[Analysis of Clinical Characteristics and Prognostic Factors of Patients with Limited-Stage Mantle Cell Lymphoma].

OBJECTIVE: To investigate the clinical characteristics, prognostic factors, and treatment outcomes of patients with limited-stage (Ann Arbor stage I or II) mantle cell lymphoma (MCL). METHODS: Examining consecutive the clinical characteristics, treatment outcomes and prognostic factors of 47 patients with stage I or II MCL diagnosed in Affiliated Tumor Hospital of Guangxi Medical University from January 2005 to June 2020 were analyzed retrospectively. RESULTS: The median age of patients was 62(37-78) years old. 36 patients were male, accounting for 76.6% of the whole. Among these, 74.5% (n=35) of the diagnoses were estimated at II stage. According to Mantle cell lymphoma International Prognostic Index (MIPI), 28 patients (59.6%) were classified as low risk. Patients who received first-line treatment and could be evaluated received rituximab combined chemotherapy, chemotherapy alone, cytarabine containing chemotherapy or chemotherapy combined with local radiotherapy, the different first-line therapies did not affect the complete response (CR) rate of patients (P＞0.05). The median follow-up time was 81.5 months, the 5-year progression-free survival (PFS) was 37.4% and the 5-year overall survival (OS) rate was 80.6%. Multivariate analysis showed that Ki-67＞30% (P＜0.05) the independent adverse prognostic factor for PFS and OS. CONCLUSION: Limited-stage MCL is rare. Patients with limited-stage MCL had a better outcome than those with III-IV stage MCL. Patients with limited-stage MCL whose Ki-67≤30% had better PFS and OS.

A novel prognostic model for angioimmunoblastic T-cell lymphoma: A retrospective study of 55 cases.

OBJECTIVE: To explore prognostic factors and develop an accurate prognostic prediction model for angioimmunoblastic T-cell lymphoma (AITL). METHODS: Clinical data from Chinese patients with newly diagnosed AITL were retrospectively analysed. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier method survival curves; prognostic factors were determined using a Cox proportional hazards model. The sensitivity and specificity of the predicted survival rates were compared using area under the curve (AUC) of receiver operating characteristic (ROC) curves. RESULTS: The estimated 5-year OS and PFS of 55 eligible patients with AITL were 22% and 3%, respectively. Multivariate analysis showed that the presence of pneumonia, and serous cavity effusions at initial diagnosis were significant prognostic factors for OS. Based on AUC ROC values, our novel prognostic model was superior to IPI and PIT based models and suggested better diagnostic accuracy. CONCLUSIONS: Our prognostic model based on pneumonia, and serous cavity effusions at initial diagnosis enabled a balanced classification of AITL patients into different risk groups.

Diagnostic accuracy of pelvic magnetic resonance imaging for the assessment of bone marrow involvement in diffuse large B-cell lymphoma.

PURPOSE: We investigated the efficacy of pelvic magnetic resonance imaging (MRI) in the diagnosis of bone marrow involvement (BMinv) in diffuse large B-cell lymphoma (DLBCL) patients. PATIENTS AND METHODS: This was a retrospective study of data from a previous study (NCT02733887). We included 171 patients who underwent bone marrow biopsy (BMB) and bone marrow smear (BMS), pelvic MRI, and whole-body positron emission tomography-computed tomography (PET/CT) from January 2016 to December 2019 at a single center. BMB/BMS and whole-body PET/CT results were used as reference standards against which we calculated the diagnostic value of pelvic MRI for BMinv in DLBCL patients. A chi-square test was used to compare detection rates, and a receiver operating characteristic curve was used to evaluate diagnostic value of pelvic MRI. Propensity-score matching was performed according to clinical information, and Kaplan-Meier curves were constructed to compare progression-free survival (PFS) and overall survival (OS) of patients. RESULTS: The BMinv detection rate of pelvic MRI (42/171) was higher (P = 0.029) than that of BMB/BMS (25/171), and similar to that of PET/CT (44/171; P = 0.901). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pelvic MRI were 83.33%, 98.37%, 94.15%, 95.24%, and 93.80%, respectively. Median PFS values were as follows: BMB/BMS-positive, 17.8 months vs. BMB/BMS-negative, 26.9 months (P = 0.092); PET/CT-positive, 24.8 months vs. PET/CT-negative, 33.0 months (P = 0.086); pelvic MRI-positive, 24.9 months vs. pelvic MRI-negative, 33.1 months (P<0.001). Median OS values were as follows: BMB/BMS-positive, 22.3 months vs. BMB/BMS-negative, 29.8 months (P = 0.240); PET/CT-positive, 27.9 months vs. PET/CT-negative, 33.9 months (P = 0.365); pelvic MRI-positive, 27.3 months vs. pelvic MRI-negative, 35.8 months (P = 0.062). CONCLUSION: Pelvic MRI is effective for detecting BMinv in DLBCL patients, providing a more accurate indication of PFS than BMB/BMS and PET/CT do. It may ultimately be used to improve the accuracy of clinical staging, guide patient treatment, and evaluate prognosis.

