[Guillain-Barre syndrome after allogeneic hematopoietic stem cell transplantation: a case report and literature review].

Guillain-Barre syndrome rarely develops after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and only a few reports exist in China. Guillain-Barre syndrome is an acute and life-threatening condition that requires early diagnosis and treatment. A patient with acute myeloid leukemia underwent allogeneic HSCT for >5 months and gradually developed limb muscle weakness and limited eye movement after coexisting with delayed acute intestinal graft-versus-host disease. After the examination of cerebrospinal fluid and electromyography, the diagnosis of Guillain-Barre syndrome was confirmed. After a high-dose intravenous immunoglobulin (IVIg) treatment, muscle strength gradually recovered, and the prognosis was good.

[The prediction value of combined serum levels of TMAO and TML for poor prognosis in patients with heart failure].

Objective: To evaluate the predictive value of combined serum levels of trimethylamine N-oxide (TMAO) and trimethyllysine (TML) for poor prognosis in patients with heart failure. Methods: This single-center prospective cohort study included hospitalized patients with heart failure and complete baseline data from the Department of Cardiology at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2017 to December 2020. Patients were categorized into four groups based on median serum levels of TMAO and TML after admission: TMAO low level TML low level group (TMAO<9.7 µmol/L, TML<0.73 µmol/L), TMAO low level TML high level group (TMAO<9.7 µmol/L, TML≥0.73 µmol/L), TMAO high level TML low level group (TMAO≥9.7 µmol/L, TML<0.73 µmol/L) and TMAO high level TML high level group (TMAO≥9.7 µmol/L, TML≥0.73 µmol/L). The primary endpoint was a composite endpoint of cardiovascular death and readmission for heart failure. Multiple factor Cox regression analysis was conducted to evaluate the correlation between serum TMAO and TML levels and poor prognosis in patients with heart failure. Results: A total of 471 patients with heart failure were included, with an mean age of (62.5±12.0) years and a median follow-up time of 1.61 (1.06, 2.90) years. Multivariate Cox regression analysis showed that after adjusting for age, gender, and traditional risk factors, the TMAO high level TML high level group had a higher incidence of primary endpoint events compared to the TMAO low level TML low level group (HR=1.71, 95%CI 1.05-2.77, P=0.03). Conclusion: Elevated serum levels of both TMAO and TML can effectively predict the occurrence of long-term adverse events in patients with heart failure.

Role of Taste Receptors in Innate Immunity and Oral Health.

Taste receptors are receptor proteins that detect ligands belonging to the 5 taste modalities: sweet, bitter, sour, salty, and umami. Taste receptors are not restricted to taste cells in taste buds; rather, they are distributed throughout the entire body. For example, solitary chemosensory cells (SCCs) and tuft cells express taste signal proteins and are present in several mucosae. In the airways, SCCs sense bacteria, allergens, viruses, and noxious stimuli and drive evasive behavior, neuroinflammation, and antibacterial responses. In the gut, tuft cells detect helminth infection and bacterial dysbiosis and initiate type II immune responses characterized by tissue remodeling. In the gingiva, SCCs detect oral pathogenic bacteria, evoke innate immune responses and release antimicrobial compounds in the epithelium, and regulate the microbiome composition. This review summarizes the most recent research on extragustatory taste receptors and their function in antibacterial defense. We also discuss how these findings have provided insights into the development of potential therapeutic strategies for mucosal bacterial infection and dental diseases.

[Epidemiological characteristics of COVID-19 epidemic in Ejina banner, Inner Mongolia Autonomous Region, October 2021].

