Involvement of the Laboratory Department in MDT Discussion for the Diagnosis of Unexplained Leukocytosis.

BACKGROUND: This paper reports the diagnostic process of a case involving an 86-year-old male patient who was admitted with cough, sputum, and fever, accompanied by persistent leukocytosis. METHODS: Through a multidisciplinary team (MDT) discussion, the laboratory department identified elevated ferritin levels, prompting clinical consideration of potential malignancy. RESULTS: Further investigations confirmed the diagnosis of thyroid cancer with multiple lung metastases. CONCLUSIONS: This case highlights the potential value of ferritin in tumor diagnosis, offering new insights into the etiology of abnormal leukocyte elevation. Additionally, the active involvement of the laboratory department in MDT discussions proves to be crucial for diagnosing challenging cases.

Difficult Blood Typing Caused by Rouleaux Agglutination in Patient with Acute Brain Trauma: a Case Report.

BACKGROUND: Rouleaux agglutination is a common cause of difficult blood typing, but it is rarely reported in patients with acute brain trauma. METHODS: This article describes a 69-year-old male with head injury who was admitted to the hospital. Blood typing showed type O, Rh(D) positive, but the Rh(D) control was also positive. After ruling out the possibility of the patient having abnormal autoantibodies, it was suspected that rouleaux agglutination might be the cause. Microscopic examination of the specimen revealed rouleaux agglutination, which was believed to be the cause of the false-positive Rh(D) control result. The patient's red blood cells were treated with physiological saline and retested by microcolumn gel card testing. RESULTS: The retest showed negative Rh(D) control results, indicating normal results. The patient subsequently received normal blood transfusion. CONCLUSIONS: Laboratory personnel should be aware of the possibility of difficult blood typing caused by rouleaux agglutination in various diseases, especially in relatively rare traumatic diseases.

MiR-141 targets ZEB2 to suppress HCC progression.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide. Increasing evidence suggests that microRNAs (miRNAs) are associated with HCC tumorigenesis. The present study was designed to define the role of miR-141 in HCC. The expression of miR-141 was significantly decreased in four HCC cell lines. Overexpression of miR-141 suppressed both the growth and the motility of HCC cells. Furthermore, we identified zinc finger E-box binding homeobox 2 (ZEB2) as a target of miR-141 and miR-141 functioned as a tumor suppressor via ZEB2 targeting in HCC. These data provide a novel potential therapeutic target for HCC treatment.

Advanced glycation end products promote differentiation of CD4(+) T helper cells toward pro-inflammatory response.

This study investigated the effect of advanced glycation end products (AGEs) on differentiation of naïve CD4(+) T cells and the role of the receptor of AGEs (RAGE) and peroxisome proliferator-activated receptors (PPARs) activity in the process in order to gain insight into the mechanism of immunological disorders in diabetes. AGEs were prepared by the reaction of bovine serum albumin (BSA) with glucose. Human naïve CD4(+) T cells, enriched from blood of healthy adult volunteers with negative selection assay, were cultured in vitro and treated with various agents including AGEs, BSA, high glucose, PGJ2 and PD68235 for indicated time. In short hairpin (sh) RNA knock-down experiment, naïve CD4(+) T cells were transduced with media containing shRNA-lentivirus generated from lentiviral packaging cell line, Lent-X(TM) 293 T cells. Surface and intracellular cytokine stainings were used for examination of CD4(+) T cell phenotypes, and real-time PCR and Western blotting for detection of transcription factor mRNA and protein expression, respectively. The suppressive function of regulatory T (Treg) cells was determined by a [(3)H]-thymidine incorporation assay. The results showed that AGEs induced higher pro-inflammatory Th1/Th17 cells differentiated from naïve CD4(+) T cells than the controls, whereas did not affect anti-inflammatory Treg cells. However, AGEs eliminated suppressive function of Treg cells. In addition, AGEs increased RAGE mRNA expression in naïve CD4(+) T cells, and RAGE knock-down by shRNA eliminated the effect of AGEs on the differentiation of CD4(+) T cells and the reduction of suppressive function of Treg cells. Furthermore, AGEs inhibited the mRNA expression of PPARγ, not PPARα PPARγ agonist, PGJ2, inhibited the effect of AGEs on naïve CD4(+) T cell differentiation and reversed the AGE-reduced suppressive function of Treg cells; on the other hand, PPARγ antagonist, PD68235, attenuated the blocking effect of RAGE shRNA on the role of AGEs. It was concluded that AGEs may promote CD4(+) T cells development toward pro-inflammatory state, which is associated with increased RAGE mRNA expression and reduced PPARγ activity.

