Integrated Analysis of Long Non-Coding RNA and mRNA Expression Profile in Myelodysplastic Syndromes.

BACKGROUND: Myelodysplastic syndromes (MDS) are a heterogeneous group of myeloid malignancies. The incidence of MDS is gradually increasing, but the pathogenesis is still not very clear. Studies have shown that long non-coding RNAs (lncRNAs) play a critical role in both oncogenic and tumor-suppressive pathways. However, the function of lncRNAs in MDS is still unknown. The purpose of this study was to investigate the expression profiles and biological function of the aberrantly expressed lncRNAs and mRNAs in MDS. METHODS: We downloaded two data sets (GSE4619 and GSE19429) from the Gene Expression Omnibus database and obtained differentially expressed (DE) lncRNAs and DE-mRNAs between MDS cases and healthy controls. Then we performed systematic bioinformatics analysis to know the biological function of DE-lncRNAs and DE-mRNAs in MDS. RESULTS: We identified 40 DE-lncRNAs and 643 DE-mRNAs between MDS cases and healthy controls. Gene Ontology (GO) and pathway analysis revealed that DE-lncRNAs and DE-mRNAs were mainly involved in necroptosis, apoptosis, immunodeficiency, p53 and FoxO signaling pathways. LncRNA-mRNA co-expression and lncRNA functional similarity network showed that twelve down-regulated lncRNAs co-regulated the same target gene and they were similar in function. CONCLUSIONS: The comprehensive analysis of lncRNA and mRNA is helpful in understanding the pathogenesis of MDS, and the synergistically down-regulated lncRNAs may contribute to the development of new diagnostic and therapeutic strategies.

DNA methyltransferases-associated long non-coding RNA PRKCQ-AS1 regulate DNA methylation in myelodysplastic syndrome.

INTRODUCTION: Myelodysplastic syndrome (MDS) is a group of clonal hematopoietic stem cell disorders. DNA hypermethylation is considered to be the key mechanism of pathogenesis for MDS. Studies have demonstrated that DNA methylation can be regulated by the co-effect between long non-coding RNAs (lncRNAs) and DNA methyltransferases (DNMTs). The aim of this study was to identify DNMTs-associated differentially expressed (DE) lncRNAs, which may be a novel diagnostic and therapeutic target for MDS. METHODS: Two gene expression profile datasets (GSE4619 and GSE19429) were downloaded from the Gene Expression Omnibus (GEO) database. Systematic bioinformatics analysis was conducted. Then we verified the expression of PRKCQ-AS1 in MDS patients and features in SKM-1 cells. RESULTS: Bioinformatics analysis revealed that the DNMT-associated DE-lncRNA PRKCQ-AS1 was functionally related to DNA methylation. The target genes of PRKCQ-AS1 associated with DNA methylation are mainly methionine synthetase (MTR) and ten-eleven-translocation 1 (TET1). Moreover, the high expression of PRKCQ-AS1 was verified in real MDS cases. Further cellular analysis in SKM-1 cells revealed that overexpressed PRKCQ-AS1 promoted methylation levels of long interspersed nuclear element 1 (LINE-1) and cell proliferation, and apparently elevated both mRNA and protein levels of MTR and TET1, while knockdown of PRKCQ-AS1 showed opposite trend in SKM-1 cells. CONCLUSION: DNMT-associated DE-lncRNA PRKCQ-AS1 may affects DNA methylation levels by regulating MTR and TET1.

Analysis of the Clinical Efficacy of Azacytidine + Venetoclax in the Treatment of Elderly Patients with Relapsed Refractory Acute Myeloid Leukemia.

Objective: To explore the clinical efficacy of azacytidine + venetoclax in the treatment of elderly patients with relapsed refractory acute myeloid leukemia (AML). Method: The present study included 20 elderly patients with relapsed refractory AML from January 2019 to January 2021. These patients were randomized into treatment groups (n = 10, azacytidine alone) and control groups (n = 10, azacytidine + venetoclax) by a random number table. The differences in efficacy, adverse reactions, hematology parameters, and immune functions in elderly patients with relapsed refractory AML in two groups were analyzed. Results: The total efficiency for elderly patients with relapsed refractory AML was 90.00% and significantly higher than that in the control group (40.00%), P < 0.05; PLT and WBC after treatment in the treatment group were significantly higher than those in the control group, and Hb was significantly lower than in the control group, P < 0.05; CD4+, CD3+, and CD4+/CD8+ after treatment in both groups were significantly lower than those before treatment, P < 0.05; CD4+, CD3+, and CD4+/CD8+ after treatment were not significantly different between the two groups, P > 0.05; the incidences of adverse reactions were not significantly different between the two groups, P > 0.05. Conclusion: Azacytidine + venetoclax in the treatment of elderly patients with relapsed refractory AML could improve efficacy and hematology parameters with high safety, which is of great significance.

Efficiency of Modified Triple-Branched Stent Graft in Type I Aortic Dissection: Two-Year Follow-up.

BACKGROUND: The efficacy of hemiarch replacement combined with a modified triple-branched stent graft in Debakey type I aortic dissection remains to be confirmed. METHODS: From January 2016 to December 2017, 167 patients with acute Debakey type I aortic dissection underwent hemiarch replacement combined with a modified triple-branched stent graft. The clinical and imaging data were retrospectively analyzed. The early composite endpoint was defined to comprise perioperative mortality, permanent neurologic deficits, and renal failure requiring hemodialysis at discharge. RESULTS: The overall 30-day mortality was 4.2% (7 of 167). The incidence of the composite endpoint was 11.4% (19 of 167). The risk factors for the composite endpoint were malperfusion syndrome (odds ratio 5.17; 95% confidence interval, 1.46 to 18.35; P = .011) and creatine greater than 1.5 mg/dL (odds ratio 5.44; 95% confidence interval, 2.27 to 13.06; P < .001). The overall survival was 94% at 1 year and 92.2% at 2 years during a median follow-up of 20.9 ± 9.6 months. Three patients required distal aorta reintervention. Complete thrombosis in the false lumen of the descending aorta at the level of the pulmonary bifurcation and at the level of the celiac trunk was observed in 98.8% and 10.8% of the patients, respectively. CONCLUSIONS: Hemiarch replacement combined with a modified triple-branched stent graft is a reliable technique for acute Debakey type I aortic dissection as indicated by 2 years of follow-up.