[Survival and Prognosis of Patients with Acute Myeloid Leukemia with Myelodysplasia-Related Changes Transformed from Myelodysplastic Syndrome].

OBJECTIVE: To explore the risk factors affecting the survival and efficacy of patients with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) transformed from myelodysplastic syndrome (MDS). METHODS: The clinical data of 60 patients with AML-MRC transformed from MDS who hospitalized in The Third Affiliated Hospital of Soochow University from January 2010 to December 2021 were retrospectively analyzed. The demographic data and laboratory parameters, cytogenetic karyotypes, target genes of AML detected by next generation sequence, risk stratification, treatment regimen, therapeutic efficacy and survival outcome were documented. Rank sum test and Chi-square test or Fisher exact test were used to compare the survival and efficacy. The effects of clinical parameters, risk stratification and treatment regimens on the survival and efficacy of the AML-MRC patients were analyzed by univariate and multivariate analysis. RESULTS: The median overall survival (OS) of the AML-MRC patients was 4.5 months, the 1-year OS rate was 28.3%, and the complete remission (CR) rate after treatment was 33.3%. The univariate analysis showed that age≥60 years, leukocytosis, severe thrombocytopenia, poor-risk group and only accepted hypomethylating agents(HMAs) or supportive therapy were the risk factors affecting OS. COX multivariate analysis showed that thrombocytopenia ( HR=4.46), HMAs therapy (compared to transplantation, HR=10.47), supportive therapy (compared to transplantation, HR=25.80) and poor-risk group (compared to medium-risk group, HR=13.86) were independent hazard factors for median OS of patients with AML-MRC. The univariate analysis showed that the risk factors affecting 1-year OS in patients with AML-MRC were age≥60 years, thrombocytopenia, time of transformation from MDS to AML (TTA)≥3 months, fibrinogen-albumin ratio index (FARI)≥0.07, CONUT score≥5, poor-risk group and supportive therapy. Binary logistic regression analysis showed that the independent risk factors for 1-year OS in AML-MRC patients were age≥60 years ( HR=11.23), thrombocytopenia ( HR=8.71), FARI≥0.07 ( HR=5.19) and poor-risk group ( HR=14.00). The risk factors affecting CR of AML-MRC patients in univariate analysis were age≥60 years, thrombocytopenia, FARI≥0.1, CONUT score≥5, poor-risk group and supportive therapy, while binary logistic regression analysis showed that age≥60 years( HR=7.35), CONUT score≥5 ( HR=9.60), thrombocytopenia ( HR=12.05) and poor-risk group ( HR=32.5) were independent risk factors affecting CR of the patients. CONCLUSION: The OS of AML-MRC patients is poor, old age(≥60 years old), supportive therapy, HMA therapy, poor-risk, thrombocytopenia, FARI≥0.07 and CONUT score≥5 may be associated with poor prognosis.

Nanograded artificial nacre with efficient energy dissipation.

The renowned mechanical performance of biological ceramics can be attributed to their hierarchical structures, wherein structural features at the nanoscale play a crucial role. However, nanoscale features, such as nanogradients, have rarely been incorporated in biomimetic ceramics because of the challenges in simultaneously controlling the material structure at multiple length scales. Here, we report the fabrication of artificial nacre with graphene oxide nanogradients in its aragonite platelets through a matrix-directed mineralization method. The gradients are formed via the spontaneous accumulation of graphene oxide nanosheets on the surface of the platelets during the mineralization process, which then induces a lateral residual stress field in the platelets. Nanoindentation tests and mercury intrusion porosimetry demonstrate that the material's energy dissipation is enhanced both intrinsically and extrinsically through the compressive stress near the platelet surface. The energy dissipation density reaches 0.159 ± 0.007 nJ/µm3, and the toughness amplification is superior to that of the most advanced ceramics. Numerical simulations also agree with the finding that the stress field notably contributes to the overall energy dissipation. This work demonstrates that the energy dissipation of biomimetic ceramics can be further increased by integrating design principles spanning multiple scales. This strategy can be readily extended to the combinations of other structural models for the design and fabrication of structural ceramics with customized and optimized performance.

[Clinical Characteristics and Prognostic Factors of Patients with Primary Parotid Gland Lymphoma].