High-altitude hypoxia promotes BRD4-mediated activation of the Wnt/ß-catenin pathway and disruption of intestinal barrier.

Hypobaric hypoxia, commonly experienced at elevated altitudes, presents significant physiological challenges. Our investigation is centered on the impact of the bromodomain protein 4 (BRD4) under these conditions, especially its interaction with the Wnt/ß-Catenin pathway and resultant effects on glycolytic inflammation and intestinal barrier stability. By combining transcriptome sequencing with bioinformatics, we identified BRD4's key role in hypoxia-related intestinal anomalies. Clinical parameters of altitude sickness patients, including serum BRD4 levels, inflammatory markers, and barrier integrity metrics, were scrutinized. In vitro studies using CCD 841 CoN cells depicted expression changes in BRD4, Interleukin (IL)-1ß, IL-6, and ß-Catenin. Transepithelial electrical resistance (TEER) and FD4 analyses assessed barrier resilience. Hypoxia-induced mouse models, analyzed via H&E staining and Western blot, provided insights into barrier and protein alterations. Under hypoxic conditions, marked BRD4 expression variations emerged. Elevated serum BRD4 in patients coincided with intensified Wnt signaling, inflammation, and barrier deterioration. In vitro, findings showed hypoxia-induced upregulation of BRD4 and inflammatory markers but a decline in Occludin and ZO1, affecting barrier strength-effects mitigated by BRD4 inhibition. Mouse models echoed these patterns, linking BRD4 upregulation in hypoxia to barrier perturbations. Hypobaric hypoxia-induced BRD4 upregulation disrupts the Wnt/ß-Catenin signaling, sparking glycolysis-fueled inflammation and weakening intestinal tight junctions and barrier degradation.

In silico evidence implicating novel mechanisms of Prunella vulgaris L. as a potential botanical drug against COVID-19-associated acute kidney injury.

COVID-19-associated acute kidney injury (COVID-19 AKI) is an independent risk factor for in-hospital mortality and has the potential to progress to chronic kidney disease. Prunella vulgaris L., a traditional Chinese herb that has been used for the treatment of a variety of kidney diseases for centuries, could have the potential to treat this complication. In this study, we studied the potential protective role of Prunella vulgaris in COVID-19 AKI and explored its specific mechanisms applied by network pharmacology and bioinformatics methods. The combination of the protein-protein interaction network and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment -target gene network revealed eight key target genes (VEGFA, ICAM1, IL6, CXCL8, IL1B, CCL2, IL10 and RELA). Molecular docking showed that all these eight gene-encoded proteins could be effectively bound to three major active compounds (quercetin, luteolin and kaempferol), thus becoming potential therapeutic targets. Molecular dynamics simulation also supports the binding stability of RELA-encoded protein with quercetin and luteolin. Together, our data suggest that IL6, VEGFA, and RELA could be the potential drug targets by inhibiting the NF-κB signaling pathway. Our in silico studies shed new insights into P. vulgaris and its ingredients, e.g., quercetin, as potential botanical drugs against COVID-19 AKI, and warrant further studies on efficacy and mechanisms.

Long Non-Coding RNA ZEB2-AS1 Promotes Hepatocellular Carcinoma Progression by Regulating The miR-582-5p/FOXC1 Axis.

Objective: Long non-coding RNAs (lncRNAs) feature prominently in tumors. Reportedly, lncRNA zinc finger E-box-binding homeobox 2 antisense RNA 1 (ZEB2-AS1) is aberrantly expressed in a variety of tumors. The present study was aimed to explore ZEB2-AS1 functions and determine mechanism in hepatocellular carcinoma (HCC) progression. Materials and Methods: In this experimental study, expressions of ZEB2-AS1, microRNA (miR)-582-5p and forkhead box C1 (FOXC1) mRNA in HCC tissues and cell lines were detected via quantitative reveres transcription polymerase chain reaction (qRT-PCR). After establishing gain- and loss-of-functions models, cell counting kit-8, 5-bromo-2'-deoxyuridine (BrdU), Transwell assays and flow cytometry analysis were conducted to examine HCC cell multiplication, migration, invasion and apoptosis, respectively. The targeted relationship between miR-582- 5p and ZEB2-AS1 was verified via dual-luciferase reporter gene assay. Western blot was utilized for detecting FOXC1 expression in HCC cells after selectively regulating ZEB2-AS1 and miR-582-5p. Results: In HCC tissues and cells, ZEB2-AS1 expression was increased. High ZEB2-AS1 expression was related to relatively large tumor volume, increased tumor-node-metastasis (TNM) stage and positive lymph node metastasis of the patients. ZEB2-AS1 overexpression facilitated HCC cell multiplication, migration, invasion and suppressed apoptosis, while ZEB2-AS1 knock-down caused the opposite effects. It was also confirmed that ZEB2-AS1 could competitively bind with miR-582-5p to repress its expression, and indirectly up-regulate FOXC1 expression level in HCC cells. Conclusion: The current study revealed that ZEB2-AS1 was over-expressed in HCC tissues and cells. It also upregulated (FOXC1), through sponging miR-582-5p, to promote HCC progression. This provides new perspectives for elucidating the pathogenesis of HCC.