Objective: To understand the epidemiological characteristics of COVID-19 epidemic in Ejina banner, Inner Mongolia, in October 2021 and provide evidence for the improvement of COVID-19 prevention and control. Methods: The information about the time, area and population distributions of COVID-19 cases in Ejina before November 13, 2021 and the gene sequencing result of the isolates were collected for a statistical descriptive analysis. Results: The first COVID-19 case in Ejina occurred on 7 October, 2021. A total of 164 COVID-19 cases were reported from October 19 to November 12. Most cases were distributed in 6 communities in Darahub (156 cases, 95.12%). The result of full gene sequencing of the isolates indicted that the pathogen was Delta variant (B.1.617.2). The male to female ratio of the cases was 1.3∶1. The age of cases ranged from 1 to 85 years, and the cases aged 20-59 years accounted for 78.66%. The main clinical symptoms were sore throat (91 cases, 91.92%), cough (49 cases, 49.49%) and fever (23 cases, 23.23%). Most cases were ordinary ones (81 cases, 49.39%) and mild ones (68 cases, 41.46%). The cases were mainly detected at the isolation points (84 cases, 51.22%) and through population based nucleic acid testing (62 cases, 37.80%). The basic reproduction number (R0) of COVID-19 was 5.3, the average incubation period was 3.9 days. The local government rapidly started Ⅳ level emergency response and conducted 10 rounds of nucleic acid tests. The transferring of travelers reduced the risk for the further spread of COVID-19 in Ejina. Conclusions: The epidemic of COVID-19 in Ejina characterized by strong transmission, short incubation period, herd susceptibility and case clustering. Delta variant (B.1.617.2) was the pathogen, which might be imported from Zeke port. Comprehensive prevention and control measures, such as closed-loop management and vaccination, should be continued. The successful transferring of the patients and travelers provided evidence for the effective and precise prevention and control of COVID-19 in a routine manner.

Global cooling and enhanced Eocene Asian mid-latitude interior aridity.

Tibetan Plateau uplift has been suggested as the main driving force for mid-latitude Asian inland aridity (AIA) and for deposition of thick aeolian sequences in northern China since the Miocene. However, the relationship between earlier AIA and Tibetan Plateau mountain building is uncertain because of a lack of corresponding thick aeolian sequences with accurate age constraints. We here present results for a continuous aeolian sequence that spans the interval from >51 to 39 Ma from the eastern Xorkol Basin, Altun Shan, northeastern Tibetan Plateau. The basal age of the studied sequence postdates initial uplift of the Tibetan Plateau by several million years. Our results indicate that the local palaeoclimate was teleconnected strongly to the overall global cooling pattern, so that local enhanced aridification recorded by the studied aeolian sequence is dominantly a response to global climatic forcing rather than plateau uplift.

Autophagy in drug resistance of the multiple myeloma cell line RPMI8226 to doxorubicin.

We investigated the effect of autophagy on drug resistance of multiple myeloma (MM) to doxorubicin (DOX). A DOX-resistant MM cell line (RPMI8226/DOX) was developed by progressively increasing the DOX concentration gradient. The drug resistance index was determined using the MTT method. Transmission electron microscopy, anti-light chain 3-fluorescein isothiocyanate immunofluorescence, and Western blotting were used to detect autophagy of MM cells. Flow cytometry was applied to detect changes in apoptosis of RPMI8226/DOX cells (stained with annexin-V/propidium iodide) caused by inhibition by hydroxychloroquine and 3-methyladenine on autophagy. The drug resistance index of RPMI8226/DOX to DOX was 10.8, and autophagy/lysosomal was clearly observed in RPMI8226/DOX cells under transmission electron microscopy, while immunofluorescence showed granular immunofluorescence in cells. Western blot analysis showed that light chain 3-II protein expression level was higher in RPMI8226/DOX cells than in RPMI8226/S cells. The apoptosis test showed that hydroxychloroquine or 3-methyladenine partially reversed the drug resistance of RPMI8226/DOX cells by inhibiting autophagy. Activation of autophagy in MM cells may explain the drug resistance of myeloma.

Matrix metalloproteinase variants associated with risk and clinical outcome of esophageal cancer.

We conducted a case-control study to investigate the role of matrix metalloproteinase (MMP) 2, MMP3, and MMP9 single nucleotide polymorphisms on susceptibility to esophageal squamous cell carcinoma (ESCC) in a Chinese population, and their association with environmental factors. A total of 226 patients with ESCC, and 226 age- and gender-matched healthy controls were enrolled in this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was carried out on MMP2 -1306 C>T (rs243865), MMP3 -1171 5A>6A (rs3025058), and MMP9 -1562 C>T (rs3918242) genotypes. Unconditional regression analysis showed that individuals carrying the MMP2 -1306 TT genotype had a decreased incidence of ESCC compared to those with the CC genotype [odds ratio (OR) = 0.32; 95% confidence interval (CI), 0.10-0.89, P value = 0.02]. Moreover, MMP9 -1562 CC carriers were associated with an increased ESCC risk compared to those with the TT genotype (OR = 2.71; 95%CI, 1.04-7.87, P value = 0.02). In the Cox proportional hazards model, after adjusting for potential confounding factors, patients carrying the MMP9 -1562 CC genotype had a significantly increased risk of death from ESCC (hazard ratio = 2.97; 95%CI, 1.25-6.87, P value = 0.005). In conclusion, this study showed that the MMP2 -1306 TT and MMP9 -1562 CC genotypes were associated with increased ESCC, and patients carrying the MMP9 -1562 CC genotype had a significantly increased risk of death from ESCC.