Development of an immune-related prognostic index associated with osteosarcoma.

Tumor immunity is closely associated with the prognosis of tumors, including osteosarcoma (OS). The aim of the present study was to construct an immune-related prognostic index (PI) to predict the prognosis of OS. Herein, OS expression data were sourced from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. We divided the OS patients into nonmetastatic and metastatic groups, allowing differentially immune-related genes (DIRGs) to be selected. After DIRGs were further investigated by enrichment analysis, four keys prognostic IRGs (CD79A, CSF3R, MTNR1B and NPPC) were identified using a Cox proportional hazards model. Then, an immune-related prognostic index was constructed. Finally, gene set enrichment analysis (GSEA) was employed to further explore the underlying mechanisms. The difference in tumor-infiltrating immune cell (TIIC) abundance was also discussed. In our study, eight upregulated genes and 30 downregulated genes were identified. Several Gene Ontology (GO) terms and the most significantly enriched KEGG pathways were immune-associated functions and pathways. Four genes, including CD79A, CSF3R, MTNR1B and NPPC, were used to establish a risk assessment model for evaluating OS prognosis. GSEA revealed that the risk score was related to cytokine receptor interaction and to the chemokine and B cell receptor signaling pathways. Furthermore, high risk markedly related to the infiltration of several immune cell types, including M2 macrophages, naïve CD4 T cells, and CD8 T cells. In sum, we developed a survival model for OS. The underlying molecular mechanisms of the high-risk group may affect immune-related biological processes and TIICs.Abbreviations TARGET: Therapeutically Applicable Research To Generate Effective Treatments; PI: Prognostic index; OS: Osteosarcoma; DIRGs: Differentially immune-related genes; GSEA: Gene set enrichment analysis; TIIC: Tumor-infiltrating immune cell.

Novel bioinformatic classification system for genetic signatures identification in diffuse large B-cell lymphoma.

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is a spectrum of disease comprising more than 30% of non-Hodgkin lymphomas. Although studies have identified several molecular subgroups, the heterogeneous genetic background of DLBCL remains ambiguous. In this study we aimed to develop a novel approach and to provide a distinctive classification system to unravel its molecular features. METHOD: A cohort of 342 patient samples diagnosed with DLBCL in our hospital were retrospectively enrolled in this study. A total of 46 genes were included in next-generation sequencing panel. Non-mutually exclusive genetic signatures for the factorization of complex genomic patterns were generated by random forest algorithm. RESULTS: A total of four non-mutually exclusive signatures were generated, including those with MYC-translocation (MYC-trans) (n = 62), with BCL2-translocation (BCL2-trans) (n = 69), with BCL6-translocation (BCL6-trans) (n = 108), and those with MYD88 and/or CD79B mutations (MC) signatures (n = 115). Comparison analysis between our model and traditional mutually exclusive Schmitz's model demonstrated consistent classification pattern. And prognostic heterogeneity existed within EZB subgroup of de novo DLBCL patients. As for prognostic impact, MYC-trans signature was an independent unfavorable prognostic factor. Furthermore, tumors carrying three different signature markers exhibited significantly inferior prognoses compared with their counterparts with no genetic signature. CONCLUSION: Compared with traditional mutually exclusive molecular sub-classification, non-mutually exclusive genetic fingerprint model generated from our study provided novel insight into not only the complex genetic features, but also the prognostic heterogeneity of DLBCL patients.

MiR-451a ameliorates alcoholic hepatitis via repressing HDAC8-mediated proinflammatory response.