A Novel NR0B1 Gene Mutation Causes Different Phenotypes in Two Male Patients with Congenital Adrenal Hypoplasia.

X-linked congenital adrenal hypoplasia is characterised by the acute onset of primary adrenal insufficiency in infancy or early childhood and hypogonadotropic hypogonadism (HH) at puberty, arising from mutations of the nuclear receptor subfamily 0 group B member 1 (NR0B1) gene. This study investigated an extended family with two affected males (patient A: 23 years and patient B: 2 months old) and three carrier females. Sequencing analysis of the NR0B1 gene coding region from the family revealed a novel hemizygous deletion [c.604delT; p.(C202Afs*62)] in the two male patients. Furthermore, the patients' respective mothers and their common grandmother had this heterozygous mutation, but it was not present in the Human Gene Mutation Database. The two male patients showed inconsistent clinical features at onset, particularly in early childhood; however, it is possible that the younger patient will eventually show a delay of puberty, feminisation, and nonspermatogenesis in adulthood, similar to that in the older patient. Identification of a novel NR0B1 mutation in this family is important for the diagnosis and genetic counselling of children with primary adrenal insufficiency and HH, and will be helpful for predicting long-term clinical symptoms.

miR-140-3p Knockdown Suppresses Cell Proliferation and Fibrogenesis in Hepatic Stellate Cells via PTEN-Mediated AKT/mTOR Signaling.

PURPOSE: Liver fibrosis is a major cause of morbidity and mortality and the outcome of various chronic liver diseases. Activation of hepatic stellate cells (HSCs) is the key event in liver fibrosis. Studies have confirmed that miR-140-3p plays a potential regulatory effect on HSC activation. However, whether miR-140-3p mediates the liver fibrosis remains unknown. MATERIALS AND METHODS: Expression of miR-140-3p was detected by real-time quantitative PCR (qPCR). Cell proliferation was measured by MTT, while cell apoptosis rate was determined via flow cytometry. Western blot assay was used to detect the expression of cleaved PARP. The fibrogenic effect was evaluated by expression of α-smooth muscle actin and desmin. Functional experiments were performed in transforming growth factor ß1 (TGF-ß1)-induced HSC-T6 cells with transfection of anti-miR-140-3p and/or siPTEN. Target binding between miR-140-3p and PTEN was predicted by the TargetScan database and identified using luciferase reporter assay and RNA immunoprecipitation. RESULTS: TGF-ß1 induced the activation of HSC-T6 cells, and miR-140-3p expression varied according to HSC-T6 cell activation status. Knockdown of miR-140-3p reduced cell proliferation and the expressions of α-SMA and desmin, as well as increased apoptosis, in TGF-ß1-induced HSC-T6 cells, which could be blocked by PTEN silencing. Additionally, inactivation of the AKT/mTOR signaling pathway stimulated by miR-140-3p knockdown was abolished when silencing PTEN expression. PTEN was negatively regulated by miR-140-3p via direct binding in HSC-T6 cells. CONCLUSION: miR-140-3p is an important mediator in HSC-T6 cell activation, and miR-140-3p knockdown suppresses cell proliferation and fibrogenesis in TGF-ß1-induced HSC-T6 cells, indicating that miR-140-3p may be a potential novel molecular target for liver fibrosis.

[Allelopathic Effects and Allelochemicals of Myriophyllum elatinoides on Microcystis aeruginosa and Selenastrum capricornutum].

