1 into the electrical signals, which were then measured by electrochemical technology of cyclic voltammetry and amperometric i-t curve. RESULTS: Under the optimal experimental conditions, the proposed sense array for GLP-1 had a good linear relationship from 0.1 pmol/L to 20 pmol/L with a detection limit of 0.05 pmol/L and can be used to accurately detect the GLP-1 in serum. CONCLUSIONS: The experimental results show that GLP-1 could be selectively detected by the electrochemical sense array, indicating that the proposed sense array based on the biotin-avidin system and the stem-loop aptamer has great potential in the detection of GLP-1.

Nitrogen-doped carbon dots as a ratiometric fluorescent probe for determination of the activity of acid phosphatase, for inhibitor screening, and for intracellular imaging.

The author describe a method for preparation of green fluorescent nitrogen-doped carbon dots (N-CDs) through hydrothermal treatment of a mixture of lotus leaf juice and ethylenediamine (EDA). The N-CDs have uniform size, good dispersibility and water solubility. Under 316 and 366 nm photoexcitation, they show dual fluorescence with emission peaks at 415 and 509 nm, respectively. They are positively charge and display low cytotoxicity. This makes them an excellent choice for fluorometric assays and for bioimaging. A ratiometric assay was developed for the determination of the activity of acid phosphatase (ACP). It is based on the aggregation- induced quenching (AIQ) of the fluorescence of the N-CDs by sodium hexametaphosphate (NaPO3)6. Enzymatic hydrolysis of (NaPO3)6 by ACP leads to the disintegration of (NaPO3)6 and to the restoration of fluorescence. The measurement of the ratio of fluorescence at two wavelengths (415 and 509 nm), background interference and fluctuating signals can be widely eliminated. The method works in the 1-50 U·L-1 ACP activity range and has a detection limit of 0.43 U·L-1. It was successfully applied (a) to the determination of ACP in spiked serum samples, (b) to ACP inhibitor screening, and (c) to imaging of ACP in HePG2 cells. Graphical abstract Schematic presentation of the synthesis of nitrogen-doped carbon dots (N-CDs), and their application to the ratiometric fluorometric determination of acid phosphatase (ACP) based on the aggregation-induced quenching and enzymatic hydrolysis.

The Relationship between Trypsin/Calcitonin Gene Related Peptide (CGRP) in Serum and Acute Pancreatitis (AP).

BACKGROUND: Activation of trypsin from proteolytic cleavage of trypsinogen in the pancreas can lead to acute pancreatitis. Calcitonin gene related peptide (CGRP) from both peripheral and central neurons is involved in a variety of physiological/pathophysiological processes, especially sensory (nociceptive) and efferent (effector) functions. To better understand the change of trypsin/CGRP in acute pancreatitis, the study investigated the serum level of trypsin/CGRP in patients with acute pancreatitis. METHODS: The study investigated 140 patients with acute pancreatitis, including 72 cases of biliary acute pancreatitis, 60 cases of hyperlipidemic acute pancreatitis, and 8 cases of idiopathic acute pancreatitis. Sixty volunteers acted as the normal control group. The levels of trypsin and CGRP in serum were analyzed. RESULTS: The serum levels of trypsin and CGRP in males with acute pancreatitis were higher than in females, but there was no statistical difference (p > 0.05). However, the serum levels of trypsin and CGRP in different types of acute pancreatitis were significantly higher than controls (p < 0.001), and the level of trypsin and CGRP in serum of patients with inflammation effusion was significantly higher than patients without inflammation effusion (p < 0.001). In addition, the serum levels of trypsin and CGRP in patients with I-II, III, IVA and IVB acute pancreatitis were higher than controls (p < 0.001). CONCLUSIONS: According to the results, we concluded that the trypsin and CGRP in serum can act as a new detection index of acute pancreatitis occurring. The serum levels of trypsin and CGRP in patients with acute pancreatitis is able to determine whether inflammation effusion happens.

A signal-on ratiometric fluorometric heparin assay based on the direct interaction between amino-modified carbon dots and DNA.

Amino-modified carbon dots (C-dots) with positively charged surface were prepared. They display strong blue fluorescence and are shown to act as quenchers of the green fluorescence of FAM-labeled ssDNA such as the F-probe used in this work that was immobilized on the C-dots. On the addition of highly negatively charged heparin (Hep), it will interact with the C-dots and displace the F-probe from C-dots. Once the F-probe is displaced by Hep, its green fluorescence is restored. The intrinsic blue fluorescence of the C-dots remains stable after addition of Hep. Thus, a signal-on ratiometric fluorometric assay was developed for the ultra-sensitive detection of Hep. The underlying mechanisms of quenching and recovery are discussed. Under optimized conditions, the recovery of the ratiometric fluorescence of the system composed of C-dots and quenched F-probe is proportional to the Hep concentration in the range of 0.01-2.0 µg·mL-1 (= 0.00125-0.25 U·mL-1). The method was successfully applied to the determination of Hep in spiked serum samples. Graphical abstract Schematic of a signal-on ratiometric fluorometric method for the ultra-sensitive detection of heparin on the basis of the displacement and fluorescence enhancement of adsorbed FAM-labeled ssDNA from amino-modified carbon dots (C-dots) by heparin.