Alcoholic hepatitis (AH) is identified as an inflammatory syndrome with high morbidity and mortality as a result of severe hepatocellular dysfunction and liver injury. Accumulated studies indicated that miRNAs are involved in AH. The potential effect of miR-451a in AH mice was examined in the current study. A mice AH model was established and the miR-451a expression in AH mice compared with the sham group was tested by real-time polymerase chain reaction (qRT-PCR). AH mice were injected with pre-miR-451a lentivirus for miR-451a overexpression and histone deacetylase (HDAC8) lentivirus for HDAC8 overexpression in AH mice. The underlying mechanisms were explored by searching the potential target genes of miR-451a in miRanda database and then we confirmed this. We found that miR-451a expression was significantly decreased in AH mice compared with the sham group. Moreover, miR-451a overexpression alleviated alcohol-induced liver inflammation and injuries of AH mice. Additionally, further mechanism exploration disclosed that HDAC8 was a target of miR-451a. The protective effect of miR-451a on AH in AH mice was abolished by HDAC8 overexpression. In summary, miR-451a ameliorates AH via repressing HDAC8-mediated proinflammatory response.

Bone marrow mesenchymal stem cell-derived exosome uptake and retrograde transport can occur at peripheral nerve endings.

We investigated the occurrence of mesenchymal stem cell (MSC)-derived exosome uptake and retrograde transport at peripheral nerve endings using bone marrow MSCs (bMSCs) transduced with recombinant CD63-green fluorescent protein (GFP) lentiviral plasmid. GFP was used to track the release of bMSC-derived exosomes and the uptake and transport at peripheral nerve terminals, the dorsal root ganglion (DRG), and the spinal cord. In vitro cell culture and injection of a CD63-GFP exosome suspension into the right gastrocnemius muscle of an in vivo rat model were also performed. Fluorescence microscopy of co-cultured CD63-GFP exosomes and SH-SY5Y or BV2 cell lines and primary cultured DRG cells in a separate experiment demonstrated exosome uptake into DRG neurons and glia. Moreover, we observed both retrograde axoplasmic transport and hematogenous transport of exosomes injected into rat models at the DRG and the ipsilateral side of the anterior horn of the spinal cord using fluorescence microscopy, immunohistochemistry, and Western blot analyses. In conclusion, we showed that exosome uptake at peripheral nerve endings and retrograde transport of exosomes to DRG neurons and spinal cord motor neurons in the anterior horn can occur. In addition, our findings propose a novel drug delivery approach for treating neuronal diseases.

Multi-b value diffusion-weighted magnetic resonance imaging and intravoxel incoherent motion modeling: Differentiation of aggressive lymphoma lesions on initial treatment and activity assessment after chemotherapy.

The diagnostic efficiency of diffusion-weighted magnetic resonance imaging with different b-values and application of an intravoxel incoherent motion (IVIM) model for differentiating disease states of lymphoma was investigated.Thirty-six patients at initial diagnosis and 69 after chemotherapy underwent diffusion-weighted magnetic resonance imaging (DW-MRI) with multiple b-values. Analysis parameters included the apparent diffusion coefficient (ADC) for each b-value. Standard ADC, D, D*, and f were calculated using an IVIM model.For patients at initial diagnosis, compared with aggressive lymphomas, the benign lymph nodes exhibited higher mean ADC (2.34 vs 0.66 × 10 mm/s, P < .01) for b = 200 s/mm. The AUC, sensitivity, specificity, and the cutoff value were 0.992, 96%, 100%, and 1.09 ×10 mm/s, respectively. For patients who had finished chemotherapy, the f-values of IVIM for those with partial remission (PR) were higher than those of complete remission (CR) (56.22 vs 21.81%, P < .01). The AUC, sensitivity, specificity, and the cutoff value were 0.937, 94%, 82%, 42.10%, respectively.For b = 200 s/mm, ADC values are most helpful for characterizing benign lymph nodes and malignant lymphomas. The f-value of the IVIM is most valuable in the identification of residual lesions of lymphomas after chemotherapy.

Predictive value of interim PET/CT visual interpretation in the prognosis of patients with aggressive non-Hodgkin's lymphoma.