Cervical cerclage for preventing preterm birth in twin pregnancies. A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effect of cervical cerclage on preventing preterm birth in twin pregnancies. METHODS: We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Current Controlled Trials, China Biology Medicine (CBM), Chinese National Knowlegde Infrastructure (CNKI) and VIP Chinese Journal database (VIP) from April to August 2012. All available randomized trials comparing the effects of cervical cerclage for preventing preterm birth in twin pregnancies with no cerclage were included. The study took place in the First Affiliated Hospital of ChongQing Medical University, Chongqing, People's Republic of China. RESULTS: Five eligible studies with a total of 310 participants were finally included. No statistically significant differences were found between patients who received cervical cerclage and those who did not receive cervical cerclage, in terms of preterm birth (RR 0.91, 95% CI 0.78-1.18), live births (RR 0.93, 95% CI 0.87-1.01) and mode of delivery (RR 1.34, 95% CI 0.61-2.98) per randomized woman. These results of preterm birth, premature rupture of menbrane, model of delivery did not change before and after sensitivity analysis. CONCLUSION: No significant difference was observed between cervical cerclage group and no cerclage group in twin pregnancies and large scale randomized controlled trials are needed to strengthen clinical usage of cervical cerclage.

Randomized, double-blind, controlled trial of mifepristone in capsule versus tablet form followed by misoprostol for early medical abortion.

OBJECTIVE: To compare the efficacy and side-effects of mifepristone 75 mg in capsule form versus 150 mg in tablet form followed by misoprostol for medical termination of early pregnancy. STUDY DESIGN: In a prospective randomized, double-blind, placebo-controlled trial, a total of 480 women who were 49 days or less pregnant were randomized by means of a random number table to receive either two tablets in the morning and one tablet 12 h later for 2 days (group A) or three capsules orally twice daily for 2 days, the first dose being double all subsequent doses (group B). After a further 48 h, 600 microg misoprostol was given orally. Successful abortion was defined as complete abortion with no need for surgical aspiration. RESULTS: There were no significant differences between the two study groups in the rates of complete abortion (95.4% in group A versus 96.3% in group B), incomplete abortion (3.8% in group A, 3.3% in group B) and continued pregnancy (0.8% in group A, 0.4% in group B). No significant difference in the duration and amount of vaginal bleeding was observed. The incidence of side-effects, such as vomiting, nausea, headache, diarrhea and lower abdominal pain was similar in the two groups. CONCLUSIONS: Our results indicate that 75 mg mifepristone in capsule form combined with 600 microg misoprostol is as effective and safe as 150 mg mifepristone in tablet form for the termination of pregnancy up to 49 days.

[Simultaneous intrusion and retraction of the anterior teeth using a three-piece base arch].

OBJECTIVE: To evaluate the effects of the three-piece base arch on overbite correction of Class II malocclusion. METHODS: 20 patients with high angle, flared incisors were treated using a three-piece base arch appliance. The intrusion force of four upper incisors was adjusted to approximately 50 g. The line of force action was 2 mm distally to the resistant center(RC) and the retraction force was 20 g, the right and left posterior segments were joined by a palatal bar. Cephalograms were taken before treatment (T1) and six months after treatment (T2). RESULTS: The upper molars moved mesially 0.60 +/- 0.35 mm and the distance of the vertical extrusion was 0.80 +/- 0.52 mm. The distances of the upper central incisor retraction and intrusion were -4.20 +/- 2.12 mm and 3.10 +/- 0.54 mm respectively. The RC of the central incisor retracted -4.12 +/- 1.96 mm and intruded 3.20 +/- 0.66 mm. The axial inclination of the upper incisor-palatal plane changed from 123.21 degrees +/- 4.26 degrees to 116.00 degrees +/- 3.96 degrees. CONCLUSION: The three-piece segmented approach can effectively intrude and retract the upper anterior teeth for flared incisors and deep overbite.