Prognostic factors in patients with secondary hemophagocytic lymphohistioc ytosis in a Chinese cohort.

Hemophagocytic lymphohistiocytosis (HLH) is a rare hyperinflammatory syndrome with high mortality mediated by an unbridled and persistent activation of cytotoxic T lymphocytes and natural killer cells. However, the influence factors of early death in adult sHLH patients are still not fully elucidated, which need further investigating. We have conducted an observational study of adult HLH patients between January 2016 and December 2022. All patients are enrolled according to HLH-2004 criteria. Clinical manifestations, laboratory data, treatments, and outcomes have been recorded. Influence factors associated with prognosis are calculated by using logistic regression models. Overall, 220 patients enrolled in this study. The etiologies of HLH were divided into five groups including autoimmune-associated hemophagocytic syndrome (AAHS) (n = 90, 40.9%), malignancies (n = 73, 33.2%), EBV-HLH (n = 18, 8.2%), infection excluded EBV (n = 24, 10.9%), and other triggers (n = 15, 6.8%). Among them, EBV-HLH had the highest mortality (77.8%), and AAHS had the lowest mortality (14.4%). Multivariate analysis indicated that age (≥ 38 years old), cytopenia ≥ 2 lines, platelets (≤ 50 × 109/L), aspartate aminotransferase (≥ 135U/L), prothrombin time (≥ 14.9 s) and activated partial thromboplastin time (≥ 38.5s), EBV, and fungal infection are independent risk factors for poor prognosis of HLH. Adult HLH patients with elder age, cytopenia ≥ 2 lines, levels of decreased platelets, increased AST, prolonged PT and APTT, EBV, and fungal infection tend to have a poor prognosis.

Toxicologic evaluations of recombinant liver-targeting interferon IFN-CSP: Genotoxicity and tegenicratoity.

Interferon alpha as the one of FDA recommended drugs for Hepatitis B virus (HBV) infection has many side effects. Targeting IFNα to the liver may be a strategy to increase its efficacy locally and may increase efficacy of IFNα-based therapy of HBV infection. We have prepared a novel liver-targeting fusion interferon (IFN-CSP) combining IFN α2b with plasmodium region I peptide and have revealed it may be an excellent candidate as a liver-targeting anti-HBV agent. In this study, we investigated the genotoxic and teratogenic effects of IFN-CSP. The genotoxicity of IFN-CSP was evaluated by using a standard battery of tests (bacterial reverse mutation assay, mouse bone marrow micronucleus assay, and mouse sperm malformation assay). The results showed that IFN-CSP did not increase the number of revertant colonies in the plates of four strains, had no marked effect on the incidence of mouse bone marrow micronucleus and did not affect sperm deformity proportion at doses up to 8.8 × 108IU/kg, which was 1128.2 folds of the maximum' clinical equivalent dosage. Meanwhile, for teratogenicity test of IFN-CSP in female SD rats at the dosage of 6.3 × 107 IU/kg, no toxicological signs were observed. These results indicated that IFN-CSP has no genotoxicity and teratogenicity under the testing conditions.

[Metabolism Changes of Main Active Ingredients During Liquid Fermentation of Cordyceps militaris].

Objective: To study the accumulation and changes of main active ingredients during liquid fermentation of Cordyceps militaris. Methods: The militaris varity GIM5. 270 was selected to extended fermentation time to 20 days on the basic fermentation condition. Meanwhile, the accumulation and dynamic changes of biomass, polysaccharide, cordycepic acid, adenosine and cordycepin in the fermentation system were detected by the analytical method of contents per 24 hour. Results: The foundation culture medium composed of complex nitrogen sources could reach a higher biomass level than single nitrogen sources. In addition, with the development of time, the mycelial biomass increased, the contents of polysaccharide and cordycepic acid( D-mannitol) increased firstly and then decreased, the contents of adenosine decreased gradually and cordycepin( 3-deoxy adenosine) increased gradually. Conclusion: The whole system is observed autolyzed phenomenon caused by absorbing self-generated nutrients. In this study, the dynamic changes of the main active ingredients in the fermentation system are researched and the optimum collecting time is determined, which provides evidence for reaching a better yield of the active ingredients.

Serum Klotho Is Elevated in Patients with Acute Myocardial Infarction and Could Predict Poor In-Hospital Prognosis.

INTRODUCTION: Klotho has emerged as a potential protective factor for cardiovascular diseases recently. Nevertheless, the levels of serum Klotho in acute coronary syndrome (ACS) have not been reported. Hence, we undertook a study to investigate the potential correlation between serum Klotho and ACS patients. METHOD: This observational cohort study was conducted at Peking University People's Hospital between May 2016 and April 2020. Upon admission, we collected the patients' clinical data and conducted ELISA tests to measure their serum Klotho levels. RESULT: A total of 349 patients were enrolled in this study, including 14 patients with UA and 335 patients with AMI. We observed that serum Klotho levels were obviously higher in the AMI group compared to the UA group (median 479.8 vs. 233.8 pg/mL, p = 0.035). In addition, serum Klotho levels were positively correlated with cardiac function and more pronounced in patients who died in the hospital (median 721.1 vs. 468.3 pg/mL, p < 0.001). A logistic regression analysis indicated that age ≥ 78 years old, HR ≥ 90 bpm, Killip classification ≥ 3 grade, and serum Klotho > 645.0 pg/mL were risk factors for poor prognosis. CONCLUSIONS: Serum Klotho is obviously increased in patients with AMI and with a positive correlation with cardiac function, and its elevation could serve as a predictor of poor prognosis in ACS patients.