OBJECTIVE: The objective of the study was to evaluate the prognostic value of positron emission tomography (PET)/computed tomography (CT) visual interpretation in patients with aggressive non-Hodgkin's lymphoma (NHL) using a meta-analysis and systematic review. METHODS: Using the PubMed, Embase, and Web of Science databases, we performed a systematic review of the use of visual evaluation mid-chemotherapy to evaluate the prognosis of aggressive NHL in studies published up to May 2017. Prospective and retrospective studies assessing progression-free survival (PFS) and overall survival (OS) were included. We used hazard ratio (HR) to determine the value of Deauville criteria and International Harmonization Project (IHP) criteria for measuring survival. Subgroup analysis was performed based on the number of chemotherapy cycles before the mid-term evaluation as well as the visual evaluation method. RESULTS: A total of 11 studies were included. PFS (HR =2.93, 95% confidence interval [CI]: 2.93-3.90, p<0.0001) and OS (HR =2.55, 95% CI: 1.76-3.68, p<0.0001) of PET/CT-positive patients were significantly lower when determined by the visual method. In subgroup analysis, IHP, Deauville criteria, and having no standard interpretation groups were factors able to predict PFS; IHP and having no standard interpretation group were able to predict OS. With PET/CT, IHP, and Deauville 5-point criteria, the PFS of patients receiving 2-4 cycles of chemotherapy before PET/CT was significantly lower than that of PET/CT-negative patients. No significant difference in OS was observed when patients received 3 or fewer cycles of chemotherapy before PET/CT, though OS was significantly lower in patients receiving more than 3 chemotherapy cycles. CONCLUSION: IHP and Deauville criteria are commonly used for PET/CT visual evaluation at present. Interim PET/CT analysis after 3-4 chemotherapy cycles is capable of predicting disease prognosis. Large-scale prospective clinical trials are needed to confirm whether PET/CT analysis can be used as an indication for changing a treatment strategy.

Investigation of associations between ten polymorphisms and the risk of coronary artery disease in Southern Han Chinese.

A large-scale meta-analysis of 14 genome-wide association studies has identified and replicated a series of susceptibility polymorphisms for coronary artery disease (CAD) in European ancestry populations, but evidences for the associations of these loci with CAD in other ethnicities remain lacking. Herein we investigated the associations between ten (rs579459, rs12413409, rs964184, rs4773144, rs2895811, rs3825807, rs216172, rs12936587, rs46522 and rs3798220) of these loci and CAD in Southern Han Chinese (CHS). Genotyping was performed in 1716 CAD patients and 1572 controls using mass spectrography. Both allelic and genotypic associations of rs964184, rs2895811 and rs3798220 with CAD were significant, regardless of adjustment for covariates of gender, age, hypertension, type 2 diabetes, blood lipid profiles and smoking. Significant association of rs12413409 was initially not observed, but after the adjustment for the covariates, both allelic and genotypic associations were identified as significant. Neither allelic nor genotypic association of the other six polymorphisms with CAD was significant regardless of the adjustment. Our results indicated that four loci of the total 10 were associated with CAD in CHS. Therefore, some of the CAD-related loci in European ancestry populations are indeed susceptibility loci for the risk of CAD in Han Chinese.

Association between infection of hepatitis B virus and onset risk of B-cell non-Hodgkin's lymphoma: a systematic review and a meta-analysis.

Whether an association between hepatitis B virus (HBV) infection and B-cell non-Hodgkin's lymphoma (B-NHL) risk exists is an open question. In order to provide quantification of the issue, we carried out a meta-analysis of the published data. We identified 4 case-control and 2 nested case-control studies, including a total of 5,396 B-NHL cases. We derived meta-analytic estimates using random-effects models, taking into account the correlation between estimates. The odds radio (OR) of HBV infection in B-NHL when compared with the control population was 2.98 [95 % confidence interval (CI) 2.30-3.86]. There was evidence of statistical heterogeneity among all included studies (I (2) = 65 %, P = 0.01), which disappeared in the subgroup nested case-control studies (I (2) = 0 %, P = 0.49). OR was 2.59 (95 % CI 2.03-3.30) in the random effect model, suggesting a higher prevalence of HBV carrier state in B-NHL than controls. This meta-analysis provides quantitative evidence of a favorable role of HBV infection on B-NHL risk, which needs to be confirmed by experimental and epidemiological studies.

Prognostic significance of Tet methylcytosine dioxygenase 2 (TET2) gene mutations in adult patients with acute myeloid leukemia: a meta-analysis.