The allelopathic effects of Myriophyllum elatinoides on algal growth were investigated and potential allelochemicals secreted by Myriophyllum elatinoides were analyzed. Myriophyllum elatinoides were co-cultivated with different initial concentrations (105, 106, 107, 108, and 109 ind.·L-1) of Microcystis aeruginosa and Selenastrum capricornutum. The optical density of each group was measured daily. The results showed that 2.5 g·(200 mL)-1 of Myriophyllum elatinoides has significant inhibition effect on Microcystis aeruginosa growth with initial concentrations of 107 ind.·L-1 and 108 ind.·L-1. However, there was no significant inhibition on the growth of Selenastrum capricornutum. Through solvent extraction and GC-MS analysis, hexadecanoic acid was extracted and determined as an allelochemical in Myriophyllum elatinoides. Additionally, three potentially novel allelochemical compounds secreted by Myriophyllum elatinoides were determined as follows:3-ethyl-3-methylheptane, triethyl phosphate and dibutyl phthalate.

Primary hypoparathyroidism accompanied by rhabdomyolysis induced by infection: A case report.

BACKGROUND: Primary hypoparathyroidism (HPT) is rarely seen in the clinic, and it can be combined with rhabdomyolysis. There are few reports about this phenomenon. Therefore, it is significant to explore the etiology that is conducive to early diagnosis, timely treatment, and preventing the recurrence. CASE SUMMARY: A 63-year-old man was admitted to our hospital with a severe upper respiratory tract infection and progressing decreased myodynamia of the lower limbs. Blood tests showed creatine kinase > 32000 U/L, creatinine 207.8 µmol/L, calcium 1.28 mmol/L, myoglobin 558.7 ng/mL, and parathyroid hormone 0 pg/mL. He was diagnosed with primary HPT with rhabdomyolysis, and severe upper respiratory tract infection was considered to be the initial trigger. He responded well to supplementation of intravenous calcium gluconate and oral calcium as well as bedside hemodialysis, fluid hydration, infection control, protecting the liver, etc. Creatine kinase, myoglobin, and serum calcium returned to normal, and muscle strength improved significantly. Symptoms improved after symptomatic treatment. CONCLUSION: Severe infection should be prevented, which is the key cause of rhabdomyolysis in patients with HPT.

Generation and application of ssDNA aptamers against glycolipid antigen ManLAM of Mycobacterium tuberculosis for TB diagnosis.

The development of effective Mycobacterial antigen diagnostic reagents remains a high priority. Mannose-capped lipoarabinomannan (ManLAM) is a lipoglycan serving as a major cell wall component. ManLAM is also an early released antigen in the blood circulation system during Mycobacteria tuberculosis (M.tb) infection and is a perfect target antigen for TB diagnosis. In this study, ssDNA aptamers "antibodies" against ManLAM of the predominant clinical epidemic M.tb Beijing genotype strains were generated by the Systematic Evolution of Ligands by Exponential Enrichment (SELEX) technique. The selected single aptamer T9 demonstrated the highest specificity and binding affinity, with an equilibrium dissociation constant (Kd) of 668 ± 159 nmol/L. We further detected ManLAM antigens in serum and sputum samples from active pulmonary tuberculosis (aPTB) patients, extrapulmonary TB (EPTB) patients and healthy donors by using a T9 based enzyme-linked oligonucleotide assay (ELONA). The results showed that the specificity and sensitivity were 95.31% and 83.00% (for 100 aPTB serum samples), 98.70% and 92.71% (for 96 aPTB sputum samples), and 94.44% and 88.71% (for 62 EPTB serum samples), respectively. A good correlation was observed between the T9 aptamer-based ELONA and the clinical T-SPOT.TB. Thus, T9 based ELONA has potentials for diagnosis of TB, including inactive TB, smear-negative TB, EPTB, and TB with immunodeficiency, and assist the diagnosis of LTBI albeit it could not distinguish LTBI and active TB.

[Concentrations and influencing factors of gaseous polycyclic aromatic hydrocarbons in residential air in Beijing].

7 gas phase PAHs components in indoor air collected from 38 families were investigated by modified passive air samplers in Beijing areas during the local heating and non-heating seasons, and the influencing factors were discussed as well. The analytical results indicate that the gasous PAHs in local indoor air are dominated by 2 and 3 rings compounds, the mean concentrations for the 7 individual gaseous components range from 1 to 40 ng/m3, and the average concentration of total gaseous PAHs is about 100 ng/m3. There is no significant difference in total gaseous PAHs concentrations between the heating and the non-heating seasons, while some apparent seasonal changes occur in ACY and FLA concentrations. Compared with heating season, contribution of 2 rings compounds decreases while the proportions of 3 and 4 rings species increase during the non-heating season. Based on household activity questionnaires and actual analytical concentrations, the main influencing factors accounted for gaseous PAHs in indoor air, identified by multifactor analysis of variance, include cigarette smoking, use of moth ball, intensity of draft, cuisine frequency and built age.

[Expressions of CD147 and matrix metalloproteinase-2 in breast cancer and their correlations to prognosis].