OBJECTIVE: To explore the clinical characteristics and prognostic factors of patients with primary parotid gland lymphoma, and construct a prognostic model nomogram for patients with primary diffuse large B-cell lymphoma (DLBCL) of parotid gland. METHODS: Primary parotid gland lymphoma and primary DLBCL of parotid gland patients from 1984 to 2016 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analysis were conducted to determine the independent prognostic factors of primary parotid gland lymphoma and primary DLBCL of parotid gland, respectively. According to the established independent prognostic factors of primary DLBCL of parotid gland, nomogram was built to predict 3- and 5-year survival, and the discrimination and calibration of the model were evaluated by concordance index (C-index) and calibration plots. RESULTS: A total of 2 610 patients with primary parotid gland lymphoma were identified. Their median age was 66(15-99) years old, the male to female ratio was 1∶1.8, and 20.5% of them was primary DLBCL of parotid gland, which was the most common histological subtype in aggressive lymphomas. Multivariate Cox regression analysis showed that sex, age, Ann Arbor stage, years of diagnosis, marital status, histological subtype, surgery, and radiation were the independent prognostic factors of primary parotid gland lymphoma, while age, marital status, surgery, and chemotherapy were the independent prognostic factors of primary DLBCL of parotid gland. The C-index of the prediction model was 0.702(95%CI: 0.696-0.768), reflecting a good discrimination ability. The predicted value probability of the calibration plots was close to the actual value probability, reflecting a good accuracy ability. CONCLUSIONS: Sex, age, Ann Arbor stage, years of diagnosis, marital status, histological subtype, surgery, and radiation were the independent prognostic factors of primary parotid gland lymphoma. The nomogram survival prediction model for primary DLBCL of parotid gland patients can assist clinical decision effectively.

Bioinspired High-Magnesium Calcite for Efficiently Reducing Chemical Oxygen Demand in Lake Water.

Organic matter accumulation in water can cause serious problems such as oxygen depletion and quality deterioration of waters. While calcium carbonate has been used as green and low-cost adsorbent for water treatment, its efficiency in reducing the chemical oxygen demand (COD) of water, which is a measure of organic pollution, is restrained by the limited specific surface area and chemical activity. Herein, inspired by the high-magnesium calcite (HMC) found in biological materials, a feasible method to synthesize fluffy dumbbell-like HMC with large specific surface area is reported. The magnesium inserting increases the chemical activity of the HMC moderately but without lowering its stability too much. Therefore, the crystalline HMC can retain its phase and morphology in aqueous environment for hours, which allows the establishment of adsorption equilibrium between the solution and the adsorbent that retains its initial large specific surface area and improved chemical activity. Consequently, the HMC exhibits notably enhanced capability in reducing the COD of lake water polluted by organics. This work provides a synergistic strategy to rationally design high-performance adsorbents by simultaneously optimizing the surface area and steering the chemical activity.

[Effects of Decitabine Combined with Anlotinib on Proliferation and Apoptosis of Multiple Myeloma Cells].

OBJECTIVE: To investigate the biological effects and its relative mechanism of decitabine combined with anlotinib on multiple myeloma cells. METHODS: The human MM cell lines and primary cells were treated with different concentrations of decitabine, anlotinib, and decitabine+anlotinib, respectively. The cell viability was detected and combination effect was calculated by CCK-8 assay. The apoptosis rate was measured by flow cytometry and the level of c-Myc protein was determined by Western blot. RESULTS: Both decitabine and anlotinib could effectively inhibit the proliferation and induce the apoptosis of MM cell lines NCI-H929 and RPMI-8226. The effect of combined treatment on the inhibition of cell proliferation and induction of apoptosis was stronger than that of single-drug treatment. The combination of the two drugs also showed strong cytotoxicity in primary MM cells. Decitabine and anlotinib could down-regulate the level of c-Myc protein in MM cells and the c-Myc level in the combination group was the lowest. CONCLUSION: Decitabine combined with anlotinib can effectively inhibit the proliferation and induce apoptosis of MM cells, which provides a certain experimental basis for the treatment of human MM.

Matrix-Directed Mineralization for Bulk Structural Materials.

Mineral-based bulk structural materials (MBSMs) are known for their long history and extensive range of usage. The inherent brittleness of minerals poses a major problem to the performance of MBSMs. To overcome this problem, design principles have been extracted from natural biominerals, in which the extraordinary mechanical performance is achieved via the hierarchical organization of minerals and organics. Nevertheless, precise and efficient fabrication of MBSMs with bioinspired hierarchical structures under mild conditions has long been a big challenge. This Perspective provides a panoramic view of an emerging fabrication strategy, matrix-directed mineralization, which imitates the in vivo growth of some biominerals. The advantages of the strategy are revealed by comparatively analyzing the conventional fabrication techniques of artificial hierarchically structured MBSMs and the biomineral growth processes. By introducing recent advances, we demonstrate that this strategy can be used to fabricate artificial MBSMs with hierarchical structures. Particular attention is paid to the mass transport and the precursors that are involved in the mineralization process. We hope this Perspective can provide some inspiring viewpoints on the importance of biomimetic mineralization in material fabrication and thereby spur the biomimetic fabrication of high-performance MBSMs.

General Synthesis and Solution Processing of Metal-Organic Framework Nanofibers.

By virtue of their extraordinarily high surface areas, ordered pore structures, various compositions, and rich functionality, metal-organic frameworks (MOFs) are of great interest in diverse fields such as gas separation, sensing, catalysis, energy, environment science, and biomedicine. However, the difficulty in processing MOF crystals and controlling the MOF superstructure is emerging as a critical issue in their application. Herein, it is reported that a robust template, i.e., nanofibrillated cellulose (NFC), can be used for the synthesis of MOF materials with 1D nanofiber morphology. NFC@MOF core-shell nanofibers with a uniform network structure and high aspect ratios can be prepared by use of this template. The small crystal size, flexibility, and good dispersity of the NFC@MOF nanofibers make it convenient for the macroscale assembly and solution processing of MOF materials. A proof-of-concept study is demonstrated wherein freestanding MOF nanofiber membranes represent good performance in applications of water treatment and heterogeneous catalysis reaction. This general synthesis and solution-processing strategy may herald a new era in promoting the industrial application of MOFs.

[The Effects of Decitabine Combined with All-Trans Retinoic Acid on the Number of Immune Cells in Myeloid Neoplasms].

OBJECTIVE: To investigate the effects of decitabine (DEC) combined with all-trans retinoic acid (ATRA) on the number of immune cells, efficacy and adverse reactions in the treatment of myeloid neoplasms patients. METHODS: Eighty-four patients with myeloid tumors, including AML, MDS-EB-1 or MDS-EB-2 treated by the regimen containing decitabine in our hospital from January 2009 to October 2019 were enrolled and retrospectively analyzed, among the patients, 21 patients treated with DEC alone, 24 patients treated with DEC combined with ATRA (DEC/ATRA) and 39 patients treated with DEC combined with G-CSF priming regimen (DEC/priming). The changes of peripheral blood immune cell levels before and after treatment of the patients between the three groups were compared, and the differences in clinical efficacy and adverse reactions of the patients between the three groups were also compared. RESULTS: There was no statistical differences in the number of immune cells among the patients in the three groups before treatment (P>0.05). NK cell levels decreased significantly in the patients in DEC and DEC/ATRA group after treatment (P<0.05); After treatment, the levels of CD8+ and CD3+T cells in the patients treated by DEC /priming regimen significantly increased (P<0.05), while the levels of CD3-HLA-DR+ B cells significantly decreased (P<0.05). The overall response rate (ORR) of the patients in DEC/ATRA group (75%) and DEC/priming group (74.36%) was significantly higher than 42.86% in DEC monotherapy group, and the differences showed statistically significant (P<0.05), while the ORR between the patients in DEC/ATRA and DEC/priming group showed no statistic differences (P>0.05). There were no statistical differences in overall survival (OS) and incidence of bleeding between the patients in the three groups (P>0.05). The incidences of grade 3 to 4 bone marrow suppression and the infection rate of the patients in DEC monotherapy and DEC/ATRA group were significantly lower than that in DEC/priming regimen group after treatment (all P<0.05), however, there was no statistical difference between DEC monotherapy and the DEC/ATRA group. CONCLUSION: The efficacy of DEC/ATRA on myeloid neoplasms is comparable to that of DEC/priming regimen, and the anti-myeloid tumor effect of DEC/ATRA regimen may be related to the regulation of NK cells and T cells.

Synthesis of PdSx-Mediated Polydymite Heteronanorods and Their Long-Range Activation for Enhanced Water Electroreduction.

Material interfaces permit electron transfer that modulates the electronic structure and surface properties of catalysts, leading to radically enhanced rates for many important reactions. Unlike conventional thoughts, the nanoscale interfacial interactions have been recently envisioned to be able to affect the reactivity of catalysts far from the interface. However, demonstration of such unlocalized alterations in existing interfacial materials is rare, impeding the development of new catalysts. We report the observation of unprecedented long-range activation of polydymite Ni3S4 nanorods through the interfacial interaction created by PdSx nanodots (dot-on-rod structure) for high-performance water catalytic electroreduction. Experimental results show that this local interaction can activate Ni3S4 rods with length even up to 25 nanometers due to the tailored surface electronic structure. We anticipate that the long-range effect described here may be also applicable to other interfacial material systems, which will aid the development of newly advanced catalysts for modern energy devices.

The elements of human cyclin D1 promoter and regulation involved.

Cyclin D1 is a cell cycle machine, a sensor of extracellular signals and plays an important role in G1-S phase progression. The human cyclin D1 promoter contains multiple transcription factor binding sites such as AP-1, NF-қB, E2F, Oct-1, and so on. The extracellular signals functions through the signal transduction pathways converging at the binding sites to active or inhibit the promoter activity and regulate the cell cycle progression. Different signal transduction pathways regulate the promoter at different time to get the correct cell cycle switch. Disorder regulation or special extracellular stimuli can result in cell cycle out of control through the promoter activity regulation. Epigenetic modifications such as DNA methylation and histone acetylation may involved in cyclin D1 transcriptional regulation.