Tet methylcytosine dioxygenase 2 (TET2) gene mutations have recently been recognized in acute myeloid leukemia (AML). We performed a meta-analysis to evaluate the controversial prognostic significance of TET2 mutations in AML. Eight studies, covering 2552 patients with AML, were included in this analysis. Pooled hazard ratios (HRs) indicated that TET2 mutations had a poor prognostic impact on the survival of patients with AML. The combined HR for overall survival (OS) was 1.53 and the summary HR for event-free survival (EFS) was 1.64. Additionally, TET2 mutations appeared to be an adverse prognostic indicator in both patients with cytogenetically normal (CN)-AML (HR for OS: 1.43 and HR for EFS: 1.76) and subgroups of patients with favorable-risk genotypes (HR for EFS: 2.35) and intermediate-I-risk genotypes (HR for EFS: 1.57). These findings indicate that TET2 mutations have an adverse impact on prognosis and may help to justify risk-adapted therapeutic strategies for patients with AML.

Associations between RASSF1A promoter methylation and NSCLC: a meta-analysis of published data.

BACKGROUND: RASSF1A has been reported to be a candidate tumor suppressor in non-small cell lung cancer (NSCLC). However, the association between RASSF1A promoter methylation and NSCLC remains unclear, particularly in regarding links to clinicopathologic features. METHODS: Eligible studies were identified through searching PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. Studies were pooled and odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated. Funnel plots were also performed to evaluate publication bias. RESULTS: Nineteen studies involving 2,063 cases of NSCLC and 1,184 controls were included in this meta-analysis. A significant association was observed between RASSF1A methylation and NSCLC in the complete data set (OR = 19.42, 95% CI: 14.04- 26.85, P < 0.001). Pooling the control tissue subgroups (heterogeneous/autologous) gave pooled ORs of 32.4 (95% CI, 12.4-84.5) and 17.7 (95% CI, 12.5-25.0) respectively. Racial subgroup (Caucasian/Asian) analysis gave pooled ORs of 26.6 (95% CI, 10.9-64.9) and 20.9 (95% CI, 14.4-30.4) respectively. The OR for RASSF1A methylation in poorly-differentiated vs. moderately/well-differentiated NSCLC tissues was 1.88 (95% CI, 1.32- 2.68, P<0.001), whereas there were no significant differences in RASSF1A methylation in relation to gender, pathology, TNM stage and smoking behavior among NSCLC cases. CONCLUSION: This meta-analysis suggests a significant association between RASSF1A methylation and NSCLC, confirming the role of RASSF1A as a tumor suppressor gene. Large-scale and well-designed case-control studies are needed to validate the associations identified in the present meta-analysis.

[Hematopoiesis is normally maintained in osteoblast-specific Smad4 gene knockout mice].

It was recently discovered that a subset of osteoblasts functions as a key component of the hematopoietic stem cells (HSC) niche in vivo, controlling HSC self-renewal and multi-lineage differentiation. Disruption of Smad4 gene specifically in osteoblasts leads to a remarkable decrease of osteoblast number and endosteal surface area. In order to elucidate if the osteoblast loss has any effect on hematopoietic activity, the bone marrow (BM) and extramedullary hematopoiesis in the osteoblast-specific Smad4 knockout mice were systematically analyzed, the proportions of mature hematocytes in BM, liver and spleen were detected by flow cytometry, the hematopoietic progenitor number in different stages was measured by colong-forming assay, CFU-S and analysis of LSK cells. The results indicated that the conditional mutant mice demonstrated normal BM hematopoiesis without sign of extramedullary hematopoiesis. Furthermore, the proportion of hematopoietic progenitor cells was normal, while cell number/body weight of the conditional knockout mice increased. It is concluded that hematopoiesis is normally maintained in osteoblast-specific Smad4 knockout mice, and osteoblast loss does not of necessity result in the decrease in BM hematopoiesis.

1-(4-Methyl-benzo-yl)-3-[5-(4-pyrid-yl)-1,3,4-thia-diazol-2-yl]urea.