BACKGROUND & OBJECTIVE: Matrix metalloproteinases (MMPs) play an important role in invasion and metastasis of cancers. CD147, an inducer of MMPs, can activate the expression of multiple MMPs in cancer cells and interstitial cells. This study was to investigate the correlations of CD147 and MMP-2 expressions in tumor and adjacent tissue to metastasis, invasion, and prognosis of breast cancer. METHODS: Expressions of CD147 and MMP-2 in 112 specimens of breast cancer and adjacent tissue were detected by EnVision immunohistochemistry. RESULTS: Positive rate of CD147 was 49.1% in breast cancer tissues, and 0 in adjacent tissues and interstitial cells. Positive rate of MMP-2 was 33.1% in breast cancer tissues, and 53.6% in normal adjacent tissues. The intensity of MMP-2 staining in normal tissue was positively related with tumor size, lymph node metastasis, and clinical stage (P < 0.01). CD147 staining in cancer tissue was positively related with lymph node metastasis, estrogen receptor(ER) expression, and pathologic grade (P < 0.01). Univariate analysis indicated that the overall survival rate was significantly lower in patients with positive expression of CD147 or MMP-2 than in patients with negative expression (P < 0.05). Multivariate analysis showed that CD147 was a risk predictor; the higher expression of CD147, the shorter survival time of the patients. CONCLUSIONS: MMP-2 and its inducer CD147 maybe participate in invasion and metastasis of breast cancer. CD147 may be an independent prognostic factor and, when used in combination with pathologic grading and clinical staging, may increase accuracy of predicting prognosis of patients with breast cancer.

[Pioglitazone inhibits cardiac hypertrophy of rats in vitro and in vivo].

AIM: To investigate the effects of pioglitazone on cardiac hypertrophy in vitro and in vivo. METHODS: Angiotensin II was used to establish hypertrophy of cardiac myocytes and pioglitazone was applied to these myocytes in various dosages in vitro. ANP and BNP mRNA expression was evaluated by RT-PCR, and the rate of protein synthesis in CM by 3H-leucine incorporation in cardiac myocytes. Left ventricular hypertrophy was induced by incomplete ligation of abdominal aorta of rats and pioglitazone (20 mg x kg(-1). day(-1)) was administrated one week prior to the operation until 4 weeks after the operation. Cytokines mRNA expression in left ventricle was measured by RT-PCR, left ventricular wall thickness and myocyte diameter were determined by pathological method. RESULTS: Pioglitazone inhibited ANP and BNP mRNA expression and 3H-leucine incorporation in neonatal rat cardiac myocytes induced by angiotensin II in a dose-dependent manner in vitro. Furthermore, pioglitazone reduced the mRNA expression of proinflammatory cytokines, including interleukin-1 beta and cardiotrophin-1, and inhibited the pressure overload-induced increase in the ratio of heart weight to body weight, left ventricular wall thickness and myocyte diameter of rats in vivo. CONCLUSION: Pioglitazone inhibits cardiac hypertrophy of rats in vitro and in vivo, and may play a role in prevention and treatment of cardiovascular diseases characterized by cardiac hypertrophy in future.

[Study on Growth and Maturation of Megakaryocyte Progenitors In Vitro in Patients with Chronic Idiopathic Thrombocytopenic Purpura]

To investigate the growth and maturation of megakaryocyte progenitors in patients with chronic idiopathic thrombocytopenic purpura (CITP), plasma clot culture and GPIIIa monoclonal antibody and ABC immuno- histochemical kit were used to assay CFU-Meg and BFU-Meg, and the area and diameter of GPIIIa(+) cells were determined by image analyzer in 33 CITP cases. It was found that CFU-Meg and BFU-Meg were 39.27 +/- 21.44 and 5.62 +/- 3.93 per 2 x 10(5) MNC, respectively, in CITP patients, there were no significant differences with those in control group. While the area of GPIIIa(+) cells was (134.90 +/- 6.08) micro m(2) and diameter was (12.89 +/- 3.66) micro m, those were lower than those in control group. In patients with normal number of megakaryocytes on marrow smears, CFU-Meg and BFU-Meg were 19.43 +/- 7.28 and 4.67 +/- 1.53, respectively, the values were lower as compared to control group. The positive correlation was showed between the total megakaryocytic colonies and the number of megakaryocytes on marrow smears, r = 0.6503, and there was no correlation with blood platelet counts and course of disease. The results suggest that there was a maturation disturbance of megakaryocyte progenitor in CITP patients and lower proliferative potential in patients with normal megakaryocyte counts on marrow smears.