Signal-on fluorescent sensor based on N-CQDs for the detection of glutathione in human serum and pharmaceutic preparation.

Nitrogen-doped carbon quantum dots (N-CQDs) with citric acid and ethylenediamine as raw materials were synthesized by an efficient one-step strategy. The N-CQDs showed a special property that the fluorescence was quenched by Fe3+. The quenched fluorescence of N-CQDs could be recovered by glutathione (GSH). Therefore, a "signal-on" fluorescent sensor was developed to detect GSH. The fluorescent sensor could favorably avoid the interference of ascorbic acid, dopamine, glucose, oxidized glutathione, and other amino acids in the detecting process of GSH. The proposed sensor showed a great feature that GSH can be accurately detected in the range from 0.001 to 0.1 mol/L and can be applied to detect GSH in the human serum. Therefore, the proposed method has a promising application for monitoring the blood drug concentration of GSH in clinical studies.

Muscle Strength Decline Caused by Eperisone Hydrochloride: A Case Report.

A 65-year-old female with thoracic spinal stenosis and incomplete paraplegia underwent T11-T12 posterior thoracic interbody fusion. During postoperative rehabilitation, she experienced thigh pain, involuntary lower limb convulsions, and muscle fatigue. Despite being prescribed eperisone hydrochloride for relief, her muscle strength decreased after 14 doses. This adverse effect, not listed in the latest Chinese medication instructions, subsided 4 days after discontinuation. This case suggests eperisone hydrochloride potentially caused reversible muscle strength decline, highlighting its potential unsuitability for incomplete paraplegia patients due to possible further muscle strength reduction. We propose updating the medication instructions to alert clinicians to this risk.

Sensitive electrochemical immunoassay of metallothionein-3 based on K3[Fe(CN)6] as a redox-active signal and C-dots/Nafion film for antibody immobilization.

The fabrication of a facile, sensitive, and versatile immunosensor for the quantification of metallothionein-3 (MT-3) is proposed in this work. The K3[Fe(CN)6]-chitosan-glutaraldehyde (K-CS-GA) conjugate prepared from K3[Fe(CN)6], chitosan and glutaraldehyde was employed as the redox-active signal source. Carbon nanodots (C-dots) were coupled with Nafion to form the nanocomposite architecture layer to carry antibodies (Abs). C-dots enhanced the electrochemical response of the proposed immunosensor to improve the detection sensitivity. The fabrication steps of the immunosensor were characterized using differential pulse voltammetry (DPV) and cyclic voltammetry (CV). Antigen determination was achieved via the decreased current response of the K3[Fe(CN)6] caused by the insulated coupled antigen. The detected signals were proportional to the logarithm of the concentrations of MT-3 ranging from 5 pg mL(-1) to 20 ng mL(-1) with a detection limit of 2.5 pg mL(-1) in PBS. The proposed immunosensor showed high sensitivity, good selectivity and reproducibility. Furthermore, detection results using real serum samples showed the immunosensor's potential applications in clinical diagnostics.

Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence.

Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease of the pancreas, with clinical management determined by the severity of the disease. Diagnosis, severity prediction, and prognosis assessment of AP typically involve the use of imaging technologies, such as computed tomography, magnetic resonance imaging, and ultrasound, and scoring systems, including Ranson, Acute Physiology and Chronic Health Evaluation II, and Bedside Index for Severity in AP scores. Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications. Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild, moderate, or severe categories, guiding treatment decisions, such as intensive care unit admission, early enteral feeding, and antibiotic use. Despite the central role of imaging technologies and scoring systems in AP management, these methods have limitations in terms of accuracy, reproducibility, practicality and economics. Recent advancements of artificial intelligence (AI) provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data. AI algorithms can analyze large amounts of clinical and imaging data, identify scoring system patterns, and predict the clinical course of disease. AI-based models have shown promising results in predicting the severity and mortality of AP, but further validation and standardization are required before widespread clinical application. In addition, understanding the correlation between these three technologies will aid in developing new methods that can accurately, sensitively, and specifically be used in the diagnosis, severity prediction, and prognosis assessment of AP through complementary advantages.

Synthesis of curcumin-quaternized carbon quantum dots with enhanced broad-spectrum antibacterial activity for promoting infected wound healing.

With the increasing incidence of multidrug-resistant antibacterial infections worldwide, developing new antibiotics to fight bacterial infections is urgent. The natural product curcumin has favorable antioxidant and anti-inflammatory effects, but poor water solubility greatly limits its bioavailability, bioactivity and clinical application. Herein, to improve the bioactivity and enhance broad-spectrum antibacterial of curcumin, we synthesized quaternized carbon quantum dots (Q-CQDs) derived from the natural curcumin and 2,3-epoxypropyltrimethylammonium chloride (GTA) with highly solubility and stability by "double-thermal" method. It is proposed that the surfaces of Q-CQDs would still remain the active groups of curcumin and quaternary ammonium to boost the antibacterial activity. Experimental results reveal that the Q-CQDs possess excellent broad-spectrum antibacterial activity and the activity is significantly higher than that of natural curcumin. Investigation of the antibacterial mechanism of Q-CQDs showed that Q-CQDs functionalized with -N+(CH3)3 had strong adherence behavior on the bacterial cell membrane. Like a "Trojan Horse", the bacterial cells lost their integrity, and the entry of Q-CQDs caused ROS generation and the efflux of cytoplasmic DNA and RNA, leading to the death of bacteria. The bacterial resistance of Q-CQDs was not observed, and Q-CQDs did not cause hemolysis and cytotoxicity. In vivo, the S. aureus-infected wounds, E. coli-infected wounds and mixed bacteria infected wounds healing tests with mice model indicate that Q-CQDs inhibited the bacterial population at the wound site, reduced inflammation and promoted wound healing. These results suggested that the Q-CQDs are a potential antibacterial candidate for clinical infected-wound healing applications and even bacteria resistant infections.

Quaternized carbon quantum dots with broad-spectrum antibacterial activity for the treatment of wounds infected with mixed bacteria.

Bacterial resistance to antibiotics have become one of the most severe threats in global public health, so the development of new-style antimicrobial agents is urgent. In this work, quaternized carbon quantum dots (qCQDs) with broad-spectrum antibacterial activity were synthesized by a simple green "one-pot" method using dimethyl diallyl ammonium chloride and glucose as reaction precursors. The qCQDs displayed satisfactory antibacterial activity against both Gram-positive and gram-negative bacteria. In rat models of wounds infected with mixed bacteria, qCQDs obviously restored the weight of rats, significantly reduced the death of rats from severe infection, and promoted the recovery and healing of infected wounds. Biosafety tests confirmed that qCQDs had no obvious toxic and side effects during the testing stage. The analysis of quantitative proteomics revealed that qCQDs mainly acted on ribosomal proteins in Staphylococcus aureus (Gram-positive bacteria) and significantly down-regulated proteins associated with citrate cycle in Escherichia coli (Gram-negative bacteria). Meanwhile, real-time quantitative PCR confirmed that the variation trend of genes corresponding to the proteins associated with ribosome and citrate cycle was consistent with the proteomic results after treatment of qCQDs, suggesting that qCQDs has a new antibacterial mechanism which is different from the reported carbon quantum dots with antibacterial action. STATEMENT OF SIGNIFICANCE: With the development of the research on carbon quantum dots, the application of carbon quantum dots in the field of medicine has attracted extensive attention. In this paper, quaternized carbon quantum dots (qCQDs) with antimicrobial activity prepared by specific methods were studied, including antimicrobial spectrum, antimicrobial mechanism and in vivo antimicrobial application. The antimicrobial mechanism of qCQDs was studied by proteomics and RT-qRCR, and the different mechanisms of qCQDs against Gram-positive and Gram-negative bacteria were also found. This study provides a research foundation for the application of carbon quantum dots in antimicrobial field, and also expands the application range of carbon quantum dots in medicine field.

A Novel M6A-Related Genes Signature Can Impact the Immune Status and Predict the Prognosis and Drug Sensitivity of Lung Adenocarcinoma.

Lung adenocarcinoma (LUAD) is a primary cause of cancer-related death around the world and has a poor outcome and high incidence. Treatment options are, however, restricted. One of the most critical factors in cancer and metastasis is the N6-methyladenine (m6A) alteration on RNA. This modification could alter gene expression and even function at numerous levels, such as the stability, translocation and translation of RNA splicing. This study aimed to construct an m6A-related genes signature to accurately predict the prognosis of LUAD patients. From TCGA datasets, the LUAD patient data and m6A-related genes were retrieved. LUAD patients' mutational features and differentially expressed genes (DEGs) were investigated. An univariate and LASSO model with m6A-related genes were constructed for the prediction of outcomes in LUAD. It was possible to develop a prognostic nomogram that could quantitatively predict LUAD patients' overall survival chances at 1, 3, and 5 years. Research into biological processes and cell pathways was carried out using GSEA. This study found six m6A-related DEGs in LUAD patients, and three of these DEGs(HNRNPC, IGFBP3 and IGF2BP1) were linked to the clinical outcomes of LUAD patients. We found that the overall survival rate for all LUAD patients with high-risk subgroup was considerably lower. According to ROC curves, the prognostic signature demonstrated a high degree of accuracy in predicting future outcomes. In addition, we created a novel nomogram achieved great accuracy with this one as well. The researchers also found that the novel signature might favorably modulate the immune response, and high-risk scores samples were more susceptible to numerous chemotherapeutic medicines. Overall, we developed a m6A-related gene prognostic signature that effectively predicted outcomes of LUAD patients and gave an immunological perspective for creating customized therapeutics.