In the title compound, C(16)H(13)N(5)O(2)S, the five non-H atoms of the urea linkage adopt a planar configuration owing to the presence of an intra-molecular N-H⋯O hydrogen bond. The maximum deviation from planarity is 0.022 (2) Å. The thia-diazole and pyridine heterocyclic rings are close to being coplanar, with a dihedral angle of 6.7 (2)° between their mean planes. Inter-molecular N-H⋯O hydrogen bonds link two neighbouring mol-ecules into centrosymmetric R(2) (2)(8) dimers. Four C atoms and the attached H atoms of the benzene ring are disordered over two positions of equal occupancy.

[Establishment of osteoblast-specific Cre transgenic mice].

An osteoblast-specific Cre transgenic construct (pOC-Cre) containing the osteocalcin promoter, Cre recombinase gene and polyA of human growth hormone gene was generated. The 4.6 kb DNA fragment of OC-Cre was introduced into fertilized zygotes by microinjection. 2 out of 16 offspring were identified as founders carrying the transgene by PCR and Southern blot analysis, and the integration efficiency is 12.5 %. To check the tissue distribution of the OC-Cre, the OC-Cre transgenic founder mice were bred with the mice carrying Smad4 conditional alleles. PCR results showed that the genomic DNA fragments after Cre mediated recombination could be only amplified from bone tissues of the transgenic mice. LacZ staining of OC-Cre; ROSA26 double transgenic mice revealed that Cre recombinase expressed in osteoblasts and mediated DNA recombination between LoxP sites at the ROSA26 locus. All these data indicated that the Cre recombinase was ex-pressed in the osteoblasts of the OC-Cre transgenic mice and could mediate DNA recombination between LoxP sites. The OC-Cre transgenic mice we generated in this study could serve as a useful tool for generating osteoblast specific gene-knockout mice.

Endothelial cell-specific expression of Cre recombinase in transgenic mice.

Endothelial cells participate in angiogenesis, vascular homeostasis, thrombosis, inflammation and vascular wall remodeling. To study the function of genes in endothelial cells using Cre-loxP system, we generated Tie2-Cre transgenic mice, in which expression of Cre recombinase is driven by Tie2 promoter. Total six founder mice carrying the Tie2-Cre transgene were identified by genomic PCR and Southern blot. The integration efficiency is 11%. In order to test the excision activity and tissue distribution of the Cre recombinase, the Tie2-Cre transgenic line was crossed with the mouse strain carrying the Smad4 conditional alleles (Smad4(Co/Co)) or the reporter line ROSA26. PCR of multiple tissue DNA from Tie2-Cre; Smad4(Co/+) mice revealed the Cre activity in all tissues containing endothelial cells. We detected pan-endothelial expression of the Cre transgene in Tie2-Cre; ROSA26 double transgenic embryos by lacZ staining. Therefore, this mouse line may serve as a valuable tool for endothelial cell lineage analyses and conditional gene ablation in endothelial cells.

Establishment of liver specific glucokinase gene knockout mice: a new animal model for screening anti-diabetic drugs.

AIM: To characterize the liver-specific role of glucokinase in maintaining glucose homeostasis and to create an animal model for diabetes. METHODS: We performed hepatocyte-specific gene knockout of glucokinase in mice using Cre-loxP gene targeting strategy. First, two directly repeated loxP sequences were inserted to flank the exon 9 and exon 10 of glucokinase in genomic DNA. To achieve this, linearized targeting vector was electroporated into ES cells. Then G418- and Gancyclovir-double-resistant clones were picked and screened by PCR analysis and the positives identified by PCR were confirmed by Southern blot. A targeted clone was selected for microinjection into C57BL/6J blastocysts and implanted into pseudopregnant FVB recipient. Chimeric mice and their offspring were analyzed by Southern blot. Then by intercrossing the Alb-Cre transgenic mice with mice containing a conditional gk allele, we obtained mice with liver-specific glucokinase gene knockout. RESULTS: Among 161 double resistant clones 4 were positive to PCR and Southern blot and only one was used for further experiments. Eventually we generated the liver specific glucokinase knockout mice. These mice showed increased glucose level with age and at the age of 6 weeks fasting blood glucose level was significantly higher than control and they also displayed impaired glucose tolerance. CONCLUSION: Our studies indicate that hepatic glucokinase plays an important role in glucose homeostasis and its deficiencies contribute to the development of diabetes. The liver glucokinase knockout mouse is an ideal animal model for MODY2, and it also can be applied for screening anti-diabetic